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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 sixth leading cause of death in Utah in 2020. There were 916 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?

Utah is getting closer to its target of reducing stroke deaths to 28.2 per 100,000 population. 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 2020, the age-adjusted death rate was 34.0 per 100,000 population.

How Do We Compare With the U.S.?

In 2020, the age-adjusted Utah rate was 34.0 per 100,000. In comparison, the 2019 U.S. rate was 37.0 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 only a little lower than the national rate.

What Is Being Done?

Originally the EPICC Program (The Healthy Living through Environment, Policy, and Improved Clinical Care Program), The Healthy Environments, Active Living (HEAL) Program 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. The HEAL Program 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 (2019 data, [https://www.cdc.gov/nchs/fastats/deaths.htm]). In Utah, stroke was also the fifth leading cause of death in 2018. The Utah Department of Health has a Disability Program that can provide data and resources for individuals affected by stroke. 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. in five years. 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

The Healthy Environments, Active Living (HEAL) Program is a program within the Utah Department of Health Bureau of Health Promotion. HEAL focuses on enabling education and engaged change for public health by engaging its three main audiences: individuals, partners, and decision-makers. HEAL champions public health initiatives and addresses the challenges of making health awareness and access truly universal and equitable in eight key areas: nutrition, heart health, diabetes, physical activity, schools, child care, community health workers, and worksites.


Related Indicators

Relevant Population Characteristics

In 2018, almost three quarters (74%) 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 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., 1980-2020

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confidence limits

Stroke deaths have had an overall slow but steady decline for both Utah and the U.S. In 2019, the age-adjusted stroke death rate for Utah was 34.7 per 100,000. The age-adjusted U.S. rate for 2019 was 37.0 per 100,000 (U.S. rates for 2020 were not available at the time of publication).
Utah vs. U.S.YearAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 81
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
Utah201237.334.840.0
Utah201338.335.741.0
Utah201438.035.540.7
Utah201538.636.141.3
Utah201638.836.441.4
Utah201736.434.038.9
Utah201836.534.138.9
Utah201934.732.537.1
Utah202034.031.836.3
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.199961.661.361.9
U.S.200060.960.661.2
U.S.200158.458.158.7
U.S.200257.257.057.5
U.S.200354.654.354.8
U.S.200451.250.951.4
U.S.200548.047.748.2
U.S.200644.844.645.0
U.S.200743.543.343.7
U.S.200842.141.842.3
U.S.200939.639.439.8
U.S.201039.138.939.3
U.S.201137.937.738.1
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.201637.337.137.5
U.S.201737.637.437.8
U.S.201837.136.937.3
U.S.201937.036.837.1

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 2018
  • 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, 2020

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confidence limits

Stroke deaths rise dramatically after age 75, for both males and females. Stroke deaths are identified by ICD-10 codes I60-I69.
Males vs. FemalesAge GroupRate per 100,000 PopulationLower LimitUpper Limit
Record Count: 12
MaleUnder 552.11.43.0
Male55-6421.414.730.2
Male65-7459.746.276.0
Male75+403.1356.7453.9
FemaleUnder 552.41.63.4
Female55-6417.511.525.4
Female65-7453.641.268.4
Female75+473.7428.2522.6
TotalUnder 552.21.72.9
Total55-6419.414.825.0
Total65-7456.547.267.1
Total75+442.1409.3476.9

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 2018


Stroke Deaths by Ethnicity, Utah, 2020

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confidence limits

In 2020, the age-adjusted rate of stroke deaths was lower for individuals who were Hispanic than those who were non-Hispanic.
Hispanic EthnicityAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 3
Hispanic21.315.528.6
Non-Hispanic30.728.732.8
All Utahns30.428.532.4

Data Notes

ICD-10 codes I60-I69 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 2018


Stroke Deaths by Race, Utah, 2018-2020

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confidence limits

For combined years 2018-2020, Native Hawaiian or Other Pacific Islander populations had a higher rate of stroke deaths compared to members of other races.
RaceAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 6
American Indian/Native Alaskan24.915.238.6
Asian29.422.138.4
Black32.118.951.0
Pacific Islander61.141.886.4
White31.430.232.6
All Races31.730.532.9

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 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 2018


Stroke Deaths by Local Health District, Utah, 2019-2020

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confidence limits

Two years of data were combined to increase reliability of the rates. For combined years 2019-2020, the lowest rate of stroke deaths was seen for Summit County Health District (stroke as underlying cause). The rate for Southeast Utah Health District is also low.
Local Health DistrictAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 14
Bear River34.628.342.0
Central28.621.337.7
Davis County38.533.444.1
Salt Lake County34.431.737.2
San Juan37.119.663.7
Southeast20.913.031.8
Southwest33.829.638.3
Summit19.910.334.7
Tooele28.518.641.9
TriCounty29.619.842.7
Utah County35.631.440.2
Wasatch35.020.156.4
Weber-Morgan37.932.543.9
State of Utah34.432.936.1

