Abstract Body: Introduction
Every 40 seconds, someone in the U.S. experiences a stroke, yet research shows that as few as 53% of survey respondents have known to call 911 in response. Despite the high incidence of strokes, awareness has remained low, as the proportion of respondents who can name one symptom has been as low as one-in-four. Recent studies have found that communities at a financial disadvantage are more likely to have lower levels of stroke knowledge, higher prevalence of modifiable risk factors, and significantly elevated rates of strokes—which can lead to death, economic burdens, and the need for lifelong assistance. Our study seeks to explore how ZIP-code-level income is associated with variability in stroke knowledge.

Methods
Surveys were provided to participants who attended stroke education workshops provided by our institution’s Stamp Out Stroke group. We divided our population by event ZIP code and labeled cohorts according to median annual income levels as reported in the most recent American Community Survey, conducted by the U.S. Census Bureau. A two-sided t-test was performed, and ZIP Code 4, the cohort with the lowest level of stroke knowledge, served as the reference cohort.

Results
A total of 65 participants were included in the analyses: 3 at ZIP Code 1, 7 at ZIP Code 2, 31 at ZIP Code 3, and 24 at ZIP Code 4. Participants, on average, demonstrated the most knowledge about actions to take after a stroke and where a stroke occurs in the body, and the least knowledge about stroke pathophysiology and awareness of non-modifiable risk factors, such as family history (Figure 1). ZIP Code 3 (highest median annual income) had significantly more correct answers when compared to ZIP Code 4 (second-lowest median annual income) (Figure 2). While other cohort comparisons were not significant, perhaps due to smaller sample sizes, stroke knowledge and income trended together overall (Figure 2).

Conclusions
Given that differences in stroke knowledge may correlate with ZIP code income levels, stroke education should be prioritized for communities with lower median annual income estimates. These outreach initiatives should emphasize health literacy in stroke prevention, fostering an awareness personal risk factors and the pathophysiology behind strokes. Such information provided to low-income communities may promote health equity, in particular, by raising awareness about when to seek emergency care in order to be eligible for acute stroke therapies.