First-Ever County Level Report on Stroke Hospitalizations
County-level maps can help identify racial, ethnic and geographic differences
The highest rate of stroke hospitalizations among Medicare beneficiaries exists among African-Americans and in counties located primarily in the southeastern states, according to a new report released by the Centers for Disease Control and Prevention (CDC) in collaboration with the Centers for Medicare and Medicaid Services (CMS).
The report, "Atlas of Stroke Hospitalizations Among Medicare Beneficiaries," also reveals that a significant number of Medicare beneficiaries live in counties that have no access to care or inadequate choices for emergency health care when they suffer a stroke.
The report will be released on March 28 in Washington, D.C. at a town hall meeting hosted by The National Forum for Heart Disease and Stroke Prevention and the National Association of County and City Health Officials (NACCHO).
The atlas provides county-level maps of stroke hospitalizations for African-Americans, Hispanics, and whites ages 65 and older.
Stroke is the third leading cause of death for men and women, and a major cause of serious, long-term disability. The report found that the stroke hospitalization rate for African-Americans was 27 percent higher than for the United States population in general, 30 percent higher than for whites, and 36 percent higher than for Hispanics.
"The atlas highlights that where you live can determine how you live, regarding your ability to take part in activities that reduce your risk of stroke," said Michele Casper, PhD., lead author of the study and an epidemiologist at the CDCâ€™s Division for Heart Disease and Stroke Prevention. "Examples of community conditions that can influence a personâ€™s risk for stroke include the availability of affordable healthy food, safe options for physical activity, access to high quality health care, and anti-smoking legislation and policies."
The atlas shows that approximately 21 percent of counties did not have a hospital at all, 31 percent lacked a hospital with an emergency department, and 77 percent did not have a hospital with neurology services.
"The Stroke Atlas complements nicely CMS' efforts to identify geographic variations in quality of care and cost for Medicare beneficiaries, including variations linked to race and ethnicity," said Barry M. Straube, M.D., CMS chief medical officer and director of the CMS Office of Clinical Standards and Quality. "With this information, we can target our quality initiatives and payment reform proposals to address the variations identified, and focus more attention on the needs of underserved Medicare populations."
For all types of strokes, including those caused by a blockage to a blood vessel in the brain, and those caused by a ruptured blood vessel, the maps show that counties with the highest rates are located primarily in the southeastern states, including Alabama and Louisiana. Among people hospitalized for stroke, Medicare beneficiaries in the southeastern states were also most likely to be diagnosed with high blood pressure or diabetes ? both risk factors for stroke.
"This atlas is a great tool for health professionals at the local, state, and national levels as they design and implement programs to eliminate geographic and racial/ethnic disparities in stroke hospitalizations among Medicare beneficiaries," said Darwin Labarthe, M.D., M.P.H., Ph.D., director, CDC's Division for Heart Disease and Stroke Prevention.
Copies of the atlas are available free from the National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention, N.E., Mail Stop K-47, Atlanta, Georgia 30341-3724 or by calling 1-888-232-2306.
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES