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Complete Indicator Report of Stroke Awareness and Willingness to Call 911

Definition

Percent of Utah adults who could identify 5 stroke warning signs and would call 911 if they thought someone was having a stroke.

Numerator

All survey respondents aged 18 and over who correctly identified all 5 signs and symptoms of stroke and reported that they would call 911 if they thought someone was having a stroke.

Denominator

All survey respondents aged 18 and over, except those whose answers were missing or refused.

Data Interpretation Issues

Data are age-adjusted to the U.S. 2000 standard population.
The confidence bounds are asymmetric.

Why Is This Important?

Stroke is the third leading cause of death and disability in Utah and in the U.S. Stroke disability and deaths can be reduced if stroke signs and symptoms are recognized and the Emergency Medical Services (EMS) system is activated as quickly as possible. Early recognition and rapid response are important because early treatment of stroke may decrease brain damage and subsequent disability. The stroke warning signs are:
-Sudden confusion or trouble speaking
-Sudden numbness in the face, arm, or leg, especially on one side
-Sudden trouble seeing in one or both eyes
-Sudden trouble walking, dizziness, or loss of balance
-Sudden severe headache with no known cause

The Utah Department of Health Heart Disease and Stroke Prevention Program (HDSPP) and its partners are working to improve public awareness of the signs and symptoms of stroke and the importance of calling 911.

Healthy People Objective HDS-17.1:

(Developmental) Increase the proportion of adults who are aware of the early warning symptoms and signs of a stroke and the importance of accessing rapid emergency care by calling 9-1-1 or another emergency number
U.S. Target: Developmental

Other Objectives

Heart attacks are an important cause of cardiovascular deaths in Utah. HDSPP is working to increase awareness of signs and symptoms of heart attack and stroke and willingness to call 911 to 25 percent by 2012.

How Are We Doing?

Utah's rate of stroke awareness increased significantly from 33.4% in 2003 to 45.3% in 2009. Recognition of sudden confusion/trouble speaking, sudden trouble seeing, and sudden severe headache as signs of stroke improved between 2008 and 2009.

Stroke awareness is positively associated with education and income levels and marked disparities exist by gender, race, and ethnicity.

How Do We Compare With U.S.?

Utah's rate of stroke awareness is similar to that of the U.S.

What Is Being Done?

The Heart Disease and Stroke Prevention Program (HDSPP) has created television ads, print materials, and website content to increase public awareness about stroke. HDSPP also works with hospitals to ensure that they are prepared to treat stroke. More information about stroke can be found on the HDSPP website, www.hearthighway.org.

Other Program Information

The Utah Department of Health Heart Disease and Stroke Prevention Program works to reduce the impact of heart disease and stroke among Utahns. The HDSPP focuses on strategies and priorities established by the Centers for Disease Control and Prevention (CDC) to reduce the incidence of, and death and disability from, heart disease and stroke. In addition to expanding public awareness of heart attack and stroke signs and symptoms, HDSPP works to decrease risk factors, such as high blood pressure and high cholesterol, to improve emergency response for heart attack and stroke, and to improve quality of care for those living with cardiovascular disease.



Related Indicators

Relevant Population Characteristics

According to the American Heart Association, someone in the United States has a stroke about every 40 seconds. Stroke can happen to anyone at any age. For this reason, it is particularly important for the signs and symptoms of stroke and importance of calling 911 to be widely recognized.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

HDSPP is working with partners to implement a statewide stroke system of care so that ambulances will transport stroke patients to the hospitals that are best prepared to help them. These efforts will decrease delays between symptom onset and hospital treatment for ischemic stroke.

Related Health Care System Factors Indicators:


Risk Factors

Factors that increase risk for stroke include high blood pressure, tobacco use, atrial fibrillation (a heart condition), obesity, diabetes, and physical inactivity.

Related Risk Factors Indicators:


Health Status Outcomes

Expanded public awareness of stroke signs and symptoms and calling 911 could help more stroke patients access the care they need sooner, resulting in decreased deaths and disability.

