(Stroke. 1997;28:1639-1647.)
© 1997 American Heart Association, Inc.
Articles |
Geographic Variation in Stroke Mortality in Blacks and Whites in the United States
From the Centers for Disease Control and Prevention, Hyattsville, Md.
Correspondence to Richard F. Gillum, MD, Office of Analysis, Epidemiology, and Health Promotion, National Center for Health Statistics, Centers for Disease Control and Prevention, 6525 Belcrest Rd, Room 730, Hyattsville, MD 20782.
Background and Purpose We sought to determine whether the "Stroke Belt" has continued to shift and to assess variation in geographic patterns by age, sex, and race.
Methods Mortality data for Health Service Areas for 1988 to 1992 were used for analyses of geographic mortality patterns for stroke by race, sex, and age (50, 70, and 90 years).
Results In 1988 to 1992, considerable geographic variation in stroke mortality was demonstrated for each sex/race group. In black and white women and men, previously described high mortality in the southeastern United States persisted. Mortality rates were generally higher in the South than in the North and in the East than in the West. Compared with data from 1962 to 1988, there was a continuation of the previously described westward shift of high-rate areas to the Mississippi River valley, a trend more marked at age 50 years than at 70 or 90 years. Although rates in the Pacific region were low overall, a surprising area of high rates was seen in southern California among women at all three ages examined.
Conclusions In whites, rapid declines in stroke mortality in the Southeast have left West South Central states with relatively high mortality rates; this trend may continue as younger cohorts age. However, rates in the Southeast also remain high, especially for blacks.
Key Words: Blacks • geography • cerebrovascular disorders • mortality • southeastern United States
This article has been cited by other articles:
 |
|
 |
|
  M. M. Glymour, M. Avendano, and L. F. Berkman Is the 'Stroke Belt' Worn From Childhood?: Risk of First Stroke and State of Residence in Childhood and Adulthood Stroke, September 1, 2007; 38(9): 2415 - 2421. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Ziembroski and M. J. Breiding The Cumulative Effect of Rural and Regional Residence on the Health of Older Adults J Aging Health, October 1, 2006; 18(5): 631 - 659. [Abstract] [PDF]
|
|
|
|
 |
|
 P. S. Mullenix, M. J. Martin, S. R. Steele, G. S. Lavenson Jr, B. W. Starnes, N. C. Hadro, R. P. Peterson, and C. A. Andersen Rapid High-Volume Population Screening for Three Major Risk Factors of Future Stroke: Phase I Results Vascular and Endovascular Surgery, May 1, 2006; 40(3): 177 - 187. [Abstract] [PDF]
|
|
|
|
 |
|
 E. M. Andresen and D. K. Miller The Future (History) of Socioeconomic Measurement and Implications for Improving Health Outcomes Among African Americans J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2005; 60(10): 1345 - 1350. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. J. Mukamal, A. Ascherio, M. A. Mittleman, K. M. Conigrave, C. A. Camargo Jr, I. Kawachi, M. J. Stampfer, W. C. Willett, and E. B. Rimm Alcohol and Risk for Ischemic Stroke in Men: The Role of Drinking Patterns and Usual Beverage Ann Intern Med, January 4, 2005; 142(1): 11 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. J. Fullerton, J. S. Elkins, and S. C. Johnston Pediatric Stroke Belt: Geographic Variation in Stroke Mortality in US Children Stroke, July 1, 2004; 35(7): 1570 - 1573. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. B. Gorelick TIA incidence and prevalence: The Stroke Belt perspective Neurology, April 27, 2004; 62(8_suppl_6): S12 - S14. [Full Text]
|
|
|
|
|
|
R.W. Morris, P.H. Whincup, J.R. Emberson, F.C. Lampe, M. Walker, and A.G. Shaper North-South Gradients in Britain for Stroke and CHD: Are They Explained by the Same Factors? Stroke, November 1, 2003; 34(11): 2604 - 2609. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J.P. Barker and D. T. Lackland Prenatal Influences on Stroke Mortality in England and Wales Stroke, July 1, 2003; 34(7): 1598 - 1602. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R.F. Gillum and H. B. Bosworth New Considerations in Analyzing Stroke and Heart Disease Mortality Trends: The Year 2000 Age Standard and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision Stroke, June 1, 2002; 33(6): 1717 - 1722. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Howard, V. J. Howard, C. Katholi, M. K. Oli, S. Huston, and K. Asplund Decline in US Stroke Mortality: An Analysis of Temporal Patterns by Sex, Race, and Geographic Region Editorial Comment: An Analysis of Temporal Patterns by Sex, Race, and Geographic Region Stroke, October 1, 2001; 32(10): 2213 - 2220. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Fang, M. H. Alderman, and J. V. Tu Trend of Stroke Hospitalization, United States, 1988-1997 Editorial Comment Stroke, October 1, 2001; 32(10): 2221 - 2226. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Rao Review: the location of stroke is not associated with the risk of depression Evid. Based Ment. Health, February 1, 2001; 4(1): 27 - 27. [Full Text]
|
|
|
|
|
|
B. L. Egleston, M. A. Rudberg, and J. A. Brody State Variation in Nursing Home Mortality Outcomes According to Do-Not-Resuscitate Status J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2000; 55(4): 215M - 220. [Abstract] [Full Text]
|
|
|
|
 |
|
 W. C. Cushman, D. J. Reda, H. M. Perry Jr, D. Williams, M. Abdellatif, B. J. Materson, and for the Department of Veterans Affairs Cooperative Regional and Racial Differences in Response to Antihypertensive Medication Use in a Randomized Controlled Trial of Men With Hypertension in the United States Arch Intern Med, March 27, 2000; 160(6): 825 - 831. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. O. Obisesan, C. M. Vargas, and R. F. Gillum Geographic Variation in Stroke Risk in the United States : Region, Urbanization, and Hypertension in the Third National Health and Nutrition Examination Survey Stroke, January 1, 2000; 31(1): 19 - 25. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. F. Gillum Stroke Mortality in Blacks : Disturbing Trends Stroke, August 1, 1999; 30(8): 1711 - 1715. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. D. Rosamond, A. R. Folsom, L. E. Chambless, C.-H. Wang, P. G. McGovern, G. Howard, L. S. Copper, and E. Shahar Stroke Incidence and Survival Among Middle-Aged Adults : 9-Year Follow-Up of the Atherosclerosis Risk in Communities (ARIC) Cohort Stroke, April 1, 1999; 30(4): 736 - 743. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. Gorelick Cerebrovascular Disease in African Americans Stroke, December 1, 1998; 29(12): 2656 - 2664. [Full Text] [PDF]
|
|
|
|
|
|
D. T. Lackland, D. L. Bachman, T. D. Carter, D. L. Barker, S. Timms, and H. Kohli The Geographic Variation in Stroke Incidence in Two Areas of the Southeastern Stroke Belt : The Anderson and Pee Dee Stroke Study Stroke, October 1, 1998; 29(10): 2061 - 2068. [Abstract] [Full Text] [PDF]
|
|