For more than 40 years, studies have shown that more adults in the Southeast die from strokes than anywhere else in the country, earning the region the unfortunate name the Stroke Belt. Scientists have guessed that adults born and raised in the Southeast might be at higher risk for stroke because of the prevalence of obesity, hypertension, diabetes, and other stroke risks, but a new study on children by a group of researchers from the University of California–San Francisco is causing them to rethink those ideas.

What the researchers to know: Are strokes more prevalent among children in the Southeast than in the rest of the United States?

What they did: The researchers used a database that tallies up the causes of death for people from all around the country. They compared children and adults from the southeastern states (Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia) to similar groups around the country.

What they found: Children who live in the Stroke Belt states are 21 percent more likely to die from stroke than children living in other parts of the country. For adults, the risk is similar–adults are 20 percent more likely to die from stroke than their counterparts in other states. Black children had a slightly higher mortality rate than white children all over the country, and in both races the risk increased for children living in the Stroke Belt.

What it means to you: Doctors have guessed that strokes may be more common in the Southeast because certain health problems known to cause strokes are more common there. However, those problems do not appear to cause childhood strokes, so the increased risk among children in the Southeast may force doctors to come up with another explanation for the Stroke Belt phenomenon. New candidates include environmental factors, quality of healthcare, poverty level, or genetic susceptibility.

Caveats: Because the authors used only death certificates, they could not determine the exact circumstances of death in each case. In addition, death certificates are sometimes wrong, though there's no reason to believe they are more often wrong in one region of the country.

Find out more: There is an organization that deals with the special issues of the Stoke Belt. Their website is www.strokebelt.org.

Read the article: Fullerton, H.J., Elkins, J.S., and S.C. Johnston. "Pediatric Stroke Belt: Geographic Variation in Stroke Mortality in U.S. Children." Stroke. July 2004, Vol. 35, No. 7. pp. 1570-1673.

Abstract online: http://stroke.ahajournals.org