Table 1.

Ten hypotheses about the causes of mortality in the Stroke Belt, ranging from ‘unlikely’ to ‘uninvestigated’ causes

Racial differences

Coding of death certificates

Socioeconomic status differences

Quality of health care

Stroke fatality, rather than stroke incidence, is elevated

Prevalence of stroke risk factors (e.g. hypertension, diabetes)

Environmental factors associated with geography (e.g. air temperature, exposure to local toxins)

Lifestyle choices (e.g. smoking, diet)

Genetic factors

Infection rates

Adapted from Howard [6].