SPATIAL-DISTRIBUTION OF STROKE MORTALITY IN SPAIN, 1975-1986

Cerebrovascular diseases (CVDs) constitute the most frequent cause of death in Spain. In order to identify the geographical pattern of CVD m ortality, age- and sex-specific as well as age-adjusted mortality rate s (ICD-8,9 rubrics 430-438) were calculated for the period 1975-1986 f or each province in the country. Maps were constructed after categoriz ation of mortality rates by quintile levels. In general, the geographi cal pattern was similar for the different age and sex strata. While mo st provinces in the northern half presented low or medium mortality, g eographical areas located in the south, displayed rates in the uppermo st quintiles. These results suggest that the spatial distribution of C VD mortality in Spain is not random and that the potential determinant s underlying this geographical distribution, such as type of stroke, i ncidence, fatality, diagnostic or certification practices and competin g causes of death, have an impact that is independent of age and sex a nd strongly associated with spatial location. Furthermore, these resul ts can help in identifying high-risk populations.