Census Tract Level Analysis of Stroke Burden and Social Vulnerability Index in Mississippi: Implications for Health Equity Policy

Stroke remains a leading cause of death and disability in Mississippi, accounting for approximately 1,844 deaths annually and substantial health care costs. Persistent geographical and racial disparities, driven by SDOH, contribute to an unequal burden. The publicly available CDC PLACES dataset and the CDC/ATSDR Social Vulnerability Index (SVI) provide opportunities to examine geographic disparities and identify communities at the greatest risk. An ecological analysis was conducted across 870 Mississippi census tracts (∼2.28 million adults) using CDC PLACES 2022 stroke prevalence estimates and SVI 2022 data across all four thematic domains. Stroke prevalence was categorized as low (0.7-3.8%, n = 225), moderate (3.9-5.9%, n = 433), or high (6.0-11.6%, n = 212). Spearman's rank correlation and bivariate choropleth mapping were used to assess associations between stroke burden and social vulnerability and their geographic concordance. An estimated 109,348 Mississippi adults have experienced a stroke, with 33,167 (30%) residing in highly vulnerable tracts. Stroke prevalence correlated strongly with overall SVI (ρ = 0.74), socioeconomic status (ρ = 0.75), and minority status (ρ = 0.60; all P < 0.0001). High-prevalence tracts showed extreme social vulnerability (median overall SVI = 0.82; socioeconomic SVI = 0.85), substantially higher poverty (50% vs. 15%), and predominantly minority populations (78% vs. 27%) compared with low-prevalence tracts. High-burden clusters were concentrated in the Mississippi Delta and central corridor, while Gulf Coast tracts showed comparatively lower prevalence. Stroke prevalence and social vulnerability are strongly and spatially co-patterned across Mississippi census tracts. Routinely updated CDC datasets provide actionable tools for identifying high-risk communities and guiding equity-focused stroke prevention that addresses social determinants alongside clinical risk factors.