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State of Alaska

Complete Health Indicator Report of Stroke (Cerebrovascular Disease) Mortality Rate

Definition

Age adjusted rate of stroke (cerebrovascular disease) mortality is the number of stroke deaths (ICD-9 codes 430-438 and ICD-10 codes I60-I69) per 100,000 population.

Numerator

Number of deaths due to stroke in the resident population for a specific time period.

Denominator

Total midyear resident population for a specific time period.

Data Interpretation Issues

[http://live.laborstats.alaska.gov/pop/index.cfm Alaska population estimates] provided by the State Demographer in the [http://laborstats.alaska.gov/ Research and Analysis Section] of the [http://labor.alaska.gov/ Alaska Department of Labor and Workforce Development].

Why Is This Important?

Stroke is a major cause of adult disability and economic losses as a result of impairment.^1^ Stroke damage in the brain can affect the entire body - resulting in mild to severe disabilities. These include paralysis, problems with thinking, problems with speaking, and emotional problems.^2^ About 795,000 new or recurrent strokes occur in the U.S. each year.^1^ Approximately 610,000 of these are first events and 185,000 are recurrent stroke events. In 2011, stroke caused about 1 of every 20 deaths in the United States. On average, every 40 seconds, someone in the United States has a stroke, and someone dies of stroke approximately every 4 minutes.^1^ Two major mechanisms are responsible for strokes: ischemia and hemorrhage. The most common mechanism, ischemia, is responsible for 87% of all strokes.^1^ Ischemia can be caused by thrombosis (blood clot formation in an artery or vein), embolism (anything that travels through the blood vessels until it lodges in a vessel), or systemic hypoperfusion (shock). About 13% of strokes are caused by hemorrhage (vessel rupture and bleeding) or cardiac arrest.^3^[[br]] [[br]] ---- {{class .SmallerFont 1. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation 2015;131:e29-e322. 2. NINDS | What you need to know about stroke. National Institute of Neurological Disorders and Stroke. [http://www.ninds.nih.gov/disorders/stroke/stroke_needtoknow.htm}. Accessed November 29, 2016. 3. Moskowitz MA, Lo EH, Iadecola C. The science of stroke: mechanisms in search of treatments. Neuron 2010;67:181-98. }}

Healthy People Objective: Reduce stroke deaths

U.S. Target: 34.8 deaths per 100,000 population

How Are We Doing?

Cerebrovascular disease, or stroke, was the fifth leading cause of death in Alaska in 2018, claiming the lives of 210 Alaskans. Among the leading causes of death in Alaska, cerebrovascular disease ranked eleventh in years of potential life lost with 729 years lost in 2017. On average, 3.9 years of life were lost prematurely for each stroke death.^4^ There are major regional differences, with highest rates in the Northern (54.7 per 100,000) and Southwest (54.9 per 100,000) region for the 5-year average from 2014-2018. Stroke mortality is generally higher among Alaska Native people, being 63.5 per 100,000 compared to 39.9 per 100,000 for all Alaskans in 2018. Death rates for stroke in Alaska have declined from an age adjusted rate of 65.6 per 100,000 in 2000 to 39.9 per 100,000 in 2018. The downward trend could be related to access to acute stroke care and in the result of improved detection and treatment of hypertension. Hypertension control efforts initiated in the 1970s appear to have had the most influence on the decline in stroke mortality. Control of diabetes and dyslipidemia, as well as smoking cessation programs, in combination with hypertension treatment, also appear to have contributed to the decline in stroke mortality.^5^[[br]] [[br]] ---- {{class .SmallerFont 4. Alaska Department of Health and Social Services, Division of Public Health, Health Analytics and Vital Records Section. Alaska Vital Statistics 2017 Annual Report. [http://dhss.alaska.gov/dph/VitalStats/Documents/PDFs/VitalStatistics_Annualreport_2017.pdf]. Accessed June 11, 2018. 5. Xu JQ, Murphy SL, Kochanek KD, Bastian B, Arias E. Deaths: Final data for 2016. National Vital Statistics Reports. 67(5) July 26, 2018. [https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_05.pdf]. Accessed December 6, 2018. }}

How Do We Compare With the U.S.?

