626 From the Stroke Belt to San Francisco: Racial Disparities in Stroke Persist

Abstract

INTRODUCTION: Racial disparities in stroke are classically observed in geographical areas carrying the greatest stroke burden and mortality, namely the Stroke Belt region of the Southeastern U.S. In these territories, African Americans experience a substantially greater stroke incidence than Caucasians, however there is a paucity of in-depth analyses for regions of vastly different demographic variation and socioeconomic profile. The authors seek to determine if the same disparity exists in the surrounding counties of the San Francisco Bay Area. METHODS: A county-specific search of the CDC Interactive Atlas of Heart Disease and Stroke was conducted for seventeen Bay Area counties (2017-2019) using stroke hospitalization rates by race, population counts, race distribution, and percent aged ≥65. Percent estimates of the racial distribution of IS and HS hospitalizations were calculated. The probability of Black racial identity and IS was estimated to observe the relationship between population distribution across counties and the likelihood of IS hospitalization among Blacks. RESULTS: Stroke hospitalization rates among Blacks/African Americans averaged 10.67 per 1000 for IS (95% CI [10.01, 11.32]), 2.19 for HS (95% CI [1.96, 2.42]); average rates among whites/Caucasians were 7.04 (95% CI [6.64, 7.45]) and 1.37 (95% CI [1.30, 1.43]), respectively. While the probability of Black racial identity and IS hospitalization was expectedly higher in counties with a larger Black population, it was disproportionate in counties like Alameda and Sacramento. CONCLUSIONS: Examination of CDC data revealed a 1.5-fold greater disparity in stroke hospitalization rates among African Americans in the San Francisco Bay Area, indicating a persistence of established racial disparities in other parts of the country. Further analysis of socioeconomic data by county and regional comparisons are necessary to uncover the mechanisms of racial disparity in stroke.