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

M. Maria Glymour, Anna Kosheleva, Bernadette Boden-Albala

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)1858-1865
Number of pages8
JournalNeurology
Volume73
Issue number22
DOIs
StatePublished - Dec 2009

Fingerprint

Stroke
Parturition
Mortality
Odds Ratio
Confidence Intervals
Mississippi

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Birth and adult residence in the Stroke Belt independently predict stroke mortality. / Glymour, M. Maria; Kosheleva, Anna; Boden-Albala, Bernadette.

In: Neurology, Vol. 73, No. 22, 12.2009, p. 1858-1865.

Research output: Contribution to journalArticle

Glymour, M. Maria ; Kosheleva, Anna ; Boden-Albala, Bernadette. / Birth and adult residence in the Stroke Belt independently predict stroke mortality. In: Neurology. 2009 ; Vol. 73, No. 22. pp. 1858-1865.
@article{249b10bf1ef84032baf5e93bd43a7fd5,
title = "Birth and adult residence in the Stroke Belt independently predict stroke mortality",
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.",
author = "Glymour, {M. Maria} and Anna Kosheleva and Bernadette Boden-Albala",
year = "2009",
month = "12",
doi = "10.1212/WNL.0b013e3181c47cad",
language = "English (US)",
volume = "73",
pages = "1858--1865",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "22",

}

TY - JOUR

T1 - Birth and adult residence in the Stroke Belt independently predict stroke mortality

AU - Glymour, M. Maria

AU - Kosheleva, Anna

AU - Boden-Albala, Bernadette

PY - 2009/12

Y1 - 2009/12

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=73349110398&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=73349110398&partnerID=8YFLogxK

U2 - 10.1212/WNL.0b013e3181c47cad

DO - 10.1212/WNL.0b013e3181c47cad

M3 - Article

VL - 73

SP - 1858

EP - 1865

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 22

ER -