•During 2010-2013, the age-adjusted stroke death rate for non-Hispanic black men aged 45 and over (154.8 deaths per 100,000 population) was 54% to 68% higher than the rates for men of the same age in other race-ethnicity groups. The rate for non-Hispanic black women aged 45 and over was 30% to 61% higher than the rates for women of the same age in other race-ethnicity groups. •The age distribution of stroke deaths differed by race and ethnicity. •Stroke death rates were 32% higher in counties in the lowest median household income quartile than in counties in the highest income quartile. •Nonmetropolitan counties had higher stroke death rates than counties at other urbanization levels. •Stroke mortality inside and outside the Stroke Belt differed by race and ethnicity.
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