Identification of stroke risk factors in the adult population in the Texas and New Mexico border region: A GIS and statistical approach
Stroke is one of the leading causes of death among adults. Annually, an approximated 800,000 adults will suffer a stroke, and one victim will die every four minutes. In El Paso County and Dona Ana County it is estimated that the age-adjusted prevalence is 2.9% and 3.4% respectively. Little is known about the percentage of adults at risk for stroke in this border region. In this secondary analysis of a cross-sectional study conducted by the Far West Texas and Southern New Mexico Regional Advisory Council on Trauma and Emergency Healthcare (Border RAC), over 900 participants in these counties and rural areas were screened (6 sites in Texas and 4 in New Mexico). The participants over the age of 18 were assessed for blood pressure, risk for diabetes, and personal lifestyle risk factors. Data collected were analyzed to determine the percentage of adults living in the El Paso and Dona Ana County who are at risk for stroke. Additionally, the results were layered onto a Paso del Norte GIS map and United states map, in order to highlight the determined risk of areas (zip codes) in this border region, and their proximity to primary stroke centers were measured using GIS software. A total of 959 eligible participants were identified, of which 60.4% identified as being female. Most participants were between the ages of 36-45 (20.9%) and 46-55 (22.6%), and 56-65 (17.0%). The majority of the participants reported being Hispanic (47.2%) followed by non-Hispanic white (18.0%). Also, 87 different zip codes were identified in the analysis, and of those only nine zip codes had 25 or more participants. Evaluation of the participant response to the diabetes risk assessment revealed that over 47% of participant were at high risk for diabetes, and only 12.2% of participants were at low risk. Similarly, 39% of the participants were found to be at high risk for stroke, 30.3% were at medium risk, and 26.6% were found to be at low risk. A statistically significant difference was found between stroke risk factors (diabetes risk, blood pressure, and family history) and age and zip code. There was a difference between stroke risk across the different age groups and zip codes, x2(6) = 49.621, p < 0.001 and x2(8) = 42.438, p < 0.001 respectively. There is a statistically significant difference in stroke risk level in Sierra County, New Mexico and Culberson County, Texas rural areas, (Cramer's V = 0.283, p < 0.001). Additionally, each rural area had similar rates of stroke as urban areas of the same state. GIS analysis showed that Culberson County and Sierra County had the furthest distance to the closest primary stroke center, 112.12 miles, and 76.72 miles respectively. Multiple risk factors known to increase stroke risk exist within the border land region which may contribute to the risk of stroke risk across age groups and area of residence. The implications of these findings can aide community, organizational, and political leaders to develop interventions and programs to educate and intervene individuals at risk and overall reduce the incidence of stroke in this border region.^
Health Sciences, Public Health
Rondeau, Nancy Ulloa, "Identification of stroke risk factors in the adult population in the Texas and New Mexico border region: A GIS and statistical approach" (2014). ETD Collection for University of Texas, El Paso. AAI1583948.