Lackland, Daniel TRoccella, Edward JDeutsch, Anne FFornage, MyriamGeorge, Mary GHoward, GeorgeKissela, Brett MKittner, Steven JLichtman, Judith HLisabeth, Lynda DSchwamm, Lee HSmith, Eric ETowfighi, Amytis,2020-02-072020-02-072013-12-24http://dx.doi.org/10.1161/01.str.0000437068.30550.cfhttps://lib.digitalsquare.io/xmlui/handle/123456789/15427Stroke mortality has been declining since the early 20th century The reasons for this are not completely understood although the decline is welcome As a result of recent striking and more accelerated decreases in stroke mortality stroke has fallen from the third to the fourth leading cause of death in the United States This has prompted a detailed assessment of the factors associated with the change in stroke risk and mortality This statement considers the evidence for factors that have contributed to the decline and how they can be used in the design of future interventions for this major public health burden