A new report from the federal Centers for Disease Control and Prevention says stroke is the third leading cause of death in Missouri and the state ranks 18th nationwide in the mortality rate from strokes. Michael Dietz with the State Health Department says high rates of smoking and hypertension among Missourians contribute to our higher-than-average stroke mortality rate. Plus, unequal availability to health care contributes to even higher rates in some parts of the state. Such as the counties in the Bootheel and Southeast Missouri, where there might be only one hospital or doctor in the entire county. Dietz says that adds to the response time to a victim of stroke and limits the amount of access to preventive care.