Race, gender and stroke subtypes mortality in Sao Paulo, Brazil

Stroke mortality rates have a discrepant distribution according to socioeconomic variables as social exclusion in Brazil. Recently, data from race has been available from the official health statistics considering five categories: White, Mixed, Black, Asian and Native. We addressed in the city of Sao Paulo, Brazil, an analysis of cerebrovascular mortality according to race (excluding Asian and Native due to small number of events) and gender during 1999-2001 for people aged 30 to 79 years-old. For all cerebrovascular diseases, age-adjusted mortality rates (x 100,000) for men were higher for Black (150.2), intermediate for Mixed (124.2) and lower for White (104.5) people. These gradient patterns were similar for all stroke subtypes, except for subarachnoideal hemorrhage in which no differences were detected. For women, the rates were lower compared to men and the same pattern was observed among Black (125.4), Mixed (88.5) and White (64.1) women. Compared to White men, the risk ratio of Black men was 1.4. However, compared to White women, the risk ratio for Black women was 2.0. Concluding, there is a significant gradient of stroke mortality according to race, mainly among women.