Health Outcomes
Stroke Prevalence by County — US Rankings
CDC PLACES 2023 · Age-adjusted prevalence · All 3,144 US counties
PLACES tracks adults ever told by a doctor they had a stroke. After age adjustment, the highest-prevalence counties form what the CDC has documented for decades as the "Stroke Belt" — a band across the lower Mississippi Delta, central Appalachia, and the rural South. The geographic clustering is real and well-replicated; the causal story behind it is mixed (hypertension, diabetes, smoking, healthcare access). Because the measure is diagnosis-anchored, it tends to underrepresent counties with the least access — residents who survive a small stroke without ever being clinically diagnosed do not show up in BRFSS.
How this ranking is built
Source: CDC PLACES 2023 release. Methodology: BRFSS survey responses pooled across years, fitted with a small-area statistical model, age-adjusted to the 2000 US standard population. Confidence intervals (95%) are shown for each county — wider intervals indicate more uncertainty in the modeled estimate, typically driven by smaller populations.
Lowest Stroke Rates — Top 100 Counties
Counties with the lowest reported stroke prevalence — these counties show the most favorable position on this measure.
Best 100 counties for Stroke.
Highest Stroke Rates — Bottom 100 CountiesCounties with the highest reported stroke prevalence.
Worst 100 counties for Stroke.
What this ranking suggests
Stroke prevalence is the long-tail outcome of decades of cardiovascular risk-factor exposure and unequal access to acute care. Read this ranking alongside the BPHIGH, DIABETES, and CSMOKING rankings — the four together produce the cleanest cardiovascular profile available at this geography.
Methodology notes & limitations
Estimates are statistical model outputs, not direct measurements. Small counties have wider confidence intervals; treat narrow rank differences in those rows as within-noise. Counties where the underlying population is too small to support modeling are suppressed entirely (about 1% of US counties). All measures are age-adjusted to the 2000 US standard population. The PLACES dataset uses BRFSS self-reported data — self-report introduces known direction-of-bias in some measures (BMI is under-reported; binge drinking is under-reported), but the bias is roughly uniform across counties so ranking comparability is preserved. See the methodology page for full data-pipeline documentation.
Data source: CDC PLACES 2023 release. Measure ID: STROKE.