Howard George, Labarthe Darwin R, Hu Jianfang, Yoon Sarah, Howard Virginia J
University of Alabama School of Public Health, Department of Biostatistics, Birmingham, AL 35294-0022, USA.
Ann Epidemiol. 2007 Sep;17(9):689-96. doi: 10.1016/j.annepidem.2007.03.019.
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.
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.
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.
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."
45至64岁非裔美国人的中风死亡率比同龄白人高3至4倍，且随着年龄增长，黑人与白人的死亡率比值逐渐下降。美国东南部还存在一个中风死亡率较高的“中风带”。本研究评估非裔美国人中风死亡率过高的程度是否也存在地理差异。
对26个拥有足够非裔美国人群体以进行稳定估计的州，分别计算特定年龄和性别的黑人与白人死亡率比值。南方地区的超额死亡率计算为南方地区相对于非南方地区死亡率的超额百分比。
在各个年龄和性别层次中，南方各州的黑人与白人中风死亡率比值始终较高，南方各州的黑人与白人中风死亡率平均比值比非南方各州高6%至21%。
南方各州非裔美国人中风死亡率的增长幅度甚至比预期更大。那些不属于“中风带”的南方州（弗吉尼亚州和佛罗里达州）的黑人与白人死亡率比值也较高，这表明非裔美国人面临更高风险的机制可能独立于导致“中风带”形成的原因。
