Comprehensive Summary
This study questions whether long-term residential exposure to road-traffic noise is able to predict mortality rates among hospitalized stroke patients and whether age or socioeconomic status affects that risk. The authors analyzed 36,240 stroke patient records in Fuxin, China, between 2011 and 2019, and estimated the residential noise from street-view imagery with a multimodal deep-learning model and fitting age-grouped Cox models adjusted for sex, NO2, NDVI, and insurance status, which was a substitute for socioeconomic status. Among patients who were 60 years or older with lower medical insurance, every 5 dB increase in road noise correlated with a 93.6% higher stroke-mortality hazard. Exposure prevalence was ~3% but the population-attributable fraction was 1.7%. On the other hand, there was no significant association in groups with higher/better medical insurance. Males less than 60 years old have a ~51% higher mortality rate than females, while NO2 and NDVI were not considered significant covariates. The association between age and noise was determined to be significant, as risk increased by ~2.5% per year of age, highlighting that age was a key determinant of this risk.
Outcomes and Implications
This study found that noise does impact stroke mortality. The findings of this study suggest that noise control and care strategies that prioritize older adults who have limited insurance coverage should be put in place, as they are the group that seems most impacted by noise-related stroke mortality rates. Even if there is relatively low exposure prevalence, there is still an attributable burden, which indicates that the general population would benefit from better urban planning, like traffic management and green buffers (like trees and bushes), as well as discharge care that accounts for neighborhoods with higher noise levels.