Skip directly to searchSkip directly to the site navigationSkip directly to the page's main content

Complete Health Indicator Report of Stroke (Cerebrovascular Disease) Deaths

Definition

The rate of stroke deaths (ICD-10 codes I60-I69) per 100,000 population.

Numerator

The number of deaths due to stroke (ICD-10 codes I60-I69) among Utah or U.S. residents for a calendar year.

Denominator

Total midyear resident population for the same calendar year.

Why Is This Important?

Stroke, the death of brain tissue usually resulting from artery blockage, was the fifth leading cause of death in Utah in 2015. About 700,000 new or first-time strokes occur in the U.S. each year. Stroke is a leading cause of long-term disability. Although strokes occur in all age groups, those 65 and older are most likely to experience stroke.

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

Other Objectives

Utah's 42 Community Health Indicators[[br]] CSTE Chronic Disease Indicators

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. In 2015, the crude stroke death rate was 29.6 per 100,000 population.

How Do We Compare With the U.S.?

In 2014, the age-adjusted Utah rate (37.9 per 100,000) was not statistically different from the U.S. rate (36.5 per 100,000). U.S. data were obtained through CDC WONDER. In 2015, the age-adjusted Utah rate was 38.3 per 100,000. 2015 U.S. data is currently not available.

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. The program is organized around four domains: *Domain 1: Epidemiology and Surveillance--gather, analyze, and disseminate data and information and conduct evaluation to inform, prioritize, deliver, and monitor programs and population health. *Domain 2: Policy and Environment--environmental approaches the promote health and support and reinforce healthful behaviors (statewide in schools and childcare, worksites, and communities). *Domain 3: Health Systems--Health system interventions to improve the effective delivery and use of clinical and other preventive services in order to prevent disease, detect diseases early, and reduce or eliminate risk factors and manage complications. *Domain 4: Community Clinical Linkages--Strategies to improve community-clinical linkages ensuring that communities support and clinics refer patients to programs that improve management of chronic conditions.[[br]] [[br]] The primary program strategies include: *Increasing healthy nutrition and physical activity environments in K-12 schools *Increasing healthy nutrition and physical activity environments in early care and education (childcare/preschool) *Increasing healthy nutrition and physical activity environments in worksites *Improving awareness of prediabetes and hypertension for Utahns *Improving the quality of medical care for people with diabetes and hypertension *Improving the linkages between health care providers and supporting community programs for Utahns with diabetes and hypertension *Improving access and availability to community health programs for Utahns with diabetes, hypertension, and obesity *Improving care and management of students with chronic conditions in Utah schools

Available Services

Heart disease and stroke are the first and fourth leading causes of death in the United States. Heart disease is responsible for 1 of every 3 deaths in the country. Million Hearts is a national initiative that has set an ambitious goal to prevention 1 million heart attacks and strokes by 2017. The impact will be even greater over time. Million Hearts aims to prevent heart disease and stroke by: *Improving access to effective care. *Improving the quality of care for the ABCS (appropriate aspirin prescription, blood pressure control, cholesterol control, and smoking cessation). *Focusing clinical attention on the prevention of heart attack and stroke. *Activating the public to lead a heart-healthy lifestyle. *Improving the prescription and adherence to appropriate medications for the ABCS.[[br]] [[br]] See what you can do to be part of the solution. Visit [http://millionhearts.hhs.gov/be_one_mh.html] for more information.

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 2015, almost three quarters (72.8%) of Utah stroke deaths (646 out of 887 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 (the most important risk factor), 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.^2^ Elevated cholesterol level, obesity, and lack of physical activity, all risk factors for heart disease, also increase the risk of stroke. Many of these risk factors can be modified successfully by adopting lifestyle changes.[[br]] [[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][[br]]

Related Risk Factors Indicators:


Health Status Outcomes

Stroke is a major cause of long-term disability in the U.S. For medicare patients who have experienced a stroke, 24% are discharged into an inpatient rehabilitation facility and 31% are discharged into a skill nursing facility. Of those patients that return home, 32% use home healthcare services. After stroke, women have a greater disability than men. Blacks and Hispanics had less functional status at discharge when compared to non-Hispanic whites.[[br]] [[br]] ---- 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.

