The Stroke Belt Enigma Continues

Reflections on the Geography of Stroke Mortality

Abstract

Suffering a stroke is devastating. The occurrence of this illness and the resulting loss of life in the U.S. are astronomical. While the mortality rates from strokes have plummeted dramatically over the last fifty years, especially in the Southeast, strokes continue to be menacing, as morbidity rates have remained virtually unchanged in decades. Current patterns of stroke mortality for whites, blacks, males, and females do support the notion that the stroke belt in the Southeast is becoming more fragmented and that a secondary stroke belt is becoming established along the Mississippi and Ohio River valleys. An examination of the literature on the geographic distribution of stroke reveals that physicians have written much of this research. While their interest in geography is to be applauded, the search for the stroke belt or belts would be best accomplished through multidisciplinary research teams consisting of physicians, epidemiologists, and geographers. Future studies on the geography of stroke should focus on morbidity, as these rates have remained stable for several decades.