An analysis of recent patterns of stroke hospitalization in South Carolina found that the stroke hospitalization rate has risen for black adults younger than 65 years, but not for other populations.
The pattern “results in a severe and persistent racial disparity,” Andrea D. Boan, PhD, MCSR, from the Medical University of South Carolina Stroke Center, and colleagues wrote. “It highlights the urgent need for a racial disparity reduction in the younger population to alleviate the health care burden.”
The researchers identified patients from the South Carolina State Inpatient Hospital Discharge Database who were discharged with a primary diagnosis of stroke from 2001 to 2010. They analyzed age- and race-stroke–specific hospitalization rates, hospital charges including those associated with racial disparity and race-stratified 30-day stroke mortality rates.
South Carolina is one of three states, along with North Carolina and Georgia, referred to as “the buckle of the stroke belt” for high rates of stroke incidence and mortality, according to the study background.
Of 84,179 stroke hospitalizations during the study period, 37% were from patients younger than 65 years and 35.5% were from black patients.
From 2001 to 2010, stroke hospitalization rates decreased for black and white patients aged at least 65 years (P<.001) but increased for those younger than 65 years (P=.004). However, the increase in the stroke hospitalization rate for patients younger than 65 years was driven by a 17.3% increase among black patients of that age (P=.001); there was no difference among white patients of the same age (P=.84), according to the abstract.
Hospital charges during the study period totaled $2.77 billion, with 16.4% attributed to higher age-adjusted hospitalization rates for blacks compared with whites; of that disparity, 79.6% arose from patients younger than 65 years, according to the researchers.
The 30-day stroke mortality rate declined from 16.5% in 2001 to 15.1% in 2010 (P<.001) and was not associated with any pattern of racial disparity.
“The higher prevalence of stroke risk factors, including hypertension, [type 2 diabetes] and smoking, in young/middle-aged blacks is perhaps the most important contributing factors for the excess strokes in the black population,” Boan and colleagues concluded.
Disclosure: The researchers report no relevant financial disclosures.