Closeup of hands of a senior stroke patient getting support from a medical professional.

States with the highest stroke death rate

Written by:
July 19, 2022
Lighthunter // Shutterstock

States with the highest stroke death rate

The stroke death rate has increased worldwide over the last two decades, remaining the second leading cause of death globally as of 2019 and the fifth in the U.S. While the number of Americans over 75 having strokes has decreased, they have become more prevalent among adults under 50; in the U.S., someone has a stroke every 40 seconds. The incidence of stroke and stroke-related death does not impact all Americans equally, however.

Since 1940, the southeastern region of the U.S. has experienced notably higher stroke death rates than the rest of the country, earning the region a grim nickname: the Stroke Belt. States in the Stroke Belt—which include Mississippi, the Carolinas, Tennessee, Arkansas, Georgia, Alabama, and Louisiana—have a stroke mortality rate at least 10% higher than the national rate. While this region of the U.S. has higher rates of risk factors associated with stroke—like high blood pressure and diabetes—the higher mortality rate is still not completely understood.

Stroke death rate disparities among Americans are not only geographic, but also racial. As of 2017, Black Americans made up 26% of the population of the Stroke Belt, as opposed to 10% of the national population overall. But the stroke death rate for Black Americans is significantly higher than for white Americans, particularly in the Stroke Belt. While higher rates of risk factors such as diabetes account for some of this large disparity, research increasingly shows that issues like economic hardship, less access to health care, and lower educational attainment among Black Americans—issues linked to systemic racism—produce worse health outcomes.

Stroke symptoms can also differ between people. According to the American Heart Association, common signs of stroke in the general population include numbness in the face or limbs, trouble speaking, and sudden vision problems. But those assigned female at birth can experience more subtle and less well-known symptoms, such as weakness, disorientation, and nausea or vomiting. Pregnancy (particularly in the third trimester), taking birth control pills, and smoking have been shown to increase the risk of stroke.

Stacker collected information from the Centers for Disease Control and Prevention's Interactive Atlas of Heart Disease and Stroke to find the states with the highest prevalence of stroke deaths. The data is an age-standardized death rate per 100,000 residents between 2018 and 2020 for all genders, races/ethnicities, and ages. The CDC collects information on stroke deaths from their mortality data, looking at a group of International Classification of Diseases codes related to stroke. Age-standardized means different age groups are weighted differently to account for the difference in occurrences between age groups. This allows states with different age distributions to be compared equally to one another.

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Busy streets of New York City.
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#50. New York

- Stroke deaths per 100K people: 24.3

Aerial view of Boston, Massachusetts.
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#49. Massachusetts

- Stroke deaths per 100K people: 26.1

A red fishing boat on the water in front of homes.
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#48. Rhode Island

- Stroke deaths per 100K people: 27.2

Pastel blue and green buildings on the water in New Haven, Connecticut.
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#47. Connecticut

- Stroke deaths per 100K people: 27.4

Homes and buildings from the water in New Hampshire.
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#46. New Hampshire

- Stroke deaths per 100K people: 28.5

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Aerial view of Rutland, Vermont.
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#45. Vermont

- Stroke deaths per 100K people: 29.2

Missoula from Mount Sentinel.
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#44. Montana

- Stroke deaths per 100K people: 30

Atlantic City boardwalk shops and people.
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#43. New Jersey

- Stroke deaths per 100K people: 30.6

Aerial view of Scottsdale, Arizona with palm trees in the foreground.
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#42. Arizona

- Stroke deaths per 100K people: 31.3

Casper, Wyoming with snowy mountains in the distance.
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#41. Wyoming

- Stroke deaths per 100K people: 31.5

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Des Moines, Iowa skyline.
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#40. Iowa

- Stroke deaths per 100K people: 32.3

Downtown Minneapolis, Minnesota skyline.
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#39. Minnesota

- Stroke deaths per 100K people: 32.4

Fargo, North Dakota skyline.
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#38. North Dakota

- Stroke deaths per 100K people: 32.6

Sailboats on the Maine coast.
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#37. Maine

- Stroke deaths per 100K people: 32.7

A bridge and waterway going through Omaha, Nebraska.
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#36. Nebraska

- Stroke deaths per 100K people: 33

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A quiet street in Santa Fe, New Mexico at dusk.
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#35. New Mexico

