Wing S, Casper M, Davis W B, Pellom A, Riggan W, Tyroler H A
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill 27599-7400.
Stroke. 1988 Dec;19(12):1507-13. doi: 10.1161/01.str.19.12.1507.
We mapped average age-adjusted stroke mortality rates for white men and white women aged 35-74 years for state economic areas (counties or groups of counties) in the continental United States for three 7-year periods between 1962 and 1982. Despite the decline of national stroke mortality rates, rates in some areas failed to decline between 1962-1968 and 1969-1975. All areas experienced declines in 1976-1982, by which time some rates in the highest decile of the rate distribution were comparable to rates that had been in the lowest decile in 1962-1968. An east-west gradient of high-to-low stroke mortality rates was evident for both white men and white women in all three periods. Within the eastern part of the United States, high rates appeared more commonly in the South, and more so for white men than for white women. The "stroke belt" (area of very high stroke mortality rates in the coastal plain of the South) became less concentrated over the 2 decades, while a clustering of state economic areas with high rates along the Mississippi River and in the Ohio River valley became more pronounced.
