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February 21, 2003

Risk of Fatal Stroke Is Greatest for Blacks, Government Says

By REUTERS

ATLANTA, Feb. 20 (Reuters) Blacks in the United States are more likely to die from a stroke and at a much younger age than whites, Hispanics and people of other races, a new federal report says.

The findings, reported today by the Centers for Disease Control and Prevention in its first Atlas of Stroke Mortality, confirmed a pattern long noted by public health officials, who have been warning that racial disparities in diet, smoking and access to health care were leading to wide differences in the rates of heart disease, stroke and cancer.

Strokes kill about 165,000 Americans every year, the third-highest toll after heart disease and cancer. (About 700,000 Americans have strokes each year.) The major risk factors are high blood pressure, high cholesterol, diabetes and smoking.

From 1991 to 1998, the new report says, an average of 166 out of 100,000 black Americans had fatal strokes each year, 1.4 times the rate for whites, which was 117 per 100,000.

The rates for Asians and Pacific Islanders, American Indians and Hispanics were considerably lower, with Indians and Hispanics at less than half the rate of blacks.

Among blacks, almost half of stroke deaths occurred before age 75, compared with 25 percent for whites.

Dr. Michele Casper, an epidemiologist with the centers' cardiovascular health branch who wrote the report, said poverty and other socioeconomic factors might help to explain the racial and geographic disparities in the data.

"It is important to note that the concentration of high-rate counties tend to be in areas of the country that have been chronically impoverished and underdeveloped," Dr. Casper told reporters in a conference call. "The persistent lack of socioeconomic resources makes it difficult for those communities to provide stroke-free living and working environments for their residents."

Among blacks and whites alike, stroke deaths in the 1991-98 period tended to occur more often in the coastal plains of the Carolinas, the Mississippi Delta and other parts of the Southeast.

South Carolina, Arkansas, Tennessee, North Carolina and Georgia had the highest fatality rates; New York, Massachusetts and New Jersey had the lowest.

The disease centers noted that the overall death rate from stroke declined 0.8 percent a year.

The report is available online at cdc.gov/cvh/maps.

The centers said it hoped public health officials across the nation would use its stroke data to tailor prevention policies for high-risk communities.

Suggestions include improving emergency medical response services, increasing the number of parks and recreation facilities and ensuring that high-fiber, low-fat foods are readily available in stores.

Helping Americans recognize the warning signs of a stroke, which include numbness or weakness on one side, vision problems, dizziness, severe headaches and confusion or difficulty speaking, also remains a high priority.

"A stroke is a true medical emergency like a heart attack, but patients are still not arriving on time to receive their proper treatment" in emergency rooms, said Dr. Oscar Benevente, a neurologist and stroke prevention specialist at the University of Texas Health Sciences Center in San Antonio.

"Education is crucial," Dr. Benevente said.


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