Rural-urban stroke mortality gaps in the United States

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• Stroke outcomes vary significantly based on geographic location (rural vs. urban) and access to advanced medical interventions.
• Previous research indicates disparities in stroke care, including thrombolysis, endovascular treatments, and rehabilitation.
• This study specifically examines stroke mortality disparities between rural and urban populations in the United States.

Purpose of the Study:

• To assess and quantify the disparities in stroke mortality between rural and urban areas across the US.
• To analyze temporal trends in these rural-urban stroke mortality disparities from 1999 to 2020.
• To investigate how these disparities differ across demographic subgroups and geographic regions.

Main Methods:

• Utilized the Centers for Disease Control and Prevention (CDC) data on cerebrovascular disease deaths from 1999-2020.
• Categorized mortality data into rural and urban regions for comparative analysis.
• Calculated age-adjusted mortality rates (AAMR) and rural-to-urban death ratios, employing linear regression to assess trends over time.

Main Results:

• In 1999, there were 1.13 rural stroke deaths per urban death; by 2020, this ratio slightly decreased to 1.07.
• The rural-urban mortality ratio for Hispanic populations significantly declined from 1.32 in 1999 to 0.85 in 2020.
• Non-Hispanic populations showed stagnant rural-urban mortality ratios (1.12 in 1999 to 1.07 in 2020), with the Southern US exhibiting the highest regional disparity.

Conclusions:

• Significant disparities in stroke mortality persist between rural and urban populations in the US.
• Targeted public health interventions are crucial to address and mitigate these identified stroke-related health disparities.
• The differing trends between Hispanic and non-Hispanic populations underscore the need for culturally tailored and geographically specific strategies.