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Complete Health Indicator Report of Stroke (Cerebrovascular Disease) Deaths

Definition

The rate of stroke deaths (ICD-10 codes I60-I69 as the underlying cause of death) per 100,000 population.

Numerator

The number of deaths due to stroke (ICD-10 codes I60-I69 as the underlying cause of death) in a calendar year.

Denominator

Total midyear resident population for the same calendar year.

Why Is This Important?

In the U.S., there are more than 140,000 deaths due to stroke each year. ([https://www.cdc.gov/stroke/facts.htm]). Stroke, the death of brain tissue usually resulting from artery blockage, was the fifth leading cause of death in Utah in 2017. There were 888 deaths with stroke as the underlying cause of death in the state.

Healthy People Objective HDS-3:

Reduce stroke deaths
U.S. Target: 34.8 deaths per 100,000 population
State Target: 28.2 deaths per 100,000 population

How Are We Doing?

Death rates for stroke have generally declined in recent decades. This trend is likely related to improvements in acute stroke care and in improved detection and treatment of hypertension, a risk factor for stroke. In 1999 (the year ICD-10 codes were adopted for death coding), the age-adjusted death rate for stroke in Utah was 61.3 per 100,000 population. In 2017, the age-adjusted death rate was 36.2 per 100,000 population.

How Do We Compare With the U.S.?

In 2017, the age-adjusted Utah rate was 36.2 per 100,000. The 2017 U.S. rate was 37.6 per 100,000. U.S. data were obtained through CDC WONDER. Age-adjusted rates assume the age distribution for Utah and the U.S. are the same; in other words, it provides rates as though both populations have the same number of people in each age group. The age-adjusted rate for Utah is a little lower than the national rate.

What Is Being Done?

The Healthy Living through Environment, Policy, and Improved Clinical Care Program (EPICC) was formed in 2013, consolidating three Utah Department of Health programs (Diabetes Prevention and Control Program, Heart Disease and Stroke Prevention Program, and the Physical Activity, Nutrition, and Obesity Program). The purpose of the consolidation was to ensure a productive, collaborative, and efficient program focused on health outcomes. EPICC aims to reduce the incidence of diabetes, heart disease, and stroke by targeting risk factors including reducing obesity, increasing physical activity and nutritious food consumption, and improving diabetes and hypertension control.

Available Services

Stroke is the fifth leading cause of death in the United States (2016 data, [https://www.cdc.gov/nchs/fastats/deaths.htm]). In Utah, stroke was also the fifth leading cause of death in 2017. The Utah Department of Health has a Disability Program that can provide data and resources. More information is available at [https://health.utah.gov/disabilities]. At a national level, the U.S. Department of Health and Human Services (HHS) established Million Hearts. Million Hearts is an initiative to prevent one million cardiovascular events in the U.S. by 2020. This initiative is co-led by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS). More information is available at [https://millionhearts.hhs.gov].

Health Program Information

In 2012, the Utah Department of Health published a statistical report titled ''The Impact of Heart Disease and Stroke in Utah''. This report describes overall patterns in cardiovascular disease and risk factors at the state and national levels and among Utah sub-populations (age group, sex, race, ethnicity, and Utah Small Area). To download the full report, please visit [http://www.choosehealth.utah.gov/documents/pdfs/reports/HD_Stroke_Burden_Report2012.pdf].


Related Indicators

Relevant Population Characteristics

In 2017, almost three quarters (73.3%) of Utah stroke deaths occurred among adults aged 75 and older.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Health care system factors that can continue to improve stroke mortality include: # the identification and management of high blood pressure # the establishment of stroke transport protocols for emergency medical services (EMS) agencies # the certification of hospitals as Primary Stroke Centers, the designation of other stroke-ready hospitals as Stroke Receiving Facilities, and the use of telestroke to help hospitals provide prompt assessment and care of stroke patients # the implementation of stroke treatment guidelines, such as the American Heart Association's Get with the Guidelines--Stroke program, in hospitals throughout Utah

Related Health Care System Factors Indicators:


Risk Factors

Risk factors for stroke include high blood pressure, increasing age, family history of stroke, personal history of stroke, cigarette smoking, diabetes, heart disease, carotid artery disease, transient ischemic attacks, and a high red blood cell count. Elevated cholesterol level, obesity, and lack of physical activity increase the risk of stroke. Many of these risk factors can be modified successfully by adopting lifestyle changes.[[br]] [[br]] ---- American Heart Association. ''What are the risk factors of stroke?'' Accessed at [http://www.strokeassociation.org/STROKEORG/AboutStroke/UnderstandingRisk/Understanding-Stroke-Risk_UCM_308539_SubHomePage.jsp][[br]]

Related Risk Factors Indicators:


Health Status Outcomes

Stroke is a major cause of long-term disability in the U.S.

