RELATED: If You Can See This, Your Stroke Risk Skyrockets, Study Says. The Stroke Belt, also known as Stroke Alley, is a large region of the Southeastern U.S. with abnormally high stroke rates and stroke mortality compared with the rest of the country. First identified in the early ’60s by the Centers for Disease Control and Prevention (CDC), experts now say that people who live in the Stroke Belt are at a 15 percent higher risk of having a stroke compared with the broader U.S. population. The statistics appear to be even more stark when you consider stroke mortality, or your risk of dying from stroke. A 2009 study from the University of Alabama at Birmingham (UAB) concluded that if you live in one of eight stroke belt states, your risk of stroke mortality is more than 40 percent higher than if you live elsewhere in America. These states are Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee. Three states often considered Stroke Belt states—Indiana, Kentucky, and Virginia—were not included in the study. RELATED: Drinking This Once a Day Can Triple Your Stroke Risk, Study Finds. Though health authorities have been aware of heightened stroke risk and mortality in this region for roughly 70 years, researchers are still working to understand the reason for the disparity. “Intensive investigation has been focused on developing a better understanding of the reasons for these disparities, including evaluating factors such as regional differences in race/ethnicity, poverty, access to care, case fatality rates, vascular risk factor prevalence, environmental factors, genetic factors, and epidemiological surveillance methods,” explains a 2015 study published in the medical journal Stroke.ae0fcc31ae342fd3a1346ebb1f342fcb “We found geographic and racial differences are useful in predicting stroke risk, but they only explain less than half the picture. Something else is happening,” George Howard, DrPH, professor of biostatistics in UAB’s School of Public Health and an author of the UAB study, said via press release. “It could be exposure to allergens in the home, it could be micronutrients in drinking water or it could be other factors considered ’non-traditional’ because they don’t fall into the list of nine factors commonly used to predict stroke risk,” he said. Stroke Belt states are also known to have higher rates of diabetes and hypertension—two factors that could heighten your risk of having a stroke, as well as your stroke mortality. This may mean that certain interventions which target those two conditions could reduce the geographic disparity and improve outcomes for those who do suffer stroke. Howard suggests that increased screening rates and enhanced follow-up care could lower rates of stroke death in the region. Changes in lifestyle such as dietary improvements, more frequent exercise, and quitting smoking could similarly improve stroke rates in the area. For more health news sent directly to your inbox, sign up for our daily newsletter. In addition to heightened stroke risk, those who live in the region are also more likely to experience cognitive decline as they age, studies show. A separate 2011 study led by Howard, which was published in the Annals of Neurology, found that those living in the stroke belt more frequently demonstrated signs of cognitive decline over a four year study window compared with residents of 40 non-Stroke Belt states. Researchers have not yet determined whether the higher rates of cognitive decline are caused by stroke, or by shared underlying risk factors. However, Howard told The New York Times, who reported on the findings, that some of the study subjects could have suffered from what he called “undiagnosed teeny-weeny strokes,” which could have cognitive effects. Either way, experts say that by taking measures to reduce your risk of stroke, you may also be able to prevent cognitive decline. RELATED: Half of People Who Have a Stroke Notice This a Week Earlier, Study Says.