Title |
Where to Focus Efforts to Reduce the Black–White Disparity in Stroke Mortality
|
---|---|
Published in |
Stroke, June 2016
|
DOI | 10.1161/strokeaha.115.012631 |
Pubmed ID | |
Authors |
George Howard, Claudia S Moy, Virginia J Howard, Leslie A McClure, Dawn O Kleindorfer, Brett M Kissela, Suzanne E Judd, Fredrick W Unverzagt, Elsayed Z Soliman, Monika M Safford, Mary Cushman, Matthew L Flaherty, Virginia G Wadley |
Abstract |
At age 45 years, blacks have a stroke mortality ≈3× greater than their white counterparts, with a declining disparity at older ages. We assess whether this black-white disparity in stroke mortality is attributable to a black-white disparity in stroke incidence versus a disparity in case fatality. We first assess if black-white differences in stroke mortality within 29 681 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort reflect national black-white differences in stroke mortality and then assess the degree to which black-white differences in stroke incidence or 30-day case fatality after stroke contribute to the disparities in stroke mortality. The pattern of stroke mortality within the study mirrors the national pattern, with the black-to-white hazard ratio of ≈4.0 at age 45 years decreasing to ≈1.0 at age 85 years. The pattern of black-to-white disparities in stroke incidence shows a similar pattern but no evidence of a corresponding disparity in stroke case fatality. These findings show that the black-white differences in stroke mortality are largely driven by differences in stroke incidence, with case fatality playing at most a minor role. Therefore, to reduce the black-white disparity in stroke mortality, interventions need to focus on prevention of stroke in blacks. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 8 | 73% |
Unknown | 3 | 27% |
Demographic breakdown
Type | Count | As % |
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Practitioners (doctors, other healthcare professionals) | 5 | 45% |
Members of the public | 4 | 36% |
Science communicators (journalists, bloggers, editors) | 2 | 18% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 1% |
Unknown | 66 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 12 | 18% |
Student > Doctoral Student | 9 | 13% |
Researcher | 7 | 10% |
Student > Ph. D. Student | 6 | 9% |
Student > Bachelor | 4 | 6% |
Other | 17 | 25% |
Unknown | 12 | 18% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 20 | 30% |
Nursing and Health Professions | 5 | 7% |
Neuroscience | 4 | 6% |
Computer Science | 3 | 4% |
Social Sciences | 3 | 4% |
Other | 11 | 16% |
Unknown | 21 | 31% |