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1993 Stroke Age-Adjusted Death
Rates by State
Strokes are more common in certain
parts of the United States, especially the Southeast (the
so-called "Stroke Belt"). The precise boundaries
of these areas have been variously defined. The National
Heart, Lung, and Blood Institute (NHLBI) has defined stroke
belt as those states that had a 1980 age-adjusted stroke mortality
rate of more than 10% above the national average.
Many investigators have defined the stroke belt
more narrowly, some even limiting it to a group of contiguous
counties along the coastal plains of Georgia and the Carolinas
(where there has been a greater than 40% excess risk of stroke
mortality). Among residents of this area, the relative
geographic excess risk of stroke mortality (compared to "non-stroke-belt"
regions of the United States) as similar for African-American
residents and Caucasian residents and for both men and women.
Despite a general decline in stroke mortality across the U.S.,
the relative increased risk of stroke death in this region
remained constant from 1968 to 1991 [Howard G, et al. Stroke.
1995;26:1153].
The cause of regional variation is unknown but
is probably multifactorial and may include variations in the
distributions of stroke risk factors, effects of selective
migration, and genetic- or host susceptibility factors [Lanska
DJ, Kuller LH. Stroke. 1995;26:1145].
The term "stroke belt" has been considered
a useful concept for raising public awareness of stroke and
prevention in high-rate areas.
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Stroke Education
