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BACKGROUND: Stroke is the fourth leading cause of death in Florida. The burden of stroke and related risk factors vary by age, gender, socio-economic status, race, and geographic location. Identifying geographic areas and population groups with significantly high risks of stroke is important for informing public health intervention and prevention efforts. Age-adjusted stroke hospitalization data have been mapped historically in Florida, but statistical analyses to determine if the rates in certain areas are significantly higher than other areas have not been conducted. The objective of this study is to investigate how geographic location impacts the risk of stroke in Florida.
METHODS: Stroke hospitalization and mortality data for the period of 1992-2012 were obtained from the Agency for Health Care Administration and the Florida Department of Health Office of Vital Statistics. Age-adjusted hospitalization and mortality rates were computed using SAS 9.3 for cases with stroke as the primary discharge diagnosis or underlying cause of death. To assess geographic disparities and changes over time, Geographical Information System (GIS) technology was used to develop maps to display this information.
RESULTS: Overall, age-adjusted stroke hospitalization and mortality rates have decreased over the last 20 years in Florida. Certain racial and ethnic groups were disproportionally affected by stroke. Blacks had higher hospitalization and mortality rates than their white counterparts during this time, and non-Hispanics had higher hospitalization and mortality rates than Hispanics. Geographic analyses revealed that many rural counties throughout the state tended to have higher hospitalization and mortality rates compared to urban areas.
CONCLUSIONS: The burden of stroke morbidity and mortality significantly impacts the health of many Floridians. Stroke disproportionately impacts certain populations more than others. Future studies will need to focus on these high risk regions to investigate the reasons for these occurrences. These findings can be used to help inform public health efforts and policies.