Stroke Belt Still Fastened Across the South

Across the U.S., fewer people are dying from strokes each year. Statistics released by the Centers for Disease Control and Prevention showed a 3.6 percent decrease in stroke deaths from 2007 to 2008, according to a study published this year in the Morbidity and Mortality Weekly Report. Interestingly, a higher-than-average number of strokes occur in southern states.

Although more effective and timely treatment methods have contributed to a decline in deaths, more still needs to be done to prevent the occurrence of strokes, especially in the southern “stroke belt” states, which continue to have the highest rates of stroke in the nation.

The CDC’s study showed that Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Nevada, Oklahoma, Tennessee, and South Carolina have the highest stroke rates nationwide. States with the lowest rates include Colorado, Michigan, Minnesota, New York, Wisconsin, Wyoming, and the New England states.

Birth of the Stroke Belt

The origins of the stroke belt go back more than 60 years. The stroke belt label was first applied in the 1950s, when epidemiologists compiled data showing a higher-than-average death rate from strokes among residents of southeastern states compared to other states in the U.S.

In 1980, the National Heart, Lung, and Blood Institute (NHLBI) took a closer look at age-adjusted stroke deaths by state. The NHBLI found that 11 states—most of which are clustered in the Southeast—had stroke death rates that were 10 percent higher than the average in other states. It was this data that gave birth to the South’s designation as the “stroke belt.”

A Domino Effect

Research has shown that the chances of having and surviving a stroke depend on much more complicated circumstances than simple geography. It has been well documented that obesity and high blood pressure significantly increase the risk of stroke. Genetic and socioeconomic factors also play a significant role in stroke risk, along with lifestyle and nutrition. Groups that are more at risk for stroke include the elderly, Native Americans, African Americans, and people with lower education levels.

Researchers believe that lifestyle choices and poor diet are among the primary reasons for the higher incidence of stroke in southern states. Many of the stroke belt states are also tobacco producing states, and smoking is more prevalent there. In addition, a diet that includes a significant amount of fried foods is more common in the south. These lifestyle choices create a domino effect that, when combined with smoking, poor eating habits, and lack of exercise, lead to high blood pressure and diabetes mellitus, which can then lead to an increased risk of stroke.

Public Education is Critical 

Although new medications and improved stroke treatment methods have significantly reduced the number of people who die from strokes, more work needs to be done. Many people still do not recognize the warning signs of stroke and delay seeking medical attention, increasing the severity of brain damage and the likelihood of lasting disabilities.

Stroke warning signs include:

  • sudden numbness or weakness of the face, arm, or leg—especially on one side of the body
  • sudden confusion or trouble speaking or understanding
  • sudden trouble seeing in one or both eyes
  • sudden trouble walking, dizziness, or loss of balance or coordination
  • sudden severe headache with no known cause.

Although people can’t control hereditary factors, age, or ethnicity, they can make lifestyle changes to keep blood pressure, cholesterol, and weight under control and avoid smoking. Tailoring education programs about stroke warning signs and a healthy lifestyle to those who are most at risk could significantly reduce the incidence of future strokes.

For the most complete and evidence-based stroke education, look into Hemispheres® Stroke Competency Series, a web-based program developed by Apex Innovations in partnership with Mosby’s Nursing Suite.

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