Stroke mortality varies by race and region

October 04, 2001

DALLAS, Oct. 5 - Nationwide, the stroke death rate has declined during the last 30 years, but the decline has not been equal across regions nor among races, according to a study in the October issue of Stroke: Journal of the American Heart Association.

For several decades epidemiologists reported that deaths from stroke were 40 percent higher along a wide geographic region that extends across the Southeast, the so-called "Stroke Belt." New data suggest the belt may be shifting, with the Deep South (Mississippi and Alabama) dropping out while Oregon, Washington and Arkansas are poised to replace them.

Yet racial disparities are still in place. The latest analysis suggests that the decline in deaths due to strokes is greatest among white men and smallest among black men. But researchers report that the decline in deaths for white men is likely to have plateaued, while the rate continues to fall for blacks and for white women.

Researchers examined data on stroke deaths for the years 1968 through 1996 from the National Center for Health Statistics. They analyzed the data using a multi-step mathematical model that fit crude demographic data into regional and national stroke maps.

Stroke deaths declined in the Deep South in the 29-year-period more than 65 percent for white men and in excess of 60 percent for white women, with similar declines noted for blacks. These rates are still declining. However, in Washington and Oregon, the declines have been relatively small: less than 60 percent for white men and less than 55 percent for white women. The rate of decline for much of Arkansas has generally been less than 60 percent for men and women, whites and blacks. The rate of decline in these three states appears to have stabilized.

New York City and southern Florida, areas with traditionally low stroke rates, are among the regions that demonstrated the greatest declines in stroke deaths. In addition, deaths in these regions are still declining, which is not the case in regions with traditionally high stroke death rates. For example, stroke deaths declined in Charleston County, South Carolina - considered part of the buckle on the stroke belt - but that decline has now leveled off.

The reasons for the differences in the patterns of decline are not understood.
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