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 2018


Stroke Deaths by County, Utah, 2016-2020

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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
Beaver49.627.981.6
Box Elder45.737.954.7
Cache29.624.735.1
Carbon21.413.831.8
Daggett**** Suppressed
Davis39.836.443.5
Duchesne27.017.340.3
Emery32.420.049.8
Garfield34.217.260.9* Interpret with caution
Grand34.921.753.3
Iron38.430.647.7
Juab40.224.063.0
Kane35.720.757.3
Millard39.727.355.9
Morgan40.623.864.7
Piute**** Suppressed
Rich**** Suppressed
Salt Lake37.035.238.8
San Juan32.121.146.9
Sanpete32.323.743.0
Sevier37.427.449.8
Summit24.016.433.8
Tooele29.022.437.1
Uintah30.422.041.0
Utah36.233.539.2
Wasatch26.917.938.9
Washington32.829.836.1
Wayne39.114.086.3* Interpret with caution
Weber38.735.142.6
State36.035.037.1

Data Notes

Rates are age-adjusted to the 2000 U.S. standard population using 11 age groups. **The rates for Daggett, Piute, and Rich counties 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 Garfield and Wayne counties 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 2018


Stroke Deaths by Utah Small Area, 2016-2020

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confidence limits

Utah Small AreasAge-adjusted Rate per 100,000 PopulationLower LimitUpper LimitNote
Record Count: 100
Brigham City47.736.461.4
Box Elder Co (Other) V262.842.988.7
Tremonton36.023.452.8
Logan V231.023.640.0
North Logan26.616.640.4
Cache (Other)/Rich (All) V232.221.246.8
Hyrum18.44.847.9* Interpret with caution
Smithfield38.022.360.4
Ben Lomond38.231.146.5
Weber County (East)39.730.850.2
Morgan County41.024.165.2
Ogden (Downtown)40.830.753.2
South Ogden35.627.944.7
Roy/Hooper35.927.945.4
Riverdale37.027.948.3
Clearfield Area/Hooper48.038.059.8
Layton/South Weber42.835.251.6
Kaysville/Fruit Heights34.825.546.3
Syracuse48.530.373.6
Centerville33.922.848.6
Farmington46.231.665.2
North Salt Lake26.114.543.3
Woods Cross/West Bountiful50.328.781.8
Bountiful39.933.447.2
SLC (Rose Park)34.424.447.2
SLC (Avenues)16.810.924.6
SLC (Foothill/East Bench)22.515.831.1
Magna49.033.768.7
SLC (Glendale) V254.138.573.9
West Valley (Center)43.633.855.4
West Valley (West) V248.530.273.8
West Valley (East) V240.931.652.2
SLC (Downtown) V231.123.240.9
SLC (Southeast Liberty)37.925.753.8
South Salt Lake47.835.163.6
SLC (Sugar House)35.027.444.1
Millcreek (South)23.216.831.3
Millcreek (East)31.323.640.6
Holladay V240.232.249.7
Cottonwood33.527.340.7
Kearns V248.735.365.6
Taylorsville (E)/Murray (W)29.921.939.8
Taylorsville (West)49.638.263.3
Murray39.531.149.4
Midvale48.037.161.1
West Jordan (Northeast) V240.928.856.3
West Jordan (Southeast)33.722.848.0
West Jordan (W)/Copperton28.314.948.8
South Jordan V246.036.357.6
Daybreak60.437.791.7
Sandy (West)43.233.055.6
Sandy (Center) V224.016.034.5
Sandy (Northeast)27.118.538.2
Sandy (Southeast)32.622.545.6
Draper40.128.155.7
Riverton/Bluffdale44.632.559.7
Herriman40.224.462.5
Tooele County (Other)25.213.742.4
Tooele Valley30.122.339.8
Eagle Mountain/Cedar Valley27.410.458.4* Interpret with caution
Lehi37.026.749.9
Saratoga Springs20.87.446.3*Interpret with caution
American Fork40.430.852.1
Alpine42.824.968.7
Pleasant Grove/Lindon38.930.049.7
Orem (North)48.436.463.1
Orem (West)29.820.741.5
Orem (East)35.926.048.4
Provo/BYU29.122.037.8
Provo (West City Center)39.226.655.6
Provo (East City Center)26.613.148.1*Interpret with caution
Salem City24.411.046.8*Interpret with caution
Spanish Fork40.529.254.8
Springville37.226.750.6
Mapleton72.946.9108.1
Utah County (South) V251.830.782.1
Payson49.235.067.4
Park City16.77.931.1
Summit County (East)50.431.676.2
Wasatch County27.718.639.7
Daggett and Uintah County30.722.241.4
Duchesne County33.922.049.9
Nephi/Mona41.222.968.4
Delta/Fillmore38.724.358.3
Sanpete Valley37.225.951.7
Central (Other)34.124.945.6
Richfield/Monroe/Salina38.226.553.3
Carbon County21.313.631.7
Emery County39.223.960.5
Grand County38.824.358.6
Blanding/Monticello23.711.343.7* Interpret with caution
San Juan County (Other)50.126.985.2
St. George33.629.438.1
Washington Co (Other) V234.322.550.2
Washington City43.033.055.1
Hurricane/La Verkin36.026.647.7
Ivins/Santa Clara46.433.962.0
Cedar City41.932.753.0
Southwest LHD (Other)33.725.443.8
State of Utah37.035.938.1

Data Notes

Age-adjusted to U.S. 2000 standard population using 11 age groups. *Unreliable estimates for Hyrum, Eagle Mountain/Cedar Valley, and Blanding/Monticello. Use caution in interpreting; the estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health standards. 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 2018

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 10/18/2021, Published on 11/18/2021
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 Tue, 16 August 2022 10:38:46 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, 18 Nov 2021 10:21:39 MST