biostudies-literatureXiao JNational Natural Science Foundation of China General ProgramNational Key Research and Development Program of China27https://www.ebi.ac.uk/biostudies/studies/S-EPMC12465645biostudies-literatureUnknown24(1)<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>Among elderly patients aged ≥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.<h4>Conclusions</h4>These findings highlight the need for noise mitigation strategies that prioritize vulnerable populations, particularly the elderly and those with limited healthcare access.International journal of health geographicsStreet view images help to reveal the impact of noisy environments on the survival duration of stroke patients.PMC12465645422714762024YFC3307600Yu BHuang YXiao JFei TDu YfalseStreet view images help to reveal the impact of noisy environments on the survival duration of stroke patients.<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>Among elderly patients aged ≥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.<h4>Conclusions</h4>These findings highlight the need for noise mitigation strategies that prioritize vulnerable populations, particularly the elderly and those with limited healthcare access.2025-01-01T00:00:00Z2025 Sep2026-06-03T21:36:18.389Z2026-05-02T03:07:55.785ZS-EPMC124656454101353410.1186/s12942-025-00416-8