Related Health Status Outcomes Indicators:




Graphical Data Views

Stroke Deaths, Utah and U.S., 1980-2017

::chart - missing::
confidence limits

In 2017, the age-adjusted stroke death rate for Utah was 36.2 per 100,000. The age-adjusted U.S. rate for 2017 was 37.6.
Utah vs. U.S.YearAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 76
Utah198092.988.097.8
Utah198185.681.090.3
Utah198283.679.088.1
Utah198378.974.683.3
Utah198481.577.185.9
Utah198574.670.478.7
Utah198673.569.477.6
Utah198773.669.577.7
Utah198873.269.277.3
Utah198968.064.172.0
Utah199070.166.174.0
Utah199168.064.271.8
Utah199266.662.970.4
Utah199367.363.671.0
Utah199464.661.068.1
Utah199565.662.069.1
Utah199669.065.472.6
Utah199768.364.871.9
Utah199860.357.063.6
Utah199961.357.365.6
Utah200065.361.369.6
Utah200157.053.361.0
Utah200257.954.161.8
Utah200355.051.458.8
Utah200448.244.951.7
Utah200546.142.949.5
Utah200637.734.840.6
Utah200739.736.842.7
Utah200839.236.442.1
Utah200937.534.840.3
Utah201036.233.639.0
Utah201137.935.240.6
Utah201237.334.740.0
Utah201338.335.741.0
Utah201438.035.540.7
Utah201538.636.141.3
Utah201638.736.241.3
Utah201736.233.838.6
U.S.1980102.1
U.S.198195.0
U.S.198289.4
U.S.198386.2
U.S.198483.5
U.S.198581.1
U.S.198677.6
U.S.198776.0
U.S.198875.0
U.S.198971.0
U.S.199069.4
U.S.199167.1
U.S.199265.8
U.S.199366.9
U.S.199467.0
U.S.199567.7
U.S.199666.9
U.S.199765.4
U.S.199863.1
U.S.199961.6
U.S.200060.9
U.S.200157.9
U.S.200256.2
U.S.200353.5
U.S.200450.0
U.S.200546.6
U.S.200643.643.343.8
U.S.200742.242.042.5
U.S.200840.740.541.0
U.S.200938.938.739.1
U.S.201039.138.939.4
U.S.201138.037.838.2
U.S.201236.936.737.1
U.S.201336.236.036.4
U.S.201436.536.336.7
U.S.201537.637.437.8
U.S.201637.337.1375.0
U.S.201737.637.437.8

Data Notes

ICD-9 codes 430-438; ICD-10 codes I60-I69 (equivalent to NCHS 113 Leading Causes of Death #61: Cerebrovascular Diseases). Estimates from 1998 and before have been comparability-modified to be consistent with ICD-10 coding system definitions. All rates are age-adjusted to the U.S. 2000 standard population. However, Utah rates are drawn from IBIS, which uses 11 age-adjustment groups, and may differ from the Utah rates in CDC WONDER. ICD-10 codes used were I60-I69.

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates: Utah Governor's Office of Planning and Budget
  • Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2017
  • U.S. Centers for Disease Control and Prevention, on-line data - CDC WONDER
  • National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention


Stroke Deaths by Age and Sex, Utah, 2017

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confidence limits

Males vs. FemalesAge GroupRate per 100,000 PopulationLower LimitUpper Limit
Record Count: 12
MaleUnder 552.01.32.9
Male55-6428.920.839.1
Male65-7466.551.284.9
Male75+431.1380.0487.2
FemaleUnder 551.50.92.4
Female55-6415.29.722.9
Female65-7461.947.878.9
Female75+527.5476.7582.2
TotalUnder 551.71.32.4
Total55-6421.916.928.0
Total65-7464.153.576.2
Total75+484.7448.2523.4

Data Notes

Stroke deaths rise dramatically after age 75, for both males and females. Stroke deaths are identified by ICD -10 codes I60-I69.

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2017


Stroke Deaths by Ethnicity, Utah, 2017

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confidence limits

In 2017, the age-adjusted rate of stroke deaths was substantially higher for individuals who were Hispanic than those who were non-Hispanic, 46.0 per 100,000 vs. 35.5, respectively.
Hispanic EthnicityAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 3
Hispanic46.034.959.5
Non-Hispanic35.533.038.0
All Utahns36.233.838.6

Data Notes

ICD-10 codes I60-I69 Rates are age-adjusted to the 2000 U.S. standard population using 10 age groups.

