Background <p>While road traffic noise is an emerging environmental risk for cardiovascular mortality, its age-group-specific effects on stroke mortality remain unclear. This study further explored socioeconomic disparities in this association.</p> Methods <p>We conducted a retrospective cohort study (2011–2019) with 36,240 hospitalized stroke patients in Fuxin, China. Residential noise levels were estimated using street view imagery analyzed by a novel and multimodal deep learning model. Age-grouped cox proportional hazards models adjusted for NO<sub>2</sub>, NDVI (Normalized Difference Vegetation Index), and sociodemographic covariates were applied to assess mortality risks.</p> Results <p>Among elderly patients aged <InlineEquation ID="IEq1"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12942_2025_416_Article_IEq1.gif" Format="GIF" Height="15" Rendition="HTML" Resolution="72" Type="Linedraw" Width="19" /> </InlineMediaObject> <EquationSource Format="TEX">\(\ge\)</EquationSource> </InlineEquation>60 years with lower medical insurance, each 5-dB increase in residential road noise was associated with a 93.6% increase in stroke mortality risk (HR = 1.936, 95% CI: 1.024-3.660; p = 0.042). The estimated exposure prevalence in this subgroup was 3%, yet the population attributable fraction reached 1.7%. In contrast, no significant associations were found among patients with higher insurance coverage. Younger Males had a 51.3% higher mortality risk than females (adjusted HR=1.513, 95% CI: 1.142-2.005), independent of environmental exposures. NO<sub>2</sub> and NDVI were not significantly associated with mortality across subgroups.</p> Conclusions <p>These findings highlight the need for noise mitigation strategies that prioritize vulnerable populations, particularly the elderly and those with limited healthcare access.</p>

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Street view images help to reveal the impact of noisy environments on the survival duration of stroke patients

  • Jing Xiao,
  • Teng Fei,
  • Bo Yu,
  • Yingjing Huang,
  • Yunyan Du

摘要

Background

While road traffic noise is an emerging environmental risk for cardiovascular mortality, its age-group-specific effects on stroke mortality remain unclear. This study further explored socioeconomic disparities in this association.

Methods

We conducted a retrospective cohort study (2011–2019) with 36,240 hospitalized stroke patients in Fuxin, China. Residential noise levels were estimated using street view imagery analyzed by a novel and multimodal deep learning model. Age-grouped cox proportional hazards models adjusted for NO2, NDVI (Normalized Difference Vegetation Index), and sociodemographic covariates were applied to assess mortality risks.

Results

Among elderly patients aged \(\ge\) 60 years with lower medical insurance, each 5-dB increase in residential road noise was associated with a 93.6% increase in stroke mortality risk (HR = 1.936, 95% CI: 1.024-3.660; p = 0.042). The estimated exposure prevalence in this subgroup was 3%, yet the population attributable fraction reached 1.7%. In contrast, no significant associations were found among patients with higher insurance coverage. Younger Males had a 51.3% higher mortality risk than females (adjusted HR=1.513, 95% CI: 1.142-2.005), independent of environmental exposures. NO2 and NDVI were not significantly associated with mortality across subgroups.

Conclusions

These findings highlight the need for noise mitigation strategies that prioritize vulnerable populations, particularly the elderly and those with limited healthcare access.