Stroke Mortality Rates Vary in Local Communities in a Metropolitan Area: Racial and Spatial Disparities and Correlates

• Published in: Stroke (1970) 2014-07, Vol.45 (7), p.2059-2065
• Main Authors: Hunt, Bijou R, Deot, Deepa, Whitman, Steven
• Format: Article
• Language: English
• Subjects: Age Factors; Biological and medical sciences; Chicago - epidemiology; Chicago - ethnology; Ethnic Groups - ethnology; Ethnic Groups - statistics & numerical data; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Health Status Disparities; Humans; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Registries; Residence Characteristics - statistics & numerical data; Socioeconomic Factors; Stroke - epidemiology; Stroke - ethnology; Stroke - mortality; United States - epidemiology; United States - ethnology; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.114.005431

BACKGROUND AND PURPOSE—For the past decade, stroke has held steady as one of the top 4 leading causes of death in the United States. Aggregated data provide information about how the country or individual states are faring with respect to stroke mortality, but disaggregation provides data that may facilitate targeted interventions and community engagement. METHODS—We analyzed deaths from stroke to residents of Chicago to calculate age-adjusted stroke mortality rates (AASMRs). We calculated AASMRs for Chicago by race/ethnicity, sex, and community area. We also examined the correlation between AASMR and (1) racial/ethnic composition of a community area and (2) median household income. RESULTS—The AASMR for Chicago (44.9 per 100 000 population) was significantly higher than the national rate (42.2). Within both the United States and Chicago, the highest AASMRs were found among non-Hispanic blacks, followed by non-Hispanic whites, and then Hispanics. There was a strong, positive correlation between the proportion of black residents in a community area and the AASMR (0.58). There was a strong, negative relationship between household income and the AASMR for the entire city (−0.56) and for the predominantly black community areas (−0.47). CONCLUSIONS—These data provide insight into where the worst stroke mortality problems reside in Chicago. We anticipate that the data can be used to work toward the development of solutions to the high stroke mortality rates observed in several of Chicago’s community areas and in similar communities throughout the United States.