Related Health Status Outcomes Indicators:




Graphical Data Views

Stroke Deaths, Utah and U.S., 1980-2015

::chart - missing::
confidence limits

In 2014, the age-adjusted stroke death rate for Utah was 37.9 per 100,000, and the U.S. rate was 36.5. The difference between the rates was not statistically significant. In 2015, the age-adjusted rate was 38.3 for Utah. 2015 data is not currently available for the U.S.
Utah vs. U.S.YearAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 71
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
Utah201137.835.240.6
Utah201237.234.739.9
Utah201338.235.640.9
Utah201437.935.440.6
Utah201538.335.841.0
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

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.

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 2015
  • 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, 2015

::chart - missing::
confidence limits

Males vs. FemalesAge GroupRate per 100,000 PopulationLower LimitUpper Limit
Record Count: 12
MaleUnder 552.21.43.2
Male55-6424.316.934.0
Male65-7486.267.8108.0
Male75+457.7403.1517.6
FemaleUnder 551.61.02.5
Female55-6418.011.726.3
Female65-7463.548.481.7
Female75+553.6500.1611.2
TotalUnder 551.91.42.6
Total55-6421.116.127.2
Total65-7474.462.388.0
Total75+511.5472.8552.5

Data Notes

ICD-10 codes I60-I69 (equivalent to NCHS 113 Leading Causes of Death #61: Cerebrovascular Diseases).

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 2015


Stroke Deaths by Ethnicity, Utah, 2015

::chart - missing::
confidence limits

In 2015, there were no significant differences between the Hispanic and non-Hispanic populations.
Hispanic EthnicityAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 3
Hispanic37.426.850.8
Non-Hispanic38.235.740.9
All Utahns38.335.840.9

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 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 2015


Stroke Deaths by Race, Utah, 2012-2015

::chart - missing::
confidence limits

For combined years 2012-2015, Native Hawaiian or Other Pacific Islander (68.2 per 100,00) populations had higher rates of stroke death compared to the general Utah population (35.8 per 100,000).
RaceAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 6
American Indian/Native Alaskan22.513.136.1
Asian33.325.243.2
Black37.723.657.2
Pacific Islander68.245.897.7
White35.734.537.0
All Races36.034.837.3

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 3 age groups, 0-44, 45-64, and 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 2015


Stroke Deaths by Local Health District, Utah, 2013-2015

::chart - missing::
confidence limits

For combined years 2013-2015 Utah County was significantly higher when compared to the state.
Local Health DistrictAge-adjusted Rate per 100,000 PopulationLower LimitUpper LimitNote
Record Count: 14
Bear River37.531.744.1
Central45.337.154.6
Davis County36.832.441.7
Salt Lake County38.435.940.9
San Juan12.54.029.5*
Southeast39.729.752.0
Southwest34.830.839.0
Summit38.224.057.7
Tooele27.719.039.0
TriCounty29.520.940.4
Utah County43.239.047.7
Wasatch39.223.361.9
Weber-Morgan40.135.345.3
State of Utah38.236.740.0

Data Notes

ICD-10 codes I60-I69 (equivalent to NCHS 113 Leading Causes of Death #61: Cerebrovascular Diseases). *Use caution in interpreting, the estimate has a relative standard error greater than 30% and does not meet UDOH standards for reliability. Prior to 2015 San Juan County was part of the Southeast Local Health District. In 2015 the San Juan County Local Health District was formed. Data reported are for all years using the current boundaries. 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 2015


Stroke Deaths by County, Utah, 2011-2015

::chart - missing::
confidence limits

Data indicate a wide geographic disparity in stroke death rates by county. Box Elder (51.6) and Utah (45.3) counties were significantly higher while San Juan (16.0) and Washington (32.1) were significantly lower than the state.
CountyAge-adjusted Rate per 100,000 PopulationLower LimitUpper LimitNote
Record Count: 30
Beaver32.115.259.7Unreliable estimate
Box Elder51.642.761.8
Cache35.229.541.6
Carbon45.033.659.2
Daggett**Suppressed
Davis34.931.538.6
Duchesne37.425.253.5
Emery30.717.749.5
Garfield37.920.164.9
Grand42.426.264.9
Iron46.837.158.2
Juab32.718.254.1
Kane49.231.473.5
Millard33.422.048.8
Morgan25.111.448.0Unreliable estimate
Piute55.122.1113.5Unreliable estimate
Rich36.811.886.4Unreliable estimate
Salt Lake36.534.738.5
San Juan16.07.629.7Unreliable estimate
Sanpete41.130.654.0
Sevier40.429.554.0
Summit37.526.052.5
Tooele30.523.039.7
Uintah36.426.648.6
Utah45.341.948.9
Wasatch37.524.854.5
Washington32.128.735.7
Wayne52.723.9100.6Unreliable estimate
Weber41.637.745.8
State37.936.839.1