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates by Age, Sex, Race, and Hispanic Origin for Counties in Utah, U.S. Bureau of the Census, IBIS Version 2017


Stroke Deaths by Race, Utah, 2015-2017

::chart - missing::
confidence limits

For combined years 2015-2017, Native Hawaiian or Other Pacific Islander populations had much higher rates of stroke deaths compared to members of other races. The rate of this group was 51.7 per 100,000 population, while the rate for the state overall was 35.1.
RaceAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 6
American Indian/Native Alaskan31.419.148.6
Asian26.218.635.7
Black25.313.044.4
Pacific Islander51.731.979.2
White34.933.536.2
All Races35.133.736.4

Data Notes

ICD-10 codes I60-I69 (equivalent to NCHS 113 Leading Causes of Death #61: Cerebrovascular Diseases). Rates are age-adjusted to the 2000 U.S. standard population using 3 age groups (0-44, 45-64, 65+).

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates by Age, Sex, Race, and Hispanic Origin for Counties in Utah, U.S. Bureau of the Census, IBIS Version 2017


Stroke Deaths by Local Health District, Utah, 2015-2017

::chart - missing::
confidence limits

Three years of data were combined to increase reliability of the estimates. For combined years 2015-2017, the highest rate of stroke deaths was seen for Central Utah Local Health District, 45.0 stroke deaths per 100,000 population (stroke as underlying cause).
Local Health DistrictAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 14
Bear River38.332.644.8
Central45.036.954.2
Davis County40.035.544.9
Salt Lake County39.036.641.5
San Juan27.314.546.8
Southeast37.428.049.0
Southwest34.130.438.2
Summit30.319.046.0
Tooele28.520.139.4
TriCounty30.522.041.2
Utah County37.633.841.7
Wasatch28.115.846.3
Weber-Morgan39.234.544.2
State of Utah37.836.439.3

Data Notes

ICD-10 codes I60-I69 (equivalent to NCHS 113 Leading Causes of Death #61: Cerebrovascular Diseases). Rates are age-adjusted to the 2000 U.S. standard population using 11 age groups.

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2017


Stroke Deaths by County, Utah, 2013-2017

::chart - missing::
confidence limits

Data indicate a wide geographic disparity in stroke death rates by county.
CountyAge-adjusted Rate per 100,000 PopulationLower LimitUpper LimitNote
Record Count: 30
Beaver31.014.657.7*
Box Elder47.739.457.2
Cache32.427.138.4
Carbon35.925.748.9
Daggett****
Davis39.135.642.9
Duchesne29.018.643.3
Emery38.223.758.2
Garfield22.19.543.6*
Grand38.724.258.8
Iron46.136.956.8
Juab47.929.872.9
Kane46.729.770.0
Millard41.628.658.5
Morgan33.618.256.8
Piute45.316.698.6*
Rich32.910.577.4*
Salt Lake38.336.440.3
San Juan19.711.032.6
Sanpete43.933.256.9
Sevier47.035.361.3
Summit32.122.145.0
Tooele28.621.737.0
Uintah29.120.739.7
Utah39.636.542.9
Wasatch31.821.146.0
Washington33.330.036.8
Wayne49.620.3101.2*
Weber40.937.144.9
State37.936.839.1

Data Notes

Rates are age-adjusted to the 2000 U.S. standard population using 11 age groups. **The rate for Daggett County was suppressed due to a relative standard error >0.5, which does not meet Utah Department of Health standards for reliability. *Unreliable estimates: The rates for Beaver, Garfield, Piute, Rich, and Wayne had relative standard errors >0.3 and should be interpreted with caution.

