1 Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
2 Department of Neurology, Changwon Fatima Hospital, Changwon, Korea.
Int J Stroke. 2017 Oct;12(8):869-874. doi: 10.1177/1747493017694389. Epub 2017 Feb 24.
Background Stroke outcomes can differ by women's legal or socioeconomic status. Aim We investigated whether differences in women's rights or gender inequalities were associated with stroke mortality at the country-level. Methods We used age-standardized stroke mortality data from 2008 obtained from the World Health Organization. We compared female-to-male stroke mortality ratio and stroke mortality rates in women and men between countries according to 50 indices of women's rights from Women, Business and the Law 2016 and Gender Inequality Index from the Human Development Report by the United Nations Development Programme. We also compared stroke mortality rate and income at the country-level. Results In our study, 176 countries with data available on stroke mortality rate in 2008 and indices of women's rights were included. There were 46 (26.1%) countries where stroke mortality in women was higher than stroke mortality in men. Among them, 29 (63%) countries were located in Sub-Saharan African region. After adjusting by country income level, higher female-to-male stroke mortality ratio was associated with 14 indices of women's rights, including differences in getting a job or opening a bank account, existence of domestic violence legislation, and inequalities in ownership right to property. Moreover, there was a higher female-to-male stroke mortality ratio among countries with higher Gender Inequality Index (r = 0.397, p < 0.001). Gender Inequality Index was more likely to be associated with stroke mortality rate in women than that in men (p < 0.001). Conclusions Our study suggested that the gender inequality status is associated with women's stroke outcomes.
女性的法律或社会经济地位可能会影响中风的治疗效果。目的：我们研究了国家层面的妇女权利差异或性别不平等是否与中风死亡率有关。方法：我们使用了 2008 年世界卫生组织获得的年龄标准化中风死亡率数据。我们根据 2016 年妇女、商业和法律中的 50 项妇女权利指数以及联合国开发计划署人类发展报告中的性别不平等指数，比较了各国女性与男性中风死亡率的比例以及女性和男性的中风死亡率。我们还比较了各国的中风死亡率和收入水平。结果：在我们的研究中，共有 176 个国家提供了 2008 年中风死亡率和妇女权利指数的数据。有 46 个（26.1%）国家的女性中风死亡率高于男性。其中，29 个（63%）国家位于撒哈拉以南非洲地区。在调整了国家收入水平后，较高的女性与男性中风死亡率比例与妇女权利的 14 项指数有关，包括就业或开户、家庭暴力立法、财产所有权不平等方面的差异。此外，性别不平等指数较高的国家女性与男性中风死亡率比例也较高（r=0.397，p<0.001）。性别不平等指数与女性中风死亡率的相关性大于男性（p<0.001）。结论：我们的研究表明，性别不平等状况与女性中风的治疗结果有关。