Stroke was the 5th leading cause of death in the U.S. and the 6th leading cause of death in Alaska in 2017. In 2017, Alaska had an age-adjusted mortality rate for cerebrovascular disease (stroke) of 34.8 deaths per 100,000 population as compared to the 2017 U.S. mortality rate for stroke of 37.6 deaths per 100,000 population. The decline in stroke mortality rates in the U.S. has been mirrored in Alaska. Stroke mortality was lower among females (36.6 per 100,000) than males (38.0 per 100,000) in the U.S. in 2017. There are also major national differences in stroke mortality rates per 100,000 between races: Black- 52.7, White - 36.4, American Indian/Alaska Native people - 34.1, and Asian/Pacific Islanders - 30.3.^6^[[br]] [[br]] ---- {{class .SmallerFont 6. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017. National Vital Statistics Reports; vol 68 no 9. Hyattsville, MD: National Center for Health Statistics. 2019.[https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf]. Accessed October 4, 2019. }}

What Is Being Done?

Three Alaska hospitals are Joint-Commission certified as a Primary Stroke Centers and also participate in the American Heart Association's [http://www.heart.org/HEARTORG/HealthcareProfessional/GetWithTheGuidelinesHFStroke/GetWithTheGuidelinesStrokeHomePage/Get-With-The-Guidelines-Stroke-Home-Page_UCM_305098_SubHomePage.jsp Get with the Guidelines-Stroke] program to enhance stroke quality of care. In addition to these three primary stroke centers, 5 hospitals are "spoke" hospitals connected to the Primary Spoke Center "hub" through a telestroke network. Alaska EMS agencies are standardizing evidenced-based stroke care protocols throughout the state. The Alaska Heart Disease and Stroke Prevention Program (HDSPP) educates and encourages partner organizations to utilize information from the American Heart Association (AHA) "[http://www.heart.org/HEARTORG/Conditions/My-Life-Check---Lifes-Simple-7_UCM_471453_Article.jsp#W1YY8jaWyHt 7 simple steps]", and the Centers for Medicare and Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) "[https://millionhearts.hhs.gov/about-million-hearts/index.html Million Hearts]" initiative in program activities. The AHA defines and promotes 7 simple steps to a healthier heart to help individuals improve health behaviors. These steps include managing blood pressure, controlling blood cholesterol, reducing blood sugar, getting active, eating better, losing weight and smoking cessation. In 2012, CMS and CDC launched the Million Hearts initiative to prevent 1 million heart attacks and strokes by 2017. To meet this goal, the many Million Hearts public and private partners focus, coordinate, and enhance cardiovascular disease prevention activities. Significant progress was made towards the goal, however challenges faced include an aging population and increasing rates of obesity and diabetes. Million Hearts has developed a year 2020 framework based on optimizing health care and an evidence-based process to improve ABCS (Aspirin when appropriate, Blood pressure control, Cholesterol management and Smoking cessation), keeping people healthy and improving outcomes for priority populations (reducing heart disease disparity in racial/ethnic groups). In Alaska, the Southeast Alaska Regional Health Consortium (SEARHC) and Southcentral Foundation (SCF) operate the [https://www.cdc.gov/wisewoman/about.htm WISEWOMAN] program to help Alaska Native women understand and reduce their risk for heart disease and stroke and promote lasting heart-healthy lifestyles. The program serves low-income uninsured and underinsured women aged 40 to 64 years with free screenings and counseling about their risk for heart disease and stroke as they participate in evidenced-based lifestyle programs, individual health coaching or are referred to other community resources.

Available Services

Information about stroke can be found at the Alaska Heart Disease and Stroke Prevention Program (HDSPP) website: [http://dhss.alaska.gov/dph/Chronic/Pages/Cardiovascular/default.aspx]


Related Indicators

Relevant Population Characteristics

Stroke is more common in older compared to younger persons. Although strokes occur in all age groups, those 65 and older are most likely to experience stroke. In fact, for people over age 55, the incidence of stroke more than doubles in each successive decade. Women account for almost 60% of US stroke deaths. The incidence of stroke also varies by race and ethnicity. Compared with whites, blacks have a 1.3 times greater rate of nonfatal stroke, a 1.8 times greater rate of fatal stroke. Stroke is a leading cause of long-term disability with women having greater disability than men.^3^[[br]] [[br]] ---- {{class .SmallerFont 3. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation 2015;131:e29-e322. }}

