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Complete Health 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 fifth 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 [[br]] The Utah Department of Health Health Heart Disease and Stroke Prevention Program (HDSPP) was consolidated into the Healthy Living through Environment, Policy and Improved Clinical Care (EPICC) program was formed in 2012. EPICC has worked with partners to improve public awareness of the signs and symptoms of stroke and the importance of calling 911.

Healthy People Objective HDS-17.1:

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 911 or another emergency number
U.S. Target: 56.4 percent

Other Objectives

Heart attacks are an important cause of cardiovascular deaths in Utah. EPICC has worked to increase awareness of signs and symptoms of heart attack and stroke and willingness to call 911.

How Are We Doing?

Utah's rate of stroke awareness increased significantly from 33.4% in 2003 to 54.3% in 2011. 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 the U.S.?

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

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

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

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

EPICC 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

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confidence limits

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.
Major Symptom of StrokeAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 5
Sudden numbness, especially on one side of the body94.2%92.5%95.5%
Sudden confusion or trouble speaking90.6%88.7%92.2%
Sudden loss of balance88.2%86.4%89.8%
Sudden trouble seeing73.9%71.5%76.2%
Sudden severe headache67.9%65.4%70.4%

Data Notes

Data are age-adjusted to the U.S. 2000 standard population.

Data Source

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., 2003-2011

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confidence limits

Utah vs. U.S.YearAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 9
Utah200333.4%30.8%36.1%
Utah200540.9%38.6%43.3%
Utah200738.8%36.3%41.2%
Utah200945.3%42.7%47.8%
Utah201154.3%51.0%57.7%
U.S.200341.1%40.5%41.7%
U.S.200539.8%39.2%40.4%
U.S.200739.0%38.3%39.6%
U.S.200943.6%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.

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

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confidence limits

In 2009, females had higher stroke awareness rates than males at each age interval. The differences were not statistically significant.
Males vs. FemalesAge GroupPercentage of AdultsLower LimitUpper Limit
Record Count: 8
Male18-3437.8%31.8%48.3%
Male35-4942.6%36.2%49.3%
Male50-6449.1%42.6%55.6%
Male65+34.3%27.7%41.6%
Female18-3444.7%38.0%51.7%
Female35-4950.5%44.4%56.6%
Female50-6459.6%53.8%65.1%
Female65+41.8%35.7%48.2%

Data Notes

Data are age-specific, not age-adjusted.

Data Source

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

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confidence limits

Hispanics had the lowest rate of stroke awareness of all ethnic groups. The EPICC 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/].
EthnicityAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 3
Hispanic or Latino27.3%23.0%32.1%
White, Non-Hispanic44.6%43.2%46.0%
Other, Non-Hispanic38.2%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.

Data Source

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

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confidence limits

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.
Income CategoryAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 4
<$25,00035.4%29.1%42.2%
$25,000-$49,99945.0%39.8%50.4%
$50,000-$74,99945.5%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.

Data Source

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, 2003, 2005, 2007, and 2009

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confidence limits

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.
Race/EthnicityAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 7
American Indian, Alaskan Native29.7%18.1%44.7%
Asian25.5%16.6%37.0%
Black, African American21.4%10.2%39.4%
Native Hawaiian, Pacific Islander50.4%33.2%67.5%
White41.2%39.8%42.6%
Other17.8%14.0%22.3%
All Races/Ethnicities39.2%37.9%40.5%

Data Notes

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

Data Source

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

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confidence limits

Generally, knowledge of all 5 signs and symptoms of stroke and willingness to call 911 increases with education level.
Education LevelAge-adjusted Percentage of Adults 25+Lower LimitUpper Limit
Record Count: 4
Less Than High School28.4%18.5%40.9%
H.S. Grad or G.E.D.37.2%32.5%42.2%
Some Post High School44.8%40.8%49.0%
College Graduate54.1%50.0%58.2%

Data Notes

Adults aged 25 years and over. Data are age-adjusted to the U.S. 2000 standard population.

Data Source

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, 2011

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confidence limits

Local Health DistrictAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 14
Bear River56.6%43.5%68.9%
Central40.3%27.1%55.0%
Davis County57.8%47.5%67.5%
Salt Lake County58.0%52.4%63.4%
San Juan55.6%28.5%79.8%
Southeast40.2%26.8%55.2%
Southwest48.3%34.8%62.1%
Summit50.7%33.3%68.0%
Tooele61.7%49.3%72.8%
TriCounty50.5%37.4%63.5%
Utah County51.6%42.3%60.8%
Wasatch50.9%39.0%62.7%
Weber-Morgan52.7%43.0%62.2%
State of Utah54.3%51.0%57.7%

Data Notes

Data are age-adjusted to the U.S. 2000 standard population. 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.

Data Source

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

References and Community Resources

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 05/18/2017, Published on 05/26/2017
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 Mon, 20 November 2017 4:47:36 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Fri, 26 May 2017 10:19:49 MDT