All ETDs from UAB

Advisory Committee Chair

Leslie A McClure

Advisory Committee Members

Mohammad Z Al-Hamdan

Gustavo De Los Campos

George Howard

Monika M Safford

Document Type

Dissertation

Date of Award

2015

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

Stroke mortality rates are highest in the Southeast US, and the cause for this "Stroke Belt" is not well understood. We investigate the spatial distribution of hypertension, an important risk factor for stroke. This investigation explores statistical issues in performing spatial analysis in a large cohort (over 30,000 participants), relating to type 1 error rate control and geocoding error. Recommendations for handling these statistical issues are made. In an applied analysis, we find that hypertension prevalence varies across the continental US, and is highest in northeast Louisiana, southeast Arkansas, west Mississippi, and east Michigan. These areas are not concordant with the areas that have the highest stroke mortality rates (coastal planes of North Carolina, South Carolina, and Georgia). We recommend further investigation of the spatial distribution of other risk factors for cerebrovascular disease in order to understand the causes for the Stroke Belt.

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