Impact of COVID-19 on Physical Activity, Diet, and Stroke Awareness in Homeless Individuals of Chicago

ABSTRACT

Objective: This research aims to characterize stroke awareness in homeless individuals of Chicago while providing guidance on stroke recognition and response. Additionally, we aim to assess the effects that the COVID-19 pandemic and social isolation have on stroke risk factors. Background: Strokes occur every 40 seconds in the United States and are one of the leading causes of preventable death and debilitation for both men and women. Higher stroke mortality rates occur in neighborhoods with larger proportions of Black residents and lower median incomes. Some physicians are concerned that risk factors for stroke such as physical inactivity and poor diet have worsened in the setting of the COVID-19 pandemic and have led to an even higher risk stratification in these populations. Design/Methods: A 53-item stroke survey along with health and wellness questionnaires were administered to 40 residents at A Safe Haven, a social enterprise serving the homeless. Participants were recruited at random from a booth on-site. Results: The majority of participants were Black (n=36/40) with most being between the ages 30-44. Participants identified as male (n=18) or female (n=22). Those surveyed endorsed decreased physical activity levels (m=2.2/5) and increased screen time (m=4.0/5) since the beginning of the pandemic. Subjectively worse dietary changes were reported in 78% of participants since the pandemic began. Stroke symptom and risk factor awareness was poor in 29%, fair in 40%, and good in 31% of participants. Among those surveyed, 45% agreed they would not be able to recognize a stroke and 55% agreed they would not know what to do if they witnessed a stroke. Conclusions: These data suggest that poor stroke awareness, decreased physical activity levels, and worsening dietary habits have become more prevalent among homeless populations in Chicago during the ongoing pandemic. Our goals of promoting healthy lifestyles and raising stroke awareness are particularly important during this time.