Health Care System Factors

Health care system factors that can continue to decrease stroke mortality include: [[br]]1. the identification and management of high blood pressure [[br]]2. the establishment of stroke transport protocols for emergency medical services (EMS) agencies [[br]]3. 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 [[br]]4. the implementation of stroke treatment guidelines, such as the American Heart Association's Get with the Guidelines--Stroke program, in hospitals throughout Alaska [[br]]5. the implementation of hypertension treatment protocols, such as the American Heart Association and American College of Cardiology [[br]]6. improving access to effective care [[br]]7. improving the quality of care for the ABCS (Aspirin when appropriate, Blood pressure control, Cholesterol management, Smoking cessation) [[br]]8. focusing clinical attention on the prevention of heart attack and stroke [[br]]9. activating the public to lead a heart-healthy lifestyle [[br]]10. improving the prescription and adherence to appropriate medications for the ABCS

Related Health Care System Factors Indicators:


Risk Factors

Risk factors for stroke include high blood pressure (the most important risk factor), atrial fibrillation, increasing age, personal or family history of stroke, transient ischemic attacks, carotid artery disease, and a high red blood cell count.^8^ All risk factors for heart disease also increase the risk of stroke; many of which can be modified by adopting lifestyle changes or by treating or addressing health factors. Modifiable risk factors for stroke and heart disease include behaviors (e.g., tobacco use, lack of physical activity, and improper nutrition) and health status (e.g., untreated hypertension, atrial fibrillation, diabetes, blood clotting disorders, hyperlipidemia, overweight/obesity, obstructive sleep apnea, and psychosocial stress).^9^ Those who practice a healthy lifestyle have an 80% lower risk of a first stroke compared with those who do not.^8^ Substantial differences in risk and preventive factors exist by race, age, sex, place of residence, and other demographic factors. Approximately 77% of those who have a first stroke have a blood pressure >140/90 mm Hg[1]. Atrial fibrillation (AFib) increases the risk of having a stroke by nearly 5 times and AFib related strokes kill nearly twice as frequently as non-AFib strokes.^9^ Current smokers have a 2 to 4 times increased risk of stroke compared with nonsmokers or those who have quit for >10 years.^10^[[br]] [[br]] ---- {{class .SmallerFont 2. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation 2015;131:e29-e322. 8. American Heart Association. What are the risk factors of stroke? [http://www.strokeassociation.org]. Accessed September 15, 2015. 9. Chiuve SE, Rexrode KM, Spiegelman D, Logroscino G, Manson JE, Rimm EB. Primary prevention of stroke by healthy lifestyle. Circulation 2008;118:947-54. 10. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991;22:983-22. }}

Related Risk Factors Indicators:


Health Status Outcomes

Stroke is a major cause of long-term disability in the U.S. Of those 65 years or older who experience an ischemic stroke, 30% of survivors are unable to walk without some assistance. In addition, of those age 40 and older, 21% of men and 24% of women who have an initial stroke die within one year. The time required to recover from a stroke can vary based on the severity of brain damage. About 50% to 70% of survivors regain functional independence. About 15% to 30% are permanently disabled.^1^[[br]] [[br]] ---- {{class .SmallerFont 1. Centers for Disease Control and Prevention (CDC). National Center for Health Statistics: National Vital Statistics System: mortality 2014. [http://www.cdc.gov/nchs/data/dvs/lcwk9_2014.pdf]. Accessed October 4, 2016. }}

Related Health Status Outcomes Indicators:




Graphical Data Views

Stroke mortality rate per 100,000 population (age-adjusted), all Alaskans, Alaska Native people, and U.S., 2000-2018

