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Factors explaining excess stroke prevalence in the US Stroke Belt
Youlian Liao1, Kurt J Greenlund, Janet B Croft
1Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717, USA. ycl1@cdc.gov
Stroke
|August 15, 2009
Summary
Stroke prevalence is higher in the southeastern Stroke Belt region. Socioeconomic factors, chronic diseases, and risk factors explain most of these disparities.
Area of Science:
- Public Health
- Epidemiology
- Health Disparities
Background:
- Southeastern United States (Stroke Belt) exhibits higher stroke risk and burden.
- Regional disparities in stroke prevalence necessitate investigation into underlying causes.
Purpose of the Study:
- To investigate the reasons behind elevated stroke prevalence in the Stroke Belt region.
- To identify demographic, socioeconomic, and clinical factors contributing to stroke disparities.
Main Methods:
- Utilized nationwide cross-sectional data from the Behavioral Risk Factor Surveillance System (2005, 2007).
- Analyzed self-reported stroke prevalence (n=27,962) among 765,368 participants.
- Employed multivariate logistic regression to assess contributions of demographics, socioeconomic status, risk factors, and chronic diseases.
Main Results:
- Stroke Belt region showed a 25% higher age- and sex-adjusted stroke prevalence (OR=1.25).
- Racial disparities (Black/White distribution) accounted for 20% of the excess prevalence.
- Socioeconomic status, risk factors, and chronic diseases collectively explained a significant portion of the excess prevalence, reducing the OR to 1.07 in the fully adjusted model.
Conclusions:
- Regional differences in socioeconomic status, common risk factors, and chronic disease prevalence are primary drivers of stroke disparities in the Stroke Belt.
- Addressing these factors may help mitigate the disproportionate stroke burden in the southeastern United States.
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