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Birth and adult residence in the Stroke Belt independently predict stroke mortality.

Authors
Glymour-MM; Kosheleva-A; Boden-Albala-B
Source
Neurology 2009 Dec; 73(22):1858-1865
NIOSHTIC No.
20036207
Abstract
Background: Understanding how the timing of exposure to the US Stroke Belt (SB) influences stroke risk may illuminate mechanisms underlying the SB phenomenon and factors influencing population stroke rates. Methods: Stroke mortality rates for United States' born black and white people aged 30-80 years were calculated for 1980, 1990, and 2000 for strata defined by birth state, state of adult residence, race, sex, and birth year. Four SB exposure categories were defined: born in a SB state (North Carolina, South Carolina, Georgia, Tennessee, Arkansas, Mississippi, or Alabama) and lived in the SB at adulthood; non-SB born but SB adult residence; SB-born but adult residence outside the SB; and did not live in the SB at birth or in adulthood (reference group). We estimated age-, sex-, and race-adjusted odds ratios for stroke mortality associated with timing of SB exposure. Results: Elevated stroke mortality was associated with both SB birth and, independently, SB adult residence, with the highest risk among those who lived in the SB at birth and adulthood. Compared to those living outside the SB at birth and adulthood, odds ratios for SB residence at birth and adulthood for black subjects were 1.55 (95% confidence interval 1.28, 1.88) in 1980, 1.47 (1.31, 1.65) in 1990, and 1.34 (1.22, 1.48) in 2000. Comparable odds ratios for white subjects were 1.45 (95% confidence interval 1.33, 1.58), 1.29 (1.21, 1.37), and 1.34 (1.25, 1.44). Patterns were similar for every race, sex, and age subgroup examined. Conclusion: Stroke Belt birth and adult residence appear to make independent contributions to stroke mortality risk.
Keywords
Age-groups; Cardiovascular-disease; Cardiovascular-function; Exposure-assessment; Exposure-levels; Mortality-rates; Mortality-surveys; Racial-factors; Risk-analysis; Risk-factors; Risk-analysis; Risk-factors
Contact
Dr. M. Maria Glymour, 677 Huntington Avenue, Kresge 617, Boston, MA 02115
CODEN
NEURAI
Publication Date
20091201
Document Type
Journal Article
Email Address
mglymour@hsph.harvard.edu
Funding Type
Grant
Fiscal Year
2010
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R03-OH-009338
Issue of Publication
22
ISSN
0028-3878
Priority Area
Manufacturing; Services
Source Name
Neurology
State
MA
Performing Organization
Harvard University School of Public Health
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