Reassessing the Stroke Belt

Karp, David; Wolff, Catherine; Wiebe, Douglas J.; Branas, Charles C.; Carr, Brendan G.; Mullen, Michael T.

doi:10.1161/strokeaha.116.012997

Cited by 43 publications

(20 citation statements)

References 10 publications

(9 reference statements)

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“…We must note that the “southern Mississippi River” areas identified as hot spots in the current analysis have consistently been shown to be associated with poorer health outcomes using geospatial analyses in previous studies investigating varied diseases [56-61]. For example, studies have shown that the southern Mississippi River region has higher risks for lung cancer [60], coronary heart disease and stroke [61], and sepsis [58].…”

Section: Discussionmentioning

confidence: 74%

“…For example, studies have shown that the southern Mississippi River region has higher risks for lung cancer [60], coronary heart disease and stroke [61], and sepsis [58]. Consistent poverty and lower access to healthcare are likely significant contributors to the health disparities affecting this region, and targeted healthcare strategies focused on this geographic region are likely to have significant impact.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mapping hot spots of breast cancer mortality in the United States: place matters for Blacks and Hispanics

Moore

Royston

Langston

et al. 2018

Cancer Causes Control

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Mapping hot spots of breast cancer mortality in the United States: place matters for Blacks and Hispanics

Moore

Royston

Langston

et al. 2018

Cancer Causes Control

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“…Participants with low education were likely subjected to particularly severe economic circumstances with families hovering on the brink of starvation as well as dealing with barriers to employment, health and social services as a result of institutionalized racism (Dollard, 1957). There is now considerable evidence that certain geographically defined communities, particularly in the south are at greater risk for chronic illnesses including cancer, vascular diseases, stroke, increased all-cause mortality rates, reduced life expectancy, and most recently, for greater recording of dementia/AD in death certificates (Dwyer-Lindgren et al, 2016;Karp et al, 2016;Labarthe et al, 2016;Rosenberg et al, 2016;Taylor, Greenlund, McGuire, Lu, & Croft, 2017). The explanations given for these geographically defined areas of increased risk include socioeconomic disparities, access to health care, lifestyle factors such as physical inactivity and smoking, obesity-increased rates of vascular risk factors, obesity, hypertension, and diabetes (Karp et al, 2016;Labarthe et al, 2016;Rosenberg et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

The Association of Early Life Factors and Declining Incidence Rates of Dementia in an Elderly Population of African Americans

Hendrie

Smith-Gamble

Lane

et al. 2018

The Journals of Gerontology: Series B

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Objectives To explore the possible association of childhood residence, education levels, and occupation with declining incidence rates of dementia in 2 cohorts of elderly African Americans. Methods African Americans residing in Indianapolis without dementia were enrolled in 1992 and 2001 and evaluated every 2–3 years. The cohorts consist of 1,440 participants in 1992 and 1,835 participants in 2001 aged 70 years and older. Cox proportional hazard regression models were used to compare cohort differences in dementia and Alzheimer’s disease (AD) risk. Results The 2001 cohort had significantly decreased risk of both incident dementia and AD (hazard ratio [HR]: 0.62/0.57 for dementia/AD). Years of education was associated with decreased risk of dementia (HR = 0.93; p = .0011). A significant interaction (p = .0477) between education and childhood rural residence was found for the risk of AD that higher education level is significantly associated with reduced AD risk (HR = 0.87) in participants with childhood rural residence, but no association in those with urban upbringing. The cohort difference for dementia rates were attenuated by adjusting for the 3 risk factors but remained significant (HR = 0.75; p = .04). Discussion These results emphasize the importance of early life factors including rural residence and education for the risk for dementia later in life.

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“…In ecological studies, CVD mortality (CED, IHD, and hypertensive disease) has been associated with social inequalities and low socio-economic levels [ 46 , 47 ], and low mortality has been observed in rural non-metropolitan counties with agricultural production in the United States [ 48 ]. Changes in agricultural production, food processing, and diet in European Mediterranean countries have been related to an increase in CVD incidence [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Production of Vegetables and Artichokes Is Associated with Lower Cardiovascular Mortality: An Ecological Study

Arnedo-Pena

Puig-Barberà

Bellido-Blasco

et al. 2020

IJERPH

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Mortality due to cardiovascular disease (CVD), including cerebrovascular disease (CED) and ischaemic heart disease (IHD), was considerably different in eight municipalities of the province of Castellón, Community of Valencia (Spain) during the period of 1991–2011. In addition, these villages showed differences in agricultural practices and production. Since high vegetable consumption has been linked to decreased all-cause, CVD, and CED mortalities, we hypothesized that the diversity in vegetable and artichoke production, used as proxies for their consumption, could be associated with the diversity of mortality rates. In order to test our hypothesis, we estimated the smoothed standardized mortality ratios (SMRs) of CVD, CED, and IHD mortalities and a directed, age-adjusted mortality rate (AMR). We used a multilevel linear regression analysis to account for the ecological nature of our study. After adjustment, the CVD and CED SMRs were inversely associated with vegetable and artichoke production, with a reduction in SMRs for CVD: −0.19 (95% Confidence Interval [CI] −0.31 to −0.07) and −0.42 (95% CI −0.70 to −0.15) per hectare/103 inhabitants, respectively. The SMRs for CED also decreased: −0.68 (95% CI −1.61 to −0.19) and −1.47 (95% CI −2.57 to −0.36) per hectare/103 inhabitants, respectively. The SMRs for IHD were not associated with vegetal and artichoke production. When the directed AMR was used, CED mortality was consistent with the previous results, whereas the CVD mortality association was lost. Our results indicate that vegetable and artichoke production may act as protective factors of CED and CVD mortalities.

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Reassessing the Stroke Belt

Cited by 43 publications

References 10 publications

Mapping hot spots of breast cancer mortality in the United States: place matters for Blacks and Hispanics

Mapping hot spots of breast cancer mortality in the United States: place matters for Blacks and Hispanics

The Association of Early Life Factors and Declining Incidence Rates of Dementia in an Elderly Population of African Americans

Production of Vegetables and Artichokes Is Associated with Lower Cardiovascular Mortality: An Ecological Study

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