::chart - missing::
confidence limits

** = Data not available.
Geog: Alaska vs. U.S.YearStroke mortality rateLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 56
All Alaskans200065.663.767.6169626,932
All Alaskans200159.457.661.2161632,716
All Alaskans200255.854.157.6157641,729
All Alaskans200361.159.362.8182649,466
All Alaskans200453.251.654.9173659,653
All Alaskans200554.553.056.1176667,146
All Alaskans200647.846.449.3174674,583
All Alaskans200746.745.348.1156680,169
All Alaskans200844.242.845.6169686,818
All Alaskans200942.140.843.4162697,828
All Alaskans201040.839.642.1167710,231
All Alaskans201139.438.240.7169722,818
All Alaskans201241.740.542.9187731,191
All Alaskans201340.038.941.1188735,662
All Alaskans201431.630.632.7157735,601
All Alaskans201535.334.236.4178737,183
All Alaskans201638.237.139.3193739,828
All Alaskans201734.833.835.8187737,080
All Alaskans201839.938.840.9210736,239
Alaska Natives200056.051.360.825107,929
Alaska Natives200180.475.085.839108,430
Alaska Natives200235.931.940.020109,873
Alaska Natives200393.987.999.946111,314
Alaska Natives200470.965.875.934112,356
Alaska Natives200593.287.698.848113,773
Alaska Natives200662.558.067.133114,977
Alaska Natives200756.652.560.726115,421
Alaska Natives200858.654.263.032115,969
Alaska Natives200976.271.680.841117,974
Alaska Natives201054.150.457.830120,428
Alaska Natives201150.646.854.531122,441
Alaska Natives201260.657.064.235123,605
Alaska Natives201363.759.867.642124,911
Alaska Natives201448.244.551.836126,090
Alaska Natives201547.944.051.936127,155
Alaska Natives201654.350.757.936127,545
Alaska Natives201759.856.163.644127,656
Alaska Natives201863.559.667.442127,929
U.S.200060.9167,661281,421,906
U.S.200158.4163,538284,968,955
U.S.200257.2162,672287,625,193
U.S.200354.6157,689290,107,933
U.S.200451.2150,074292,805,298
U.S.200548.0143,579295,516,599
U.S.200644.8137,119298,379,912
U.S.200743.5135,952301,231,207
U.S.200842.1134,148304,093,966
U.S.200939.6128,842306,771,529
U.S.201039.1129,476308,745,538
U.S.201137.9128,932311,591,917
U.S.201236.9128,546313,914,040
U.S.201336.2128,978316,128,839
U.S.201436.5133,103318,563,456
U.S.201537.6140,323320,896,618
U.S.201637.3142,142323,127,513
U.S.201737.6146,383325,719,178

Data Notes

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

Data Sources

  • [http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Health Analytics and Vital Records Section (HAVRS)], Division of Public Health, Alaska Department of Health and Social Services
  • National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention


Stroke mortality rate per 100,000 population (age-adjusted), by sex, all Alaskans, 2000-2018

::chart - missing::
confidence limits

HA: Males vs. FemalesYearStroke mortality rateLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 38
Males200069.366.372.477324,111
Males200160.057.262.869327,207
Males200252.850.255.570331,873
Males200354.552.057.175335,905
Males200451.849.354.381341,164
Males200558.455.960.881345,077
Males200643.841.746.078349,145
Males200752.450.154.679352,090
Males200846.744.548.881355,560
Males200941.739.743.774361,200
Males201040.538.642.478369,628
Males201137.235.439.077375,633
Males201241.840.043.687378,915
Males201335.934.337.581380,362
Males201440.238.541.992380,864
Males201535.633.937.288381,888
Males201639.537.941.194382,143
Males201732.130.733.482379,423
Males201838.236.739.792378,817
Females200063.060.465.592302,821
Females200158.856.461.292305,509
Females200256.053.758.387309,856
Females200364.161.866.5107313,561
Females200452.850.655.092318,489
Females200552.350.254.495322,069
Females200650.048.052.196325,438
Females200741.139.442.877328,079
Females200842.340.444.288331,258
Females200941.740.043.488336,628
Females201039.938.341.589340,603
Females201139.938.241.692347,185
Females201241.239.642.8100352,276
Females201342.440.844.0107355,300
Females201424.122.925.365354,737
Females201534.132.735.590355,295
Females201636.835.338.399357,685
Females201737.035.638.5105357,657
Females201841.139.742.6118357,422

Data Notes

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


Stroke mortality rate per 100,000 population (age-adjusted), by race, all Alaskans, 2000-2018

