CDC atlas documents disparity in stroke deaths

FRIDAY, FEBRUARY 21, 2003

American Indians and Alaska Natives are less likely to die from strokes than any other racial or ethnic group in the nation, the Centers for Disease Control and Prevention reported on Thursday.

But data varied so greatly that some in Indian Country face a significantly higher risk of death than their counterparts. Alaska Natives, in particular, suffered rates two to three times the national average, according to the CDC.

And researchers cautioned that misreporting of race on death certificates almost certainly means the rates for Native Americans are higher than those documented yesterday. When the Indian Health Service (IHS) adjusts its figures, death rates jump by 39 percent.

Based on data from 1991 to 1998, the "Atlas of Stroke Mortality" is the CDC's first-ever geographic-based study of the third leading cause of death. Only heart disease and cancer, which affect Indian Country in disproportionate rates, rank higher.

American Indian and Alaska Native adults made up 1.5 percent of the study population. For the reporting period, their death rate was 79 per 100,000.

In comparison, the rate for African-Americans was much higher, at 166 per 100,000. The national average was 121 per 100,000.

Depending on the area of the country, Native Americans matched and exceeded the national average. High rates were reported in Alaska, Washington, Idaho, Montana, Wyoming, South Dakota, Wisconsin, and Minnesota. These are typically the states where smoking among Indian Country is high.

Low rates were reported in central Oklahoma, predominantly among the Cherokee Nation, southern California, Arizona, and New Mexico. Again, these areas correspond with low rates of tobacco use.

When viewed by gender, Native men and women faced similar risk of stroke death. The rate for women was 77 per 100,000 compared to 80 per 100,000 for men. These were comparable to Hispanic men and women, who also had the lowest rates of racial and ethnic groups in the U.S.

Like Indian Country, death rates for rest of the nation have always varied by geography, leading to the coining of the term "stroke belt" to apply to the southeastern U.S. The Atlas looks closer at this phenomenon on a county-by-county basis.

Approximately 600,000 U.S. residents suffer a new or recurrent stroke each year and roughly 167,000 die of a stroke each year, according to the CDC. Risk factors include high blood pressure, high cholesterol, diabetes and smoking.

Stroke deaths rates actually dropped during the 1970s and 1980s but haven't improved since, according to the CDC.

Get the Study:
Atlas of Stroke Mortality (CDC February 2003)

Relevant Links:
National Stroke Association - http://www.stroke.org