Related Health Status Outcomes Indicators:




Graphical Data Views

Percentage of Adults Who Could Correctly Identify the Corresponding Major Symptom of Stroke, Utah, 2009

::chart - missing::
confidence limits

Major Symptom of Stroke Percentage of Adults Lower Limit Upper Limit
Record Count: 5
Sudden numbness, especially on one side of the body 94.2% 92.5% 95.5%
Sudden confusion or trouble speaking 90.6% 88.7% 92.2%
Sudden loss of balance 88.2% 86.4% 89.8%
Sudden trouble seeing 73.9% 71.5% 76.2%
Sudden severe headache 67.9% 65.4% 70.4%

Data Notes

Data are age-adjusted to the U.S. 2000 standard population.
In 2009, 94 percent of Utah adults recognized that sudden numbness or weakness of face, arm, or leg, especially on one side of the body was a symptom of stroke. Although sudden severe headache with no known cause is a hallmark of hemmorhagic stroke, only 67 percent of Utahns recognized it as a stroke symptom and would call 911. A person having a stroke may experience any one symptom or multiple symptoms. It is important to call 911 for any sign of stroke.

Data Sources

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health.



Percentage of Adults Who Could Correctly Identify the Major Symptoms of Stroke and Would Call 911 by Year, Utah and U.S., 2003-2009

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confidence limits

Geog: Utah vs. U.S. Year Percentage of Adults Lower Limit Upper Limit
Record Count: 8
Utah 2003 33.4% 30.8% 36.1%
Utah 2005 40.9% 38.6% 43.3%
Utah 2007 38.8% 36.3% 41.2%
Utah 2009 45.3% 42.7% 47.8%
U.S. 2003 41.1% 40.5% 41.7%
U.S. 2005 39.8% 39.2% 40.4%
U.S. 2007 39.0% 38.3% 39.6%
U.S. 2009 43.6% 43.0% 44.2%

Data Notes

Data are age-adjusted to the U.S. 2000 standard population.
This view is provided to assist with comparing stroke awareness in Utah and in other states. However, the number of states included in the U.S. rate varies from year to year.
2003: 16 states; 2005: 14 states; 2007: 12 states
Utah was not included in the 2009 U.S. rate, which included 19 states.
Utah's 2009 rate was not statistically different from the U.S. rate.

Data Sources

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health. U.S. Data: Behavioral Risk Factor Surveillance System (BRFSS), Division of Behavioral Surveillance, CDC Office of Surveillance, Epidemiology, and Laboratory Services.



Percentage of Adults Who Could Correctly Identify the Major Symptoms of Stroke by Age and Gender, Utah, 2009

::chart - missing::
confidence limits

Males vs. Females Age Group Percentage of Adults Lower Limit Upper Limit
Record Count: 8
Male 18-34 37.8% 31.8% 48.3%
Male 35-49 42.6% 36.2% 49.3%
Male 50-64 49.1% 42.6% 55.6%
Male 65+ 34.3% 27.7% 41.6%
Female 18-34 44.7% 38.0% 51.7%
Female 35-49 50.5% 44.4% 56.6%
Female 50-64 59.6% 53.8% 65.1%
Female 65+ 41.8% 35.7% 48.2%

Data Notes

In 2009, females had higher stroke awareness rates than males at each age interval. The differences were not statistically significant.

Data are age-specific, not age-adjusted.

Data Sources

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health.



Percentage of Adults Who Could Correctly Identify the Major Symptoms of Stroke and Would Call 911 by Ethnicity, Utah, 2007-2009

::chart - missing::
confidence limits

Ethnicity Percentage of Adults Lower Limit Upper Limit
Record Count: 3
Hispanic or Latino 27.3% 23.0% 32.1%
White, Non-Hispanic 44.6% 43.2% 46.0%
Other, Non-Hispanic 38.2% 31.9% 45.0%

Data Notes

Data are age-adjusted to the U.S. 2000 standard population. For reliability, data represent combined years 2007-2009.

Hispanics had the lowest rate of stroke awareness of all ethnic groups. The Utah Heart Disease & Stroke Prevention Program has identified Hispanics as a priority population and has developed a culturally and linguistically appropriate Spanish-language campaign to raise awareness about the signs and symptoms of stroke. Campaign materials and the Spanish language website can be located at http://tucorazon.health.utah.gov/.

Data Sources

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health.



