Alabama: heart of the ‘Stroke Belt’
Stroke (or cerebrovascular diseases) is Alabama’s fourth leading cause of death, exceeded only by heart diseases, cancer and chronic lower respiratory diseases. Alabama is a prominent member of “The Stroke Belt,” an 11-state region where the risk of experiencing a stroke is 34 percent higher than it is in other areas.
Stroke is required to be reported in Alabama; however, analyzing stroke mortality data reveals many interesting facts about this disease. In 2000, Alabama lost nearly 3,200 residents to strokes and was tied for having the 7th highest age-adjusted stroke mortality (or death) rate among all 50 states, at 71.5 deaths per 100,000 standard population. In 2015, this rate had decreased by nearly 27 percent to 52.2. Alabama lost more than 2,900 residents to strokes in 2015.
Significant progress in stroke survival has been seen nationally and in Alabama. Unfortunately, in spite of this progress, Alabama had the 2nd highest stroke mortality rate in 2015 and the highest rate among all states in 2013.
Stroke mortality varies significantly by race and gender. African Alabamian males had the highest rate in 2015 at 72.2 followed by African Alabamian females at 58.0, white males at 49.0, and white females at 47.9. While all four of these components of Alabama’s population had healthy and significant decreases in stroke mortality since 2000, all four remained significantly higher when compared to the same population components nationally.
Alabama’s rural counties had a higher stroke mortality rate than the urban counties. While these rates did not vary greatly, (53.6 in rural counties and 51.0 in urban counties) the 20 counties with the highest rates were all rural.
Risk factor modifications, such as increased use of cholesterol reducing medications, improved and faster stroke diagnosis, and improved stroke treatment are credited with most of the healthy decrease that has been seen in stroke mortality. Alabama continues to rank among the leading states in stroke mortality because of the greater presence of major risk factors such as diabetes, obesity, and tobacco use.
The expansion of stroke diagnosis and treatment through the use of telemedicine provides considerable promise for improvement in stroke mortality and quality of life. The Southeast Alabama Medical Center (SAMC) in Dothan was an Alabama pioneer in providing this service through its Stroke Care Network.
Through this network, neurologists affiliated with the SAMC conduct real-time video examinations of patients presenting in emergency departments at the Medical Center Barbour in Eufaula, Mizell Memorial Hospital in Opp, Dale Medical Center in Ozark, and Troy Regional Medical Center who may have experienced a stroke. Through this timely evaluation, drugs may be prescribed quickly, resulting in less permanent damage or even the saving of life.
Remembering the stroke acronym “FAST” is another way that we can all possibly prevent death and decrease permanent damage.
F Does one side of the face tend to droop?
A Ask the victim to raise both arms. Does one arm tend to drift downward?
S Is speech being slurred?
T Time! If any of these symptoms are present, seek emergency attention.
Dale Quinney is executive director of the Alabama Rural Health Association, 1414 Elba Highway, Troy, 36081.