Analysis

As shown in Table 1 below, the death rate due to stroke has declined since 2004, and it is now the sixth-leading cause of death in Minnesota. As recently as 2010, it was the third-leading cause of death in the state, but has fallen below Accidental Injury, Chronic Obstructive Pulmonary Disease, and Alzheimer’s Disease, all of which have rising death rates. The age-adjusted death rate for stroke for men and women is similar. More women die of stroke than men, but usually at an older age, which explains the similar death rate. Total stroke deaths were lowest in 2009 and have risen slightly in the years since. Chart 1 shows the pattern in total number of deaths and for women (green) and men (blue) since 2009. Even though the number of deaths has increased slightly, death rates have remained relatively stable. This can be explained by our aging population, with the number of older people who are at a risk of dying from stroke also increasing each year.

Table 1: Total Deaths and Death Rate due to Stroke for all Minnesotans and by sex, 2004-2018

Year	Total Number of Deaths	Total Age-Adjusted Death Rate (per 100,000)	Number of Deaths, Females	Age-Adjusted Death Rate (per 100,000 Females)	Number of Deaths, Males	Age-Adjusted Death Rate (per 100,000 Males)
2004	2,540	46.2	1,540	44.1	1,000	48.6
2005	2,372	42.1	1,472	41.2	900	42.3
2006	2,215	39.3	1,356	38.2	859	40.1
2007	2,081	36.2	1,258	34.5	823	37.7
2008	2,087	35.7	1,326	35.9	761	34.6
2009	2,023	34.1	1,244	33.3	779	34.7
2010	2,154	35.8	1,313	35.1	841	36.0
2011	2,145	34.8	1,304	34.4	841	34.6
2012	2,064	32.7	1,223	31.2	841	33.7
2013	2,051	31.7	1,194	29.9	857	33.2
2014	2,172	33.5	1,307	33.3	865	33.1
2015	2,228	33.4	1,291	32.1	937	34.8
2016	2,197	32.5	1,299	31.7	898	32.7
2017	2,248	32.6	1,348	32.7	900	31.9
2018	2,308	32.7	1,343	32.2	965	33.0

Chart 1: Total Deaths due to Stroke for all Minnesotans and by sex, 2004-2018

Despite Minnesota’s overall lower stroke death rate compared to the United States (13% lower in 2018), there are large disparities in the state. As shown in Chart 2 and Table 2, the death rate due to stroke is highest in African-American/African and Asian/Pacific Islander communities in Minnesota and lowest in Hispanic communities. The last column of Table 2 shows a rate ratio, which compares two rates to describe how much one group is impacted compared to another. Any number larger than 1 means that the group of interest is higher than the comparison group. Any number smaller than 1 means the group of interest is lower than the comparison group. African-American/Africans and Asians/Pacific Islanders die from stroke at a rate approximately 40% higher than whites, while stroke death rates for American Indians are 26% higher than for whites. Stroke death rates for Hispanic Minnesotans are 34% lower than for whites.

Chart 2: Death Rate due to Stroke by Race and Ethnicity, 2014-2018

Table 2: Total Deaths and Death Rate due to Stroke by Race and Ethnicity, 2014-2018

Race/Ethnicity	Total Deaths, 2014-2018	Annual Age-Adjusted Death Rate (per 100,000), 2014-2018	Rate Ratio, compared to White
White	10,376	31.9	-
African-American/African	340	44.6	1.40
American Indian	95	40.1	1.26
Asian/Pacific Islander	307	45.0	1.41
Hispanic	93	21.0	0.66

The number of deaths due to stroke increases in older age groups. Table 3 shows the number of deaths and death rate due to stroke over the three most recent five-year time periods. Over that 15 year period, the largest declines in death rates have been for Minnesotans aged 35-44 and 65-84, as shown in Chart 3. For Minnesotans aged 45-64 and 85 and older, the declines have only been about half as large.

Table 3: Total Deaths and Death Rate due to Stroke by Age Group, 2004-2018

Age Group (years)	Number of Deaths 2004-2008	Crude Death Rate (per 100,000), 2004-2008	Number of Deaths, 2009-2013	Crude Death Rate (per 100,000), 2009-2013	Number of Deaths, 2014-2018	Crude Death Rate (per 100,000), 2014-2018	Change over 15 years
35-44	125	3.3	88	2.6	93	2.7	-18%
45-54	382	9.7	343	8.6	305	8.4	-13%
55-64	561	21.0	613	18.8	714	19.4	-8%
65-74	1,179	75.6	1,184	63.3	1,383	58.6	-22%
75-84	3,342	310.0	2,718	243.0	2,907	239.8	-23%
85 and Over	5,631	1,094.3	5,431	985.1	5,688	953.6	-13%

Chart 3: Percent change in Death Rate due to Stroke by Age Group, from 2004-2008 to 2014-2018

There are two main types of stroke. About 80% of stroke events are ischemic strokes which occur when a clot blocks a blood vessel in the brain. A hemorrhagic stroke occurs when a blood vessel ruptures in the brain. A large proportion of death certificates do not specify which type of stroke was the cause of death, so it is difficult to interpret trends in the number of deaths due to the two major types of strokes.

Other Resources

• Minnesota Vital Statistics Interactive Queries
  These data are population based and include all deaths in Minnesota regardless of where the event occurred. Users can group data by cause of death, age, sex, race, ethnicity, county, and year.


• CDC Wonder Online Mortality Database
  These data are population based and include all deaths and allows users to look at multiple causes of death. Users can group data by cause of death, age, sex, race, ethnicity, county, year, and some additional characteristics. Minnesota can be compared against other states.


• Interactive Atlas of Heart Disease & Stroke
  Online mapping tool from CDC with health indicators (including mortality and hospitalizations), risk factors, social and economic data, health care delivery, insurance, and health care costs data for states and counties. Some census tract data is also available.

Data Source

Annual death records from 2004 to the present were obtained from the Minnesota Department of Health Center for Health Statistics.

Measure Definition

Since 1999, stroke deaths are identified as the underlying cause of death on death certificates as ICD-10: I60-I69. This includes ischemic stroke, hemorrhagic stroke, and other cerebrovascular diseases.