stroke belt
n. An area in the southeastern United States, particularly the states of South Carolina, Arkansas, Tennessee, North Carolina and Georgia, that has an unusually high rate of strokes and other forms of heart disease.
Geographic disparities in stroke mortality have been charted for decades. The term "stroke belt" was coined to describe the higher rate for men, women, blacks and whites in the southeastern United States. Researchers once thought geography held the answer, theorizing the South might have different chemicals, both good and bad, in its water, soil and air. But over the past 25 years, high stroke rates in counties in North Carolina, South Carolina and Georgia have shifted. New concentrations of stroke deaths appeared in counties in Mississippi, Arkansas and North Florida.

Researchers now suspect socioeconomic conditions, availability of health care and migration patterns are much more important than once thought.
—Susan Aschoff, “Mapping out stroke deaths,” St. Petersburg Times, March 18, 2003
1983 (earliest)
Three physicians from China traveled to America's southeastern coastal plains to get a country doctor's views on a problem they all encounter in their work — unusually high rates of cardiovascular disease.

Forms of the disease are high in China's Kishan Province — and in the flat coastal lands of North Carolina and South Carolina. …

Until a few years ago, adolescents and young women in Kishan Province died at alarming rates from Kishan's Disease, which causes congestive heart failure and pulmonary edema.

People in the province, as well as the "stroke belt" of Georgia and the Carolinas, have an unusually low level of the trace element selenium in their diets, Hames told his visitors.
—“Study Heart Disease In Georgia, Carolinas,” The Associated Press, March 22, 1983
The Centers for Disease Control recently released a report called the "Atlas of Stroke Mortality" which breaks down stroke deaths in the U.S. by state, country, race, and ethnic group. When the state deaths are graphed on a map, you see a striking grouping in the southeast, encompassing the five states that I mention in the definition, which have the five worst rates of stroke death. This geographical proximity has earned these states the label stroke belt, which is modeled on similar constructions such as sun belt (1969) and snow belt (1874).

Here are the ten states with the worst rates, measured in deaths per 100,000 people (the ranking begins at 35 — which represents the state with the highest rate — because some states were tied):

35. South Carolina - 169
34. Arkansas - 163
33. Tennessee - 156
32. North Carolina - 155
31. Georgia - 146
31. Oregon - 146
30. Mississippi - 140
29. Indiana - 138
28. Virginia - 137
27. Alabama - 135

Here are the ten states with the lowest rates of stroke deaths:

1. New York - 89
2. Maryland - 100
3. New Jersey - 101
4. Florida - 102
5. Connecticut - 105
6. New Mexico - 105
7. Delaware - 107
8. Arizona - 108
9. Maine - 111
10. Colorado - 110