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2017


Stroke Deaths by Utah Small Area, 2013-2017

::chart - missing::
confidence limits

Utah Small AreasAge-adjusted Rate per 100,000 PopulationLower LimitUpper LimitNote
Record Count: 100
Brigham City57.544.673.0
Box Elder Co (Other) V250.331.875.5
Tremonton36.123.153.9
Logan V236.528.046.6
North Logan31.620.247.0
Cache (Other)/Rich (All) V230.419.445.5
Hyrum**Data suppressed.
Smithfield49.831.075.7
Ben Lomond41.633.850.8
Weber County (East)34.025.444.6
Morgan County34.218.557.8
Ogden (Downtown)52.840.667.7
South Ogden39.431.049.3
Roy/Hooper41.032.051.7
Riverdale40.330.452.2
Clearfield Area/Hooper51.741.164.3
Layton/South Weber42.234.351.4
Kaysville/Fruit Heights36.326.348.9
Syracuse46.127.872.0
Centerville28.417.942.7
Farmington45.430.065.9
North Salt Lake20.49.538.1*
Woods Cross/West Bountiful45.022.879.8
Bountiful39.032.546.3
SLC (Rose Park)41.830.455.9
SLC (Avenues)21.314.230.7
SLC (Foothill/East Bench)19.813.628.0
Magna56.638.979.5
SLC (Glendale) V256.240.176.5
West Valley (Center)46.836.159.8
West Valley (West) V269.945.3103.1
West Valley (East) V237.328.148.6
SLC (Downtown) V224.917.933.7
SLC (Southeast Liberty)41.228.058.6
South Salt Lake57.142.874.6
SLC (Sugar House)40.231.550.5
Millcreek (South)25.318.533.7
Millcreek (East)31.724.041.2
Holladay V237.729.946.8
Cottonwood37.030.244.8
Kearns V251.537.569.1
Taylorsville (E)/Murray (W)39.229.750.9
Taylorsville (West)46.935.261.4
Murray41.132.251.6
Midvale52.640.966.7
West Jordan (Northeast) V238.525.954.9
West Jordan (Southeast)35.423.850.7
West Jordan (W)/Copperton30.915.954.3
South Jordan V244.134.655.5
Daybreak45.516.1101.1*
Sandy (West)43.532.656.9
Sandy (Center) V225.716.937.4
Sandy (Northeast)33.723.546.7
Sandy (Southeast)25.816.638.2
Draper54.939.674.0
Riverton/Bluffdale55.040.373.3
Herriman40.922.668.1
Tooele County (Other)26.314.344.2
Tooele Valley29.021.039.1
Eagle Mountain/Cedar Valley39.814.487.4*
Lehi43.331.458.3
Saratoga Springs52.625.097.4
American Fork47.836.761.2
Alpine38.220.964.1
Pleasant Grove/Lindon40.631.152.1
Orem (North)48.636.363.7
Orem (West)22.014.032.9
Orem (East)50.537.965.8
Provo/BYU34.426.743.6
Provo (West City Center)41.527.959.5
Provo (East City Center)29.215.051.2
Salem City25.411.449.0*
Spanish Fork44.231.859.9
Springville39.728.354.2
Mapleton65.439.6101.7
Utah County (South) V240.921.271.2
Payson50.735.670.1
Park City37.820.963.0
Summit County (East)46.327.772.7
Wasatch County31.020.644.8
Daggett and Uintah County28.420.338.7
Duchesne County31.620.147.3
Nephi/Mona44.925.473.4
Delta/Fillmore47.030.868.7
Sanpete Valley43.931.160.2
Central (Other)49.737.764.4
Richfield/Monroe/Salina46.533.462.9
Carbon County36.426.049.6
Emery County44.027.367.3
Grand County42.526.564.6
Blanding/Monticello12.03.928.3*
San Juan County (Other)38.017.372.4*
St. George36.632.041.6
Washington Co (Other) V222.112.336.5
Washington City30.021.341.1
Hurricane/La Verkin34.624.847.0
Ivins/Santa Clara53.337.972.9
Cedar City50.739.863.7
Southwest LHD (Other)35.926.747.1
State of Utah38.937.840.1

Data Notes

Age-adjusted to U.S. 2000 standard population using 11 age groups. *Unreliable estimates for North Salt Lake, Daybreak, Eagle Mountain/Cedar Valley, Salem City, Blanding/Monticello, and San Juan (Other). Use caution in interpreting; the estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health standards.[[br]] [[br]]**Data for Hyrum Small Area was suppressed.[[br]] [[br]] A description of the Utah Small Areas and details about Small Area reclassification may be found on the Methodology and Guidelines page: [https://ibis.health.utah.gov/resource/Guidelines.html].

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population estimates produced by the UDOH Center for Health Data and Informatics. Linear interpolation of U.S. Census Bureau and ESRI ZIP Code data provided annual population estimates for ZIP Code areas by sex and age groups, IBIS Version 2017

References and Community Resources

__References:__[[br]] 1. American Heart Association. ''What are the risk factors of stroke?'' Accessed at [http://www.strokeassociation.org/STROKEORG/AboutStroke/UnderstandingRisk/Understanding-Stroke-Risk_UCM_308539_SubHomePage.jsp] 2. American Heart Association. ''Heart Disease and Stroke Statistics? 2016 Update''. Downloaded from [http://circ.ahajournals.org/content/circulationaha/early/2015/12/16/CIR.0000000000000350.full.pdf/] on 12/14/2016. 3. American Stroke Association. [http://www.strokeassociation.org] __Resources:__[[br]] Healthy Living through Environment, Policy, and Improved Clinical Care (EPICC): [http://www.choosehealth.utah.gov/healthcare.php][[br]] [[br]] American Heart Association: [http://www.heart.org/][[br]] [[br]] Centers for Disease Control and Prevention, Division of Heart Disease and Stroke Prevention: [http://www.cdc.gov/dhdsp/][[br]] [[br]] Healthy People 2020 Heart Disease & Stroke Objectives: [http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke/objectives][[br]] [[br]]

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

Page Content Updated On 12/19/2018, Published on 01/16/2019
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sat, 23 February 2019 3:28:48 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Wed, 16 Jan 2019 16:19:32 MST