Stroke: Where Does Your State Rank?

May 17, 2007 -- Mississippi leads the U.S. in stroke prevalence, and Connecticut has the nation's lowest stroke prevalence rate, says the CDC.

The CDC announced that news today in its first state-by-state list of stroke prevalence rates.

Data came from a 2005 health survey of more than 356,000 civilian adults nationwide. The survey didn't include people living in nursing homes or other institutions.

In telephone interviews conducted for the survey, participants were asked, "Has a doctor or other health professional ever told you that you had a stroke?"

Overall, 2.6% of participants answered "yes" to that question. That translates to more than 5.8 million U.S. stroke survivors, states the report, published in the CDC's Morbidity and Mortality Weekly Report.

The journal also includes a separate study showing that fewer than half of U.S. stroke patients get to the hospital within two hours of the onset of stroke symptoms. Swift treatment is essential for clot-busting stroke drugs.

Learn Stroke Symptoms

Before you read the state-by-state stroke prevalence list, take a moment to review this list of stroke symptoms:

• Sudden weakness or numbness in the face, arm, or leg
• Abrupt loss of vision, strength, coordination, sensation, speech, or the ability to understand speech. These symptoms may become more marked over time.
• Sudden dimness of vision, especially in one eye
• Sudden loss of balance, possibly accompanied by vomiting, nausea, fever, hiccups, or trouble with swallowing
• Sudden and severe headache with no other cause followed rapidly by loss of consciousness
• Brief loss of consciousness
• Unexplained dizziness or sudden falls

Call 911 or seek other emergency care immediately if you or someone you know experiences possible symptoms of stroke. Don't wait to see if the symptoms pass.

State Stroke Prevalence Rates

Here is the age-adjusted percentage of participants in each state or territory who said they had been diagnosed as ever having a stroke.

The report shows "an approximately two-fold difference between states with the highest and lowest prevalence estimates," says the CDC.

States or territories with the same prevalence rate are ranked together.

1. Mississippi: 4.3%
2. Oklahoma and Washington, D.C.: 3.4%
3. Louisiana: 3.3%
4. Alabama and Nevada: 3.2%
5. Kentucky, Missouri, and Tennessee: 3.1%
6. Arkansas, Illinois, Michigan, Texas, and West Virginia: 3%
7. Georgia and South Carolina: 2.9%
8. Florida, Hawaii, and North Carolina: 2.8%
9. Virginia: 2.7%
10. California, Iowa, New Hampshire, South Dakota, and Utah: 2.6%
11. Alaska, Indiana, and Oregon: 2.5%
12. Idaho, Maine, New York, and Washington: 2.4%
13. Kansas and Ohio: 2.3%
14. Nebraska, New Mexico, and Pennsylvania: 2.2%
15. Arizona, Maryland, Massachusetts, Montana, New Jersey, Rhode Island, and Vermont: 2.1%
16. Wisconsin, Wyoming, and Puerto Rico: 1.9%
17. North Dakota: 1.8%
18. Colorado and Minnesota: 1.7%
19. Connecticut: 1.5%

The CDC didn't check participants' medical records to confirm their self-reported stroke history.

The figures don't include stroke deaths. Stroke is the No. 3 cause of death for U.S. adults.

The CDC predicts that in 2007, an estimated 700,000 people in the U.S. will suffer a stroke and about 160,000 will die from stroke.

Stroke is also a leading cause of disability. About 15% to 30% of stroke patients become permanently disabled, and one in five require institutionalization during the first three months after a stroke, says the CDC.

Race, Education, and Stroke

Stroke prevalence rates also varied among people of different races and education levels.

Here are the stroke prevalence rates by participants' self-reported racial and ethnic group:

1. American Indian/Alaska Native: 6%
2. Multiracial: 4.6%
3. Black: 4%
4. Hispanic: 2.6%
5. White: 2.3%
6. Asian/Pacific Islander: 1.6%

College graduates had a stroke prevalence rate of 1.8%, compared with 4.4% for people with less than 12 years of education.

Stroke prevalence rates were similar for men (2.7%) and women (2.5%), notes the CDC.

Delays in Getting to Hospital

The CDC also tracked how long it took stroke patients to get to the hospital in four states -- Georgia, Illinois, Massachusetts, and North Carolina -- in 2005 and 2006.

The data show that of 7,901 stroke patients in those states, fewer than half -- 48% -- arrived at a hospital emergency department within two hours of the start of stroke symptoms.
Those who took an ambulance to the hospital were more likely to get to the hospital within two hours. Patients traveling by ambulance also got brain scans sooner once they arrived at the hospital, the CDC notes.

Again, don't delay seeking emergency medical care at the first sign of a possible stroke. It could make a big difference in stroke outcome.