::chart - missing::
confidence limits

Race: Alaska Native, White, TotalYearStroke mortality rateLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 57
Alaska Native200056.051.360.825107,929
Alaska Native200180.475.085.839108,430
Alaska Native200235.931.940.020109,873
Alaska Native200393.987.999.946111,314
Alaska Native200470.965.875.934112,356
Alaska Native200593.287.698.848113,773
Alaska Native200662.558.067.133114,977
Alaska Native200756.652.560.726115,421
Alaska Native200858.654.263.032115,969
Alaska Native200976.271.680.841117,974
Alaska Native201054.150.457.830120,428
Alaska Native201150.646.854.531122,441
Alaska Native201260.657.064.235123,605
Alaska Native201363.759.867.642124,911
Alaska Native201448.244.551.836126,090
Alaska Native201547.944.051.936127,155
Alaska Native201654.350.757.936127,545
Alaska Native201759.856.163.644127,656
Alaska Native201863.559.667.442127,929
White200067.765.469.9125460,021
White200154.953.056.9110463,075
White200256.454.458.4119468,097
White200351.249.452.9111472,059
White200450.648.852.5124478,660
White200547.045.448.6111482,786
White200643.541.945.1121487,277
White200743.942.445.4113490,232
White200839.437.940.9111493,820
White200936.234.837.6105499,690
White201037.736.439.0119507,467
White201138.236.939.6124513,794
White201239.538.140.8137517,796
White201336.235.037.4128518,821
White201429.027.830.1107517,447
White201533.031.934.1121515,431
White201633.532.434.6129514,814
White201729.928.930.9122510,364
White201833.832.834.9139507,304
Total200065.663.767.6169626,932
Total200159.457.661.2161632,716
Total200255.854.157.6157641,729
Total200361.159.362.8182649,466
Total200453.251.654.9173659,653
Total200554.553.056.1176667,146
Total200647.846.449.3174674,583
Total200746.745.348.1156680,169
Total200844.242.845.6169686,818
Total200942.140.843.4162697,828
Total201040.839.642.1167710,231
Total201139.438.240.7169722,818
Total201241.740.542.9187731,191
Total201340.038.941.1188735,662
Total201431.730.632.7157735,601
Total201535.334.236.4178737,183
Total201638.237.139.3193739,828
Total201734.833.835.8187737,080
Total201839.938.840.9210736,239

Data Notes

Data are age adjusted to U.S. 2000 standard population. ICD-10 codes I60-I69 (equivalent to NCHS 113 Leading Causes of Death #61: Cerebrovascular Diseases).   ** Data not available

Data Source

[http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Health Analytics and Vital Records Section (HAVRS)], Division of Public Health, Alaska Department of Health and Social Services


Stroke mortality rate per 100,000 population, by Alaska Economic Regions, all Alaskans, 2014-2018 (5-year average)

::chart - missing::
confidence limits

Stroke mortality rate per 100,000 population (Age-adjusted)Lower LimitUpper LimitNumer- atorDenom- inator
Record Count: 8
Anchorage32.531.833.23381,490,733
Gulf Coast35.033.736.2125404,627
Interior39.738.541.0136562,386
Mat-Su37.035.738.3127510,859
Northern54.750.658.733138,472
Southeast33.832.535.1109368,319
Southwest54.951.857.955211,811
Statewide36.135.636.69253,687,207

Data Notes

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


Stroke mortality rate per 100,000 population, by boroughs and census areas, all Alaskans, 2009-2018 (10-year average)

::chart - missing::
confidence limits

Stroke mortality rate per 100,000 population (Age-adjusted)Lower LimitUpper LimitNumer- atorDenom- inator
Record Count: 25
Aleutians East Borough**30,586
Aleutians West CA**54,425
Anchorage Municipality35.234.735.86812,966,564
Bethel CA72.969.176.859177,210
Bristol Bay Borough**9,406
Denali Borough**18,157
Dillingham CA46.141.650.61149,471
Fairbanks North Star Borough42.741.643.8224984,605
Haines Borough40.535.645.41325,161
Juneau City and Borough35.333.836.873323,532
Kenai Peninsula Borough34.433.435.5178569,682
Kusilvak CA95.688.9102.42979,175
Lake and Peninsula Borough99.084.1114.0816,674
Matanuska-Susitna Borough36.235.337.2224967,045
Nome CA71.066.275.72898,408
North Slope Borough63.357.369.22094,548
Northwest Arctic Borough56.151.261.02177,371
Prince of Wales-Hyder CA33.531.735.359200,628
Sitka City and Borough46.643.849.44389,005
Skagway Municipality**31,795
Southeast Fairbanks CA40.637.044.12169,894
Valdez-Cordova CA54.650.958.23296,170
Wrangell City and Borough39.335.942.72156,878
Yakutat City and Borough**6,170
Yukon-Koyukuk CA40.336.544.21955,236

