"Our results cannot pinpoint a specific explanation, but they are consistent with other research suggesting that the roots of stroke risk begin in childhood or even infancy. Efforts to reduce the incidence of fatal stroke may need to consider how underlying physiologic changes accumulate from early life. It is possible that where one lives affects stroke risk through socioeconomic conditions, social stressors, environmental factors, or access to preventive medical care," said study author M. Maria Glymour, ScD, with Harvard School of Public Health in Boston.

"Many important behaviors such as diet, physical activity, and smoking are shaped by childhood social conditions. Future long-term national studies with detailed information on when people moved are needed to help show whether those who move may have different patterns of risk factors and also identify more precisely at what point in life stroke risk begins to build. This will help us understand how to reduce stroke for people living in every region of the country," Glymour said.

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