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(Stroke. 2005;36:e48.)
© 2005 American Heart Association, Inc.

Short Communications

Absolute Stroke Mortality Burden for Non-Hispanic Non-Latino Whites Was Disproportionately Higher Than Expected Simply Based on the US Population in 2001

From the Office of Public Health and Science of the Office of the Secretary, US Department of Health and Human Services, Washington, DC; and Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Mo.

Correspondence to Larry E. Fields, MD, MBA, FACC, Former Senior Executive Advisor to the Assistant Secretary for Health, US Department of Health and Human Services, 200 Independence Ave, Washington, DC 20201.

Background and Purpose— The absolute burden of stroke is a major determinant of health care costs and should also be considered when developing and implementing effective health policy. This study evaluated the impact of specific racial-ethnic categorization on absolute stroke mortality burden and population percentages.

Methods— In this population-based analysis, 2001 US data was used to compute absolute values of population and stroke mortality burden for white and black, and other racial–ethnic groups. To test the effect of age-mix, values were age-adjusted using the 2000 US standard population. The z test statistic was computed and a 2-tailed P value of <0.05 was considered significant.

Result— Whites comprised a majority of the 2001 absolute US stroke mortality burden and US population (86% and 82%, respectively). Surprisingly, nHnL whites comprised a much higher percentage of the absolute US stroke mortality burden than expected based on their percentage of the US population alone (81% and 69%, respectively; P<0.001). Age-adjustment indicated a contribution by age-mix, however, an age-independent residual component remained.

Conclusions— Specific race-ethnicity categorization significantly influences comparisons of the proportion of absolute stroke mortality burden to the population proportion. Accordingly, appropriate caution and care are needed when estimating the societal impact of conditions such as stroke.

Key Words: hypertension • mortality • stroke