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Pediatric Stroke Belt: geographic variation in stroke mortality in US children

Heather J Fullerton1, Jacob S Elkins, S Claiborne Johnston

  • 1Department of Neurology, University of California, San Francisco, San Francisco, Calif 94143-0114, USA.

Stroke
|June 5, 2004
PubMed

Insights

Children in the US Stroke Belt face a higher risk of stroke death compared to those in other regions. This increased risk, observed in both children and adults, suggests shared risk factors may explain the geographic disparity.

Area of Science:

  • Pediatric Neurology
  • Public Health
  • Epidemiology

Background:

  • The Southeastern United States, known as the "Stroke Belt," exhibits elevated stroke mortality rates in adults.
  • Geographic disparities in stroke mortality are often attributed to regional differences in atherosclerotic stroke risk factors.

Purpose of the Study:

  • To investigate whether the Stroke Belt phenomenon, characterized by higher stroke mortality, extends to the pediatric population.
  • To compare stroke mortality rates in children residing in Stroke Belt states versus other US states.

Main Methods:

  • Analysis of death certificate data for children under 20 years of age from 1979 to 1998.
  • Comparison of age-adjusted stroke mortality rates between 11 Stroke Belt states and other US states.
  • Parallel analysis conducted for adult stroke mortality for comparative purposes.

Main Results:

  • Children in Stroke Belt states demonstrated a significantly increased risk of stroke death (Relative Risk [RR], 1.21; 95% Confidence Interval [CI], 1.12 to 1.29).
  • This elevated risk was observed for both ischemic and hemorrhagic strokes across all pediatric age groups and both sexes.
  • The magnitude of this geographic disparity in children was comparable to that found in adults.

Conclusions:

  • Children residing in Stroke Belt states experience a higher risk of fatal stroke compared to their counterparts in other regions.
  • The findings suggest that stroke risk factors applicable to both children and adults may contribute to the observed geographic variation in stroke mortality.
Abstract

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