Lanska D J
Department of Neurology, University of Kentucky Medical Center, Lexington 40536-0284, USA.
Stroke. 1997 Jan;28(1):53-7. doi: 10.1161/01.str.28.1.53.
This study examines the geographic distribution of stroke mortality among immigrants and natives of the United States.
National Center for Health Statistics and Bureau of the Census data were used to determine the geographic distribution of age-adjusted, race-, and race/sex-specific stroke mortality rates among immigrants and natives of the United States for 1979 to 1981.
For whites and blacks and for each of the respective race/sex groups, immigrants had markedly and highly statistically significantly lower age-adjusted stroke mortality rates than either the entire US-born resident population or the US-born interregional migrant population. The spatial pattern of immigrant rates did not parallel the patterns for US-born populations. Immigrant rates were highest in the West and lowest in the Midwest for whites and highest in the Midwest and lowest in the Northeast for blacks, whereas for both US-born whites and blacks, resident and native rates were highest in the South and lowest in the Midwest. With few exceptions, region-specific immigrant rates for whites and blacks were significantly lower than rates for either US-born regional residents, US-born migrants to the regions, or US-born natives of the regions. In contrast, white immigrants to the West had significantly higher rates than US-born groups in that region.
Selection factors strongly influence stroke mortality rates among immigrants to the United States. The aberrantly high rates among white immigrants to the West may in part reflect a bias due to large census undercounts of this population.
本研究调查了美国移民和本土居民中卒中死亡率的地理分布情况。
利用国家卫生统计中心和人口普查局的数据，确定1979年至1981年美国移民和本土居民中按年龄调整、种族及种族/性别划分的卒中死亡率的地理分布。
对于白人和黑人以及各自相应的种族/性别组，移民的年龄调整卒中死亡率显著低于美国本土居民总体或美国本土地区间移民人口，且具有高度统计学意义。移民死亡率的空间模式与美国本土人口的模式不同。白人移民死亡率在西部最高，在中西部最低；黑人移民死亡率在中西部最高，在东北部最低，而对于美国本土白人和黑人，常住居民和本地居民死亡率在南部最高，在中西部最低。除少数例外，白人和黑人按地区划分的移民死亡率显著低于美国本土地区居民、迁入该地区的美国本土移民或该地区的美国本土出生者的死亡率。相比之下，迁入西部的白人移民死亡率显著高于该地区的美国本土群体。
选择因素对美国移民的卒中死亡率有强烈影响。西部白人移民中异常高的死亡率可能部分反映了由于该人群在人口普查中大量漏报所导致的偏差。
