Spatiotemporal Disparities in Stroke Mortality From 1969 to 2020, by Race and Sex, in Tennessee
Abstract
Background: – Tennessee ranks sixth in stroke mortality in the United States. Yet the patterns of stroke mortality vary significantly across counties and over time. Objectives: – This study aims to examine spatiotemporal disparities of stroke mortality at the county level in Tennessee from 1969 to 2020. Research Design: – A population-based study using the national vital statistics system of stroke mortality data through the Surveillance, Epidemiology, and End Results and National Center for Health Statistics (SEER-NCHS) database. Subjects: – Patients older than 35 years who died from stroke in Tennessee from 1969 to 2020. Methods: – Data from the SEER-NCHS were aggregated into 4 periods (1969–1980, 1981–1992, 1993–2004, and 2005–2020), and age-adjusted stroke mortality rates were calculated by county and by race and sex for each time period. Results: – The stroke mortality rates in Tennessee declined by 35.6%, 28.3%, 7.1%, and 24.4% in 1969–1980, 1981–1992, 1993–2004, 2005–2020, respectively. The degree of decline varied by race and sex groups. In the first 2 periods, the largest decline in stroke mortality was observed among Black women (43.2% and 31.5%). During 1993–2004, the largest decline was observed among Black men (22.4%), while the largest decline was observed among white women during 2005–2020 at 25.5%. There were urban–rural disparities in stroke mortality across counties and over the 4 periods. In general, urban and rural mortality rates were similar from 1969 to 1992; however, a substantial decline (24.1%) was observed in urban counties during 1993–2004, while a larger decline (34.6%) occurred later in rural counties during 2005–2020. County-level variations in stroke mortality were also evident across the 4 periods. Conclusion: – Substantial disparities in stroke mortality by counties and race-sex subgroups persisted over the past 5 decades. The disease burden was clustered in a few counties and disproportionately higher among vulnerable populations.
Publication Title
Medical Care
Recommended Citation
Roy, S., Mzayek, F., Joshi, A., & Yu, X. (2025). Spatiotemporal Disparities in Stroke Mortality From 1969 to 2020, by Race and Sex, in Tennessee. Medical Care, Publish Ahead of Print https://doi.org/10.1097/MLR.0000000000002277