Data Notes

Data are age adjusted to U.S. 2000 standard population. ICD-10 codes I60-I69 (equivalent to NCHS 113 Leading Causes of Death #61: Cerebrovascular Diseases).   ** = Data not available due to fewer than 20 responses in the numerator

References and Community Resources

'''References:''' 1. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation 2015;131:e29-e322. 2. NINDS | What you need to know about stroke. National Institute of Neurological Disorders and Stroke. [http://www.ninds.nih.gov/disorders/stroke/stroke_needtoknow.htm}. Accessed November 29, 2016. 4. Alaska Department of Health and Social Services, Division of Public Health, Health Analytics and Vital Records Section. Alaska Vital Statistics 2017 Annual Report. [http://dhss.alaska.gov/dph/VitalStats/Documents/PDFs/VitalStatistics_Annualreport_2017.pdf]. Accessed June 11, 2018. 5. Xu JQ, Murphy SL, Kochanek KD, Bastian B, Arias E. Deaths: Final data for 2016. National Vital Statistics Reports. 67(5) July 26, 2018. [https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_05.pdf]. Accessed December 6, 2018. 6. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017. National Vital Statistics Reports; vol 68 no 9. Hyattsville, MD: National Center for Health Statistics. 2019.[https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf]. Accessed October 4, 2019. 8. American Heart Association. What are the risk factors of stroke? [http://www.strokeassociation.org]. Accessed September 15, 2015. 9. Chiuve SE, Rexrode KM, Spiegelman D, Logroscino G, Manson JE, Rimm EB. Primary prevention of stroke by healthy lifestyle. Circulation 2008;118:947-54. 10. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991;22:983-22. '''Resources:''' Alaska Department of Health and Social Services, Division of Public Health, Health Analytics and Vital Records Section. Alaska Vital Statistics 2015 Annual Report. [http://dhss.alaska.gov/dph/VitalStats/Documents/PDFs/VitalStatistics_Annualreport_2015.pdf]. Alaska Heart Disease and Stroke Prevention Program: [http://dhss.alaska.gov/dph/Chronic/Pages/Cardiovascular/default.aspx] American Heart Association: [http://www.americanheart.org] CDC's Cardiovascular Health Branch: [http://www.cdc.gov/DHDSP/index.htm] CDC's Stroke website: [http://www.cdc.gov/stroke/index.htm] CDC's Blood Pressure website: [http://www.cdc.gov/bloodpressure/] CDC's Cholesterol website: [http://www.cdc.gov/cholesterol/] National Stroke Association website: [http://www.stroke.org] Healthy People 2020: [http://www.health.gov/healthypeople] Million Hearts Initiative: [http://millionhearts.hhs.gov/]

More Resources and Links

Alaska and national goals may be found at the following sites:

Alaska health promotion resources may be found at the following site:

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

Maps of health indicators for various subdivisions of Alaska may be found at the following site:

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.

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AK-IBIS Indicator Citation:
"[Indicator name]. Retrieved on [insert date] from Alaska Department of Health and Social Services, Indicator-Based Information System for Public Health (AK-IBIS) website: http://ibis.dhss.alaska.gov/.

Example:
Diabetes Prevalence. Retrieved on March 25, 2016, from Alaska Department of Health and Social Services, Indicator-Based Information System for Public Health (AK-IBIS) website: http://ibis.dhss.alaska.gov/.

Page Content Updated On 10/08/2019, Published on 10/08/2019
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Mon, 10 August 2020 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Tue, 8 Oct 2019 09:51:39 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Mon, 10 August 2020 14:56:00 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Tue, 8 Oct 2019 09:51:39 AKDT