Stroke Mortality Highest Among Blacks Living in the South
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Preliminary results of a National Institutes of Neurological Disorders and Stroke funded study suggest that while African Americans have an overall higher risk of dying from stroke than whites, that risk is even greater for blacks who live in the south.
For example, African American men living in South Carolina are almost four times more likely to die from a stroke than are white men living in that same state.
George Howard, Dr.P.H., professor and chair of the Department of Biostatistics, University of Alabama at Birmingham School of Public Health, said a black man living in any of the southern states designated as “the stroke belt” has a 51% higher risk for fatal stroke than a black man living elsewhere.
Howard, who presented his research findings today at the American Stroke Association’s International Stroke Conference 2005, noted that he has no solid answers to explain the North-South difference in stroke mortality, but he theorized that risk factors such as diabetes, high blood pressure, and smoking may be less well controlled in the south.
Or, he said, it may be that there are some unknown aspects of southern culture and lifestyle that increase the risk. “I think it is likely to be a combination of factors, but we won’t know until we have more data,” he said.
In the new study, “the question we were asking is whether the increased mortality risk for blacks is the same everywhere. So instead of calculating strokes at a national level, we calculated at a state level.”
Howard’s team looked at stroke death data from 1997 through 2001 and calculated stroke mortality rates by race, age and state.
They compared the findings in southern states (defined in this study as the “stroke belt” states: Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee plus Florida and Virginia), to those in non-southern states with large black populations: California, Illinois, Indiana, Maryland, Michigan, New Jersey, New York, Ohio and Pennsylvania.
“Stroke deaths are lowest in New York,” Howard said. “That’s true for blacks and whites. Another interesting finding is that stroke deaths are also low in Miami, but in the panhandle area of Florida the numbers are similar to that in the rest of the South.”
The racial differences in stroke risk are most pronounced between the ages of 45 and 64, he said. Not surprisingly, given the fact that stroke risk increases with age, by 85 there were no significant differences in stroke deaths between blacks and whites.
The average stroke death rate for white men aged 55- 64, living in the South was .49 per 1,000, compared to .38 per 1,000 for white men living elsewhere - representing a 29% higher death rate for white men living in the South than white men not living in the South, Howard said. For black men of the same age, the stroke death rate in the south was 1.59 per 1,000, which was 51% higher than the death rate in other regions.
Primary source: American Stroke Association
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