Data Notes

Rates are age-adjusted to the 2000 U.S. standard population using 11 age groups. **The rates were 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, Morgan, Piute, Rich, San Juan, 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 2015


Stroke Deaths by Utah Small Area, 2013-2015

::chart - missing::
confidence limits

The Utah Small Area with the lowest stroke death rate was SLC (Foothill/U of U) (20.4 per 100,000). The Utah Small Area with the highest stroke death rate was Riverton/Draper (56.8 per 100,000).
Utah Small AreasAge-adjusted Rate per 100,000 PopulationLower LimitUpper LimitNote
Record Count: 64
Brigham City55.038.975.6
Box Elder Co (Other)37.824.156.4
Logan36.627.547.7
Cache Co (Oth)/Rich Co (All)37.025.052.8
Ben Lomond40.030.052.2
Morgan Co (All)/Weber Co (E)33.523.646.2
Ogden (Downtown)54.138.274.3
South Ogden41.630.455.5
Roy/Hooper38.927.653.4
Riverdale47.133.265.0
Clearfield/Hill AFB44.632.260.3
Layton40.030.152.0
Syracuse/Kaysville41.329.256.6
Farmington/Centerville24.515.137.6
Woods Cross/North Salt Lake21.610.140.6Unreliable estimate
Bountiful40.431.950.5
SLC (Rose Park)40.226.458.7
SLC (Avenues)26.016.039.8
SLC (Foothill/U of U)20.412.831.0
Magna48.227.678.1
SLC (Glendale)49.332.471.9
West Valley (West)49.736.865.6
West Valley (East) V235.624.250.7
SLC (Downtown)29.220.640.1
South Salt Lake45.529.666.8
Millcreek34.026.642.8
Holladay35.127.943.6
Cottonwood41.432.152.6
Kearns V253.835.777.9
Taylorsville (E)/Murray (W)42.930.159.3
Taylorsville (West)41.226.760.7
Murray46.033.861.2
Midvale52.637.771.4
West Jordan (NE) V228.214.849.0
West Jordan (SE)44.227.168.2
West Jordan (W)/Copperton34.014.268.4Unreliable estimate
South Jordan36.825.950.7
Sandy (Center)33.824.545.3
Sandy (NE)41.326.661.4
Sandy (SE)24.012.941.0
Riverton/Draper56.843.872.4
Tooele Co28.419.540.1
Lehi/Cedar Valley45.231.463.0
American Fork/Alpine47.534.863.2
Pleasant Grove/Lindon54.440.072.4
Orem (North)42.228.160.9
Orem (West)26.014.942.0
Orem (East)45.630.465.7
Provo (North)/BYU36.226.248.7
Provo (South)49.333.769.7
Springville/Spanish Fork48.037.560.5
Utah Co (South)55.938.279.0
Summit Co45.028.068.6
Wasatch Co36.321.856.8
TriCounty LHD29.921.241.0
Juab/Millard/Sanpete Co44.434.256.6
Sevier/Piute/Wayne Co53.939.172.4
Carbon/Emery Co41.429.556.4
Grand/San Juan Co27.016.042.7
St George36.830.943.5
Washington Co (Other)32.325.240.9
Cedar City49.235.466.7
Southwest LHD (Other)37.125.053.0
State39.337.840.8

Data Notes

Age-adjusted to U.S. 2000 standard population using 11 age groups. Unreliable estimates: For Woods Cross/North Salt Lake and West Jordan (W)/Copperton 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]] A description of the Utah Small Areas and details about Small Area reclassification may be found on IBIS at the following URL: [http://ibis.health.utah.gov/resource/Help.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 2015

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.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 12/14/2016, Published on 12/27/2016
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 Wed, 19 September 2018 18:07:52 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Thu, 12 Oct 2017 16:30:17 MDT