A new study reveals that patients from socially and economically disadvantaged communities face significantly worse outcomes after suffering a nontraumatic subarachnoid hemorrhage (SAH), a life-threatening type of brain bleed. Researchers analyzed data from over 108,000 patients across the U.S. and found that social determinants of health—particularly neighborhood deprivation and income—play a critical role in recovery.
Patients living in areas with high Social Deprivation Index (SDI) scores were less likely to be discharged home or to rehabilitation and more likely to experience longer hospital stays. In contrast, those from higher-income areas had better odds of favorable discharge outcomes and lower in-hospital mortality. “This study demonstrates that social determinants of health significantly influence subarachnoid hemorrhage outcomes,” the authors wrote.
SAH requires immediate, specialized care often available only at high-volume neurovascular centers. Patients from lower-income or highly deprived areas may face delays in reaching such facilities, limited access to emergency services, and higher levels of chronic stress—all of which can worsen outcomes. The study also noted that allostatic load, the cumulative burden of chronic stress, may mediate these disparities.
Despite adjusting for clinical factors like age, sex, and stroke severity, the associations between social disadvantage and poor outcomes remained strong. The authors call for targeted policy measures to improve access to specialized care, enhance emergency response systems, and address the broader social conditions that contribute to health inequities.
See “Impact of Social Determinants of Health on Outcomes of Nontraumatic Subarachnoid Hemorrhage” (April 7, 2025)