Stroke (also known as cerebrovascular disease) is the third leading cause of death in the U.S. with about 140,000 people dying each year due to the disease.

While stroke can affect anyone, it has long been established that residents of Southeastern states are more likely to die from stroke than residents of other states. The region is commonly referred to as the “Stroke Belt” and it comprises Alabama, Arkansas, Georgia, Mississippi, North Carolina, South Carolina, and Tennessee.

No one reason is thought to explain the high risks, but several factors contribute to the problem. One reason might be the diet, as people in the region are known to consume more fried and high-fat foods. Another reason might relate to poverty and malnutrition in previous generations, resulting in poor prenatal care and low birth weights. And yet another reason might be the rural aspect of the area, resulting in residents not having close access to emergency medical care.

A new study published in the current issue of the journal Neurology analyzed adult death rates over 20 years, by state of birth and state of residence. There were four groups of adults in the study:

  • those born and living in the Stroke Belt
  • those born in the Stroke Belt but living elsewhere
  • those born elsewhere but living in the Stroke Belt
  • those born elsewhere and living elsewhere

Not surprisingly, people who were born in the Southeast and who continued to live there were 34% more likely than other groups to die of a stroke. However, even moving away from the region does not eliminate the risks. The results show that those who were born in Stroke Belt states but moved to live in other states were still at a higher risk of death than those who never lived in the region. The increased risk was 20% for whites and 9% for African-Americans.

While the study has important implications for people who were born in the Southeast, it doesn’t offer much explanation to the reason behind the findings. The risk of dying from stroke seems to be established early in life, and seems to be carried around even when Southeasterners move to other states. But the study’s lead author says that it is a real mystery, and admits that “we don’t know exactly what is going on that’s affecting people so broadly.”