U.S. Stroke Rate Decreases, Racial Inequality Gap Remains

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Jan. 12, 2024 -- Though the overall rate of strokes has decreased in the United States, Black adults still experience strokes more frequently and at younger ages than white adults, says a study published this week in the journal Neurology.

“We found that the rate of stroke is decreasing over time in both Black and white people—a very encouraging trend for U.S. prevention efforts,” study author Tracy E. Madsen, MD, of Brown University said in a news release.

“But there was an inequity from the beginning of the study, with the rate of stroke always being higher for Black people than their white counterparts. The disparity did not decrease in 22 years, especially among younger and middle-aged adults.”

Researchers at Brown University looked at stroke data from 1993 to 2015 from hospitals in Ohio and Kentucky. 

Overall, the rate of strokes dropped from 230 cases per 100,000 to 188 cases. But the rate of stroke among Black people stayed 50% to 80% higher than the rate for white people across the study period, even after adjusting for age and sex. 

Among Blacks, the rate went from 349 to 311 per 100,000 people. For whites, the rate went from 215 to 170 per 100,000.

The study found strokes occurred at younger ages for Blacks than for whites.

The average age for a first stroke went from 66 years at the start of the study to 62 years at the end of the study for Blacks. For whites, it went from 72 to 71 years.

Madsen noted that the study did not examine social factors like systemic racism and access to preventive care that contributed to the gap.

“These disparities present a major ongoing public health concern,” Madsen said in the news release. “More work is clearly needed to address systemic and policy problems, as well as factors at the provider and patient levels. These findings are a clear, urgent call for concrete efforts to build more equitable means of stroke prevention and care.”