- Stroke deaths per 100K people: 33.2

Busy street of bars and restaurants in Deadwood, South Dakota.
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#34. South Dakota

- Stroke deaths per 100K people: 33.7

Downtown Madison, Wisconsin with water on both sides.
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#33. Wisconsin

- Stroke deaths per 100K people: 34

Aerial view of Seattle, Washington near the space needle.
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#32. Washington

- Stroke deaths per 100K people: 34.6

Buildings in Telluride, Colorado with snow all around and mountains in the background.
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#31. Colorado

- Stroke deaths per 100K people: 34.8

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Colorful buildings at dusk in Ogden, Utah with snow-capped mountains in the distance.
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#30. Utah

- Stroke deaths per 100K people: 35

Aerial view of downtown Wichita, Kansas.
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#29. Kansas (tie)

- Stroke deaths per 100K people: 35.8

Historic brick buildings in Philadelphia, Pennsylvania.
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#29. Pennsylvania (tie)

- Stroke deaths per 100K people: 35.8

Busy street leading up to the Boise, Idaho Capitol.
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#27. Idaho

- Stroke deaths per 100K people: 35.9

Two people under the green northern lights in Alaska.
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#26. Alaska

- Stroke deaths per 100K people: 36.2

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People at the beach in Hawaii.
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#25. Hawaii

- Stroke deaths per 100K people: 37.6

Busy street in Hollywood, California.
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#24. California

- Stroke deaths per 100K people: 37.8

Downtown Reno, NV against an orange and pink sunset.
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#23. Nevada

- Stroke deaths per 100K people: 38.3

Several bridges crossing the Potomac River to Harper's Ferry, West Virginia.
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#22. West Virginia

- Stroke deaths per 100K people: 38.5

View of downtown Kansas City, Missouri from a high peak.
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#21. Missouri

- Stroke deaths per 100K people: 38.9

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A Fredericksburg, Virginia sunrise aerial.
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#20. Virginia

- Stroke deaths per 100K people: 39

Portland, Oregon from above with mountains in the background.
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#19. Oregon

- Stroke deaths per 100K people: 39.3

The bean landmark crowded with people in Chicago.
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#18. Illinois

- Stroke deaths per 100K people: 39.5

Busy restaurants and bars on a waterway in Oklahoma City, Oklahoma.
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#17. Oklahoma

- Stroke deaths per 100K people: 39.9

Aerial view of Austin, Texas.
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#16. Texas

- Stroke deaths per 100K people: 40.1

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Indianapolis, Indiana from the river.
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#15. Indiana

- Stroke deaths per 100K people: 40.4

Boardwalk to the water lined with palm trees.
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#14. Florida (tie)

- Stroke deaths per 100K people: 41.2

Aerial view of buildings and water in Traverse City, Michigan.
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#14. Michigan (tie)

- Stroke deaths per 100K people: 41.2

Ocean City, Maryland from the air.
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#12. Maryland

- Stroke deaths per 100K people: 41.5

Little Rock, Arkansas from across the bridge.
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#11. Arkansas

- Stroke deaths per 100K people: 41.9

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Rural Kentucky homes.
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#10. Kentucky

- Stroke deaths per 100K people: 42.1

Downtown Charlotte, North Carolina.
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#9. North Carolina

- Stroke deaths per 100K people: 42.4

Atlanta, Georgia skyline.
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#8. Georgia

- Stroke deaths per 100K people: 42.7

Gatlinburg, Tennessee from the air.
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#7. Tennessee

- Stroke deaths per 100K people: 43

Downtown Cleveland, Ohio.
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#6. Ohio

- Stroke deaths per 100K people: 43.4

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Downtown Columbia, South Carolina skyline aerial.
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#5. South Carolina

- Stroke deaths per 100K people: 43.7

Boats on the water in New Orleans, Louisiana and downtown in the background.
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#4. Louisiana

- Stroke deaths per 100K people: 45.8

Aerial view of water and buildings in Wilmington, Delaware.
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#3. Delaware

- Stroke deaths per 100K people: 48.1

Aerial view of Mobile, Alabama skyline.
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#2. Alabama

- Stroke deaths per 100K people: 52.5

Downtown Jackson, Mississippi.
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#1. Mississippi

- Stroke deaths per 100K people: 52.8

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