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(Stroke. 2008;39:283.)
© 2008 American Heart Association, Inc.

Advances in Stroke 2007

Advances in Population Studies 2007

From the Department of Biostatistics (G.H.), UAB School of Public Health, Birmingham, Ala, USA; and the Clinical Trials Research Unit (V.F.), School of Population Health, the University of Auckland, New Zealand.

Correspondence to George Howard, DrPH, Department of Biostatistics Ryals Building, Room 327, 1665 University Blvd, Birmingham, AL, 35294-0022. E-mail ghoward@uab.edu

Key Words: epidemiology • genetics • population studies • risk factors • stroke

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Population studies play important roles in assessing disparities and temporal changes in the burden of stroke, guiding interventional assessment in clinical trials, and describing risk factors that for ethical or design reasons cannot be addressed by clinical trials.

Population Description, Disparities, and Temporal Patterns

Concerns regarding the impact of population shifts were heightened this year with the reports describing several disturbing trends that were independent of the demographic population shift. Data from the National Hospital Discharge Study suggested that stroke hospitalization rates for the population aged 45 to 54 increased between 1980 and 2000 from 164.8/100 000 to 172.9/100 000, private insurance coverage decreased from 73% to 50%, and the proportion of stroke patients discharged home decreased from 72% to 62%.¹ While national data on incident stroke are lacking, the few available data suggests that at there are at most very modest declines (perhaps there are increases).^2,3 Finally, between 1990 to 1991 and 2000 to 2001, the inflation-adjusted costs for stroke increased 54% for infarctions, 57% for intracerebral hemorrhage, and 76% for subarachnoid hemorrhage.⁴ Collectively, when coupled with the demographic shifts in age, these trends portend an explosion in the public health impact of stroke.

Racial disparities in stroke have not been substantially reduced. In 1983 stroke was the fourth largest contributor to the male black-to-white detriment in life expectancy, contributing 7.0% of the 6.42-year disparity. By 2003 the contribution of stroke had fallen marginally to 6.2% of the 6.33-year disparity. For women in 1983 stroke contributed 10.8% of the 5.07-year disparity, and was second largest . . . [Full Text of this Article]