[Socioeconomic risk factors of stroke]

Reduction in age-adjusted mortality rate of cerebrovascular disease is one of the target of National Health Promotion 'Health Japan 21' and this is to be attained not only by the improvement of the personal health but also by developing good social environment and circumstances. This article focused on the relationship between the socioeconomic status (SES) and stroke. Personal, regional, and international comparison data shows robust relationship between low SES and higher stroke incidence, severity and mortality. Bio-Psycho-Social model is proposed as a mechanisms how SES influences stroke. Allostatic overload, behavioral difference, influence of life course, and sense of coherence explain some part of this model. New approaches in consideration of SES are needed such as 'Visualization' of the problems of patient's background, improvement of social environment through the policy, and modification of social circumstances.