Percentage of Adults Who Could Correctly Identify the Major Symptoms of Stroke by Income Level, Utah, 2009

::chart - missing::
confidence limits

Income Category Percentage of Adults Lower Limit Upper Limit
Record Count: 4
<$25,000 35.4% 29.1% 42.2%
$25,000-$49,999 45.0% 39.8% 50.4%
$50,000-$74,999 45.5% 40.1% 51.0%
$75,000+ 50.1% 45.8% 54.3%

Data Notes

Adults aged 25 and over. Data are age-adjusted to the U.S. 2000 standard population.
Following national trends, stroke symptom recognition and willingness to call 911 is positively associated with income. In other words, people at higher income levels have higher rates of stroke awareness compared to people at lower income levels. Many factors may contribute to this association.

Data Sources

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health.



Percentage of Adults Who Could Correctly Identify the Major Symptoms of Stroke and Would Call 911 by Race,

::chart - missing::
confidence limits

Race/Ethnicity Percentage of Adults Lower Limit Upper Limit
Record Count: 7
American Indian, Alaskan Native 29.7% 18.1% 44.7%
Asian 25.5% 16.6% 37.0%
Black, African American 21.4% 10.2% 39.4%
Native Hawaiian, Pacific Islander 50.4% 33.2% 67.5%
White 41.2% 39.8% 42.6%
Other 17.8% 14.0% 22.3%
All Races/Ethnicities 39.2% 37.9% 40.5%

Data Notes

Age-adjusted to the 2000 U.S. standard population.

For combined years 2003, 2005, 2007, and 2009, Pacific Islanders (50.4%) had the highest rate of stroke awareness than any other race category. The rates for Asians (25.5%) and Others (17.8%) were significantly lower than the state rate.

Data Sources

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health.



Percentage of Adults Who Could Correctly Identify the Major Symptoms of Stroke and Would Call 911 by Education Level, Utah, 2009

::chart - missing::
confidence limits

Education Level Percentage of Adults 25+ Lower Limit Upper Limit
Record Count: 4
Less Than High School 28.4% 18.5% 40.9%
H.S. Grad or G.E.D. 37.2% 32.5% 42.2%
Some Post High School 44.8% 40.8% 49.0%
College Graduate 54.1% 50.0% 58.2%

Data Notes

Adults aged 25 years and over. Data are age-adjusted to the U.S. 2000 standard population.
Generally, knowledge of all 5 signs and symptoms of stroke and willingness to call 911 increases with education level.

Data Sources

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health.



Adults Who Could Correctly Identify the Major Symptoms of Stroke by Local Health District, Utah, 2009

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confidence limits

Local Health District Age-adjusted Percentage of Adults Lower Limit Upper Limit
Record Count: 14
Bear River 35.3% 26.2% 45.5%
Central 48.0% 36.8% 59.4%
Davis County 51.3% 43.7% 58.9%
Salt Lake Valley 44.1% 40.2% 48.2%
Southeastern 41.4% 31.5% 52.1%
Southwest 42.5% 32.6% 53.1%
Summit 50.0% 39.8% 60.2%
Tooele 47.6% 37.1% 58.2%
TriCounty 40.3% 30.8% 50.6%
Utah County 48.6% 41.6% 55.6%
Wasatch 48.7% 37.2% 60.2%
Weber-Morgan 48.2% 39.1% 57.5%
State 45.3% 42.7% 47.8%
U.S. 43.6% 43.0% 44.2%

Data Notes

Data are age-adjusted to the U.S. 2000 standard population. The U.S. rate represents 19 states, including Utah, which used this question on the BRFSS in 2009.

Data Sources

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health.


References and Community Resources

Please visit the Utah Department of Health's Heart Disease and Stroke Prevention Program website for more details on stroke awareness. The English language website includes TV advertisements, radio spots, posters and pamphlets about the signs and symptoms of stroke. http://www.hearthighway.org/time.html.
Spanish-language stroke information is available on our Spanish website, http://tucorazon.health.utah.gov.

The National Institutes of Health (NIH) and the National Institute for Neurological Disorders and Stroke (NINDS) launched a public awareness campaign called "Know Stroke." English and Spanish language materials include brochures, toolkits and posters, radio ads, and TV ads. These are available at: http://stroke.nih.gov/materials/.

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 10/06/2010, Published on 08/22/2012
The information provided above is from the Utah Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.utah.gov). The information published on this website may be reproduced without permission. Please use the following citation: "Retrieved Fri, 31 October 2014 3:03:25 from Utah Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.utah.gov".

Content updated: Tue, 19 Nov 2013 23:09:24 MST