This Atlas examines stroke deaths for women and men, for the 50 states and the District of Columbia. The Atlas also includes state -specific maps and tables that show the racial, ethnic and geographic disparities in stroke death rates.
The "Stroke Belt" is usually defined as an 8-12 state region (typically including Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee, and often including Florida, Indiana, Kentucky, Virginia, and Washington, D.C. as well) where stroke death rates are substantially higher than the rest of the country.
Within the stroke belt, the highest stroke death rates are clustered in the coastal plains regions of Georgia, North Carolina, and South Carolina; this region has been called the "Stroke Buckle."
The stroke death rate in the Stroke Buckle is two times greater than that in the rest of the nation.
The excess risk of stroke death in the Stroke Buckle affects both men and women, blacks and whites.
The pattern of excess stroke death rates in the Stroke Buckle has existed for at least 50 years.
The causes of the excess stroke death rates in the Stroke Buckle are not known. Causes that have been suggested include a higher prevalence of stroke risk factors, lack of access to health care, or factors associated with the geography of the region.
Stroke is the 3rd leading cause of death in Georgia, North Carolina, and South Carolina.
In 1998, stroke killed 4,158 Georgians (7% of all deaths), 5,439 North Carolinians (8% of all deaths), and 2,900 South Carolinians (8% of all deaths).
South Carolina has the highest stroke death rate of all states in the country - and has maintained this distinction for 5 decades. North Carolina has the 4th highest stroke death rate, and Georgia has the 5th highest.
Stroke death rates declined steadily (an average of about 3% per year from 1979 to 1992) in all three states during the 1980's, but that decline slowed during the 1990's, with less than a 1% decline per year in all three states from 1992 to 1998.
African Americans in each of the three states are at greater risk of dying from a stroke than their white counterparts. In Georgia, stroke death rates for African Americans are nearly 40% higher than for whites; in North Carolina, stroke death rates for African Americans are nearly 50% higher than for whites; and in South Carolina, stroke death rates for African Americans are nearly 60% higher than for whites.
One of every six Georgians and South Carolinians who died from stroke in 1998 was younger than 65 years of age. One of every seven North Carolinians who died from stroke that year was younger than 65 years of age.
Strokes killed at least 50% more women than men in each of the three states during 1998.
In 1997, strokes caused 25,200 hospitalizations in Georgia, 29,900 in North Carolina, and 15,900 in South Carolina. These hospitalizations resulted in hospital charges of more than $310 million in Georgia, more than $343 million in North Carolina, and more than $217 million in South Carolina during 1997.
During 1998, hospitalizations for stroke among Medicare beneficiaries ages 65 and older totaled 14,890 in Georgia, 19,548 in North Carolina, and 9,657 in South Carolina.
Unexplained Stroke Disparity: Report and Recommendations from the Three Southeastern States. The executive summary of the proceedings of the Tri-State Stroke Summit held in September 1999.
Stroke Death Rates 79-2202 map attached. This map shows stroke trends in death rates
in NC. Stroke_Registry_Map_2004A.ppt
South Carolina Burden of Cardiovascular Disease: 2002 Report
