PURPOSE: The stroke mortality rate for African Americans aged 45 to 64 years is 3 to 4 times higher than for whites of the same age, with a decreasing black-to-white mortality ratio with increasing age. There is also a "STROKE BELT" with higher stroke mortality in the southeastern United States. This study assesses if there are also geographic variations in the magnitude of the excess stroke mortality for African Americans. METHODS: The age- and sex-specific black-to-white mortality ratio was calculated for each of 26 states with a sufficient African American population for stable estimates. The southern excess was calculated as the percentage excess of southern over nonsouthern rates. RESULTS: Across age and sex strata, the black-to-white stroke mortality ratio was consistently higher for southern states, with an average black-to-white stroke mortality ratio that ranged from 6% to 21% higher among southern states than in nonsouthern states. CONCLUSIONS: The increase in stroke mortality rates for African Americans in southern states is even larger than expected. That southern states that are not part of the "STROKE BELT" (Virginia and Florida) also have an elevated black-to-white mortality ratio suggests the mechanism of higher risk for African Americans may be independent of the causes contributing to "STROKE BELT."
PURPOSE: The stroke mortality rate for African Americans aged 45 to 64 years is 3 to 4 times higher than for whites of the same age, with a decreasing black-to-white mortality ratio with increasing age. There is also a "STROKE BELT" with higher stroke mortality in the southeastern United States. This study assesses if there are also geographic variations in the magnitude of the excess stroke mortality for African Americans. METHODS: The age- and sex-specific black-to-white mortality ratio was calculated for each of 26 states with a sufficient African American population for stable estimates. The southern excess was calculated as the percentage excess of southern over nonsouthern rates. RESULTS: Across age and sex strata, the black-to-white stroke mortality ratio was consistently higher for southern states, with an average black-to-white stroke mortality ratio that ranged from 6% to 21% higher among southern states than in nonsouthern states. CONCLUSIONS: The increase in stroke mortality rates for African Americans in southern states is even larger than expected. That southern states that are not part of the "STROKE BELT" (Virginia and Florida) also have an elevated black-to-white mortality ratio suggests the mechanism of higher risk for African Americans may be independent of the causes contributing to "STROKE BELT."
Authors: George Howard; Ron Prineas; Claudia Moy; Mary Cushman; Martha Kellum; Ella Temple; Andra Graham; Virginia Howard Journal: Stroke Date: 2006-03-23 Impact factor: 7.914
Authors: Virginia J Howard; Mary Cushman; Leavonne Pulley; Camilo R Gomez; Rodney C Go; Ronald J Prineas; Andra Graham; Claudia S Moy; George Howard Journal: Neuroepidemiology Date: 2005-06-29 Impact factor: 3.282
Authors: W D Rosamond; A R Folsom; L E Chambless; C H Wang; P G McGovern; G Howard; L S Copper; E Shahar Journal: Stroke Date: 1999-04 Impact factor: 7.914
Authors: James B Wetmore; Edward F Ellerbeck; Jonathan D Mahnken; Milind A Phadnis; Sally K Rigler; John A Spertus; Xinhua Zhou; Purna Mukhopadhyay; Theresa I Shireman Journal: J Am Soc Nephrol Date: 2013-08-29 Impact factor: 10.121
Authors: James B Wetmore; Milind A Phadnis; Jonathan D Mahnken; Edward F Ellerbeck; Sally K Rigler; Xinhua Zhou; Theresa I Shireman Journal: Clin J Am Soc Nephrol Date: 2014-01-23 Impact factor: 8.237
Authors: Stephanie B Jilcott Pitts; Maihan B Vu; Beverly A Garcia; Jared T McGuirt; Danielle Braxton; Constance E Hengel; Joey V Huff; Thomas C Keyserling; Alice S Ammerman Journal: Fam Community Health Date: 2013 Apr-Jun
Authors: Darwin R Labarthe; George Howard; Monika M Safford; Virginia J Howard; Suzanne E Judd; Mary Cushman; Brett M Kissela Journal: Neuroepidemiology Date: 2016-09-15 Impact factor: 3.282
Authors: Virginia J Howard; Leslie A McClure; M Maria Glymour; Solveig A Cunningham; Dawn O Kleindorfer; Michael Crowe; Virginia G Wadley; Fredrick Peace; George Howard; Daniel T Lackland Journal: Neurology Date: 2013-04-24 Impact factor: 9.910
Authors: Stephanie B Jilcott Pitts; Tosha W Smith; Linden Maya Thayer; Sarah Drobka; Cassandra Miller; Thomas C Keyserling; Alice S Ammerman Journal: J Public Health Manag Pract Date: 2013 Nov-Dec