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Death rates associated with strokes are declining, but lifestyle differences and socioeconomic forces are keeping people in Southern states more susceptible to strokes, researchers emphasize in newly released findings.

Data collected between 2006 and 2010 find that stroke prevalence has changed little in the last four years, with Georgia and South Dakota reporting significant decreases, according to a Centers for Disease Control and Prevention report. Higher stroke rates in Southern states are tied to higher rates of obesity, smoking and hypertension, the report states.

States with the highest stroke rates are: South Carolina, Alabama, Mississippi, Louisiana, Arkansas, Oklahoma, Tennessee, Kentucky, Missouri and Nevada. Upper Midwestern states fared better.

“The disparities in stroke prevalence by age, race and education continue to highlight the importance of stroke in certain segments of our population who need more intensive stroke prevention and treatment efforts,” neurologist Ralph Sacco M.D., told HealthDay News.

The findings were published in the May 25 issue of the CDC’s Morbidity and Mortality Weekly Report.