The progression of maps display the age-adjusted stroke death rates by county per 100,000 residents in New York State (NYS) and are presented by 3 year combined increments. The maps show the concentrations of counties with the highest stroke death rates are located primarily in the northern, central, and western counties of the state, while the lowest concentration of stroke deaths are predominantly in the counties closer to New York City and the eastern half of the state. The statewide stroke death rate decreased from 28.0 in 2007-2009 to 26.1 in 2013-1015. In 2014, stroke was the 4th leading cause of death in NYS. Comparatively, the stroke death rate in 2014 was 36.5 and the 5th leading cause of death in the United States.