Stroke-related mortality varies between border, nonborder US counties
Click Here to Manage Email Alerts
Vulnerable populations along the U.S. southern border require targeted intervention to improve stroke-related mortality, according to research in the Journal of the American Heart Association.
“We compared demographic and geographical trends in stroke-related mortality in the border versus nonborder counties in four border states (Arizona, California, New Mexico, Texas) using a national database of death certificates,” Safi U. Khan, MD, MS, assistant clinical professor at West Virginia University, and colleagues wrote. “A detailed assessment of the epidemiological profile of stroke-related mortality may inform policymakers and health care professionals to improve care for the socially disadvantaged population residing in this dynamic area.”
The researchers used the CDC Wide-Ranging Online Data for Epidemiologic Research – Multiple Cause of Death database to find death certificates from 1999 to 2018 in the U.S.-Mexico border area.
Stroke-related deaths were compared with non-stroke-related deaths while considering age, sex, ethnicity/race (non-Hispanic white, non-Hispanic Black, non-Hispanic American Indian/ Alaskan Native, non-Hispanic Asian/Pacific Islander, and Hispanic) and location of death.
Researchers found that 56,019 stroke-related deaths occurred in the border counties from 1999 to 2018 (147,408,326 patient-years), corresponding to an overall age-adjusted mortality rate (AAMR) of 39.3 (95% CI, 39-39.6) per 100,000 patient years. When analyzing data from nonborder counties, they found 516,329 stroke-related deaths occurred (1,243,119,793 patient-years) there, corresponding to an overall AAMR of 45.2 (95% CI, 45-45.3) per 100,000 patient-years.
From 1998 to 2018, AAMRs reduced from 55.8 per 100,000 patient-years to 34.4 per 100,000 patient-years in border counties (average annual percent change [AAPC], –2.7) and from 64.5 per 100,000 patient-years to 37.6 per 100,000 patient-years in nonborder counties (AAPC, –2.92), the researchers wrote.
In all geographic areas, AAPC in AAMR declined from 1998 to 2012 but stabilized after that, although it has increased in California’s border counties (AAPC since 2012, 3.9).
“Overall, nonborder counties had higher mortality rates than border counties, and demographically, older adults, men, and non-Hispanic Black adults had higher mortality rates than their counterparts,” Khan and colleagues wrote. “Given the substantial public health implications, targeted interventions aimed at vulnerable populations are required to improve stroke-related outcomes in the U.S.-Mexico border area.”
Collapse
Click Here to Manage Email Alerts