Regional variation in stroke mortality in Wisconsin, 1989-1998

Objective: To evaluate the regional variation in stroke mortality and determine the level of excess stroke mortality in Wisconsin over the period 1989-1998. Methods: Wisconsin stroke mortality (ICD-9 430-438) data from the Center for Disease Control and Prevention (CDC WONDER) were analyzed by county for the period 1989-1998 using indirect age standardization. Results: Estimates of observed and excess number of deaths associated with cerebrovascular disease in Wisconsin varied considerably by county during the 10-year time frame studied. Twenty-five counties had an observed number of stroke deaths that were statistically significantly different from what was expected given the age structure of their population. Of these, 14 had significantly more deaths than expected while 11 had significantly fewer. Discussion: There is substantial variation in stroke mortality between Wisconsin counties. Potential reasons for regional variation are unknown and warrant further research. This paper may give Wisconsin counties a benchmark of their progress in preventing stroke mortality to date and give direction for future public health efforts.