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American Journal of Epidemiology Vol. 147, No. 3: 259-268
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Stroke Incidence among White, Black, and Hispanic Residents of an Urban Community
The Northern Manhattan Stroke Study
1Gertrude H. Sergievsky Center, School of Public Health, Columbia University New York, NY
2Department of Neurology, College of Physicians and Surgeons, Columbia University New York, NY
3Division of Epidemiology, School of Public Health, Columbia University New York, NY
4Division of Biostatistics, School of Public Health, Columbia University New York, NY
5Department of Medicine, Division of General Medicine, College of Physicians and Surgeons, Columbia University New York, NY
Stroke mortality is reported to be greater in blacks than in whites, but stroke incidence data for blacks and Hispanics are sparse. The aim of this study was to determine and compare stroke incidence rates among whites, blacks, and Hispanics living in the same urban community. A population-based incidence study was conducted to identify all cases of first stroke occurring in northern Manhattan, New York City, between July 1, 1993, and June 30, 1996. The population of this area was approximately 210, 000 at that time, based on 1990 US Census data. Surveillance for hospitalized and nonhospitalized stroke consisted of daily screening of all admissions, discharges, and computed tomography logs at Columbia-Presbyterian Medical Center, the only hospital in the region, and review of discharge lists from outside hospitals, telephone surveys of random households, and contacts with community physicians, Visiting Nurses' Services, and community agencies. Stroke incidence increased with age and was greater in men than in women. The average annual age-adjusted stroke incidence rate at age 
20 years, per 100, 000 population, was 223 for blacks, 196 for Hispanics, and 93 for whites. Blacks had a 2.4-fold and Hispanics a twofold increase in stroke incidence compared with whites. Cerebral infarct accounted for 77 percent of all strokes, intracerebral hemorrhage for 17 percent, and subarachnoid hemorrhage for 6 percent. These data from the Northern Manhattan Stroke Study suggest that part of the reported excess stroke mortality among blacks in the United States may be a reflection of racial/ethnic differences in stroke incidence. Am J Epidemiol 1998; 147: 259–68.
blacks; cerebrovascular disorders; ethnic groups; Hispanic Americans; racial stocks
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