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State of Alaska

Health Indicator Report of Stroke (Cerebrovascular Disease) Mortality Rate

Stroke, the death of brain tissue due to interruption of blood flow, was the 5th leading cause of death in the United States and 6th leading cause of death in Alaska in 2014.^1^ Stroke is a major cause of adult disability.^2^ 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.^3^ About 795,000 new or recurrent strokes occur in the U.S. each year.^2^ 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.^2^ Two major mechanisms are responsible for strokes: ischemia and hemorrhage. The most common mechanism, ischemia, is responsible for 87% of all strokes.^2^ 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.^4^[[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. 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. 3. 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. Moskowitz MA, Lo EH, Iadecola C. The science of stroke: mechanisms in search of treatments. Neuron 2010;67:181-98. }}
** = Data not available.

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 Alaska Health Analytics and Vital Records], 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

Data Interpretation Issues

Alaska populations are from the [http://laborstats.alaska.gov/pop/popest.htm Alaska Department of Labor and Workforce Development, Research and Analysis].

Definition

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 (age-adjusted to 2000 U.S. standard population).

Numerator

Number of deaths due to stroke in the resident population within a reporting period.

Denominator

Total midyear resident population for the reporting period.

Healthy People Objective: Reduce stroke deaths

U.S. Target: 33.8 deaths per 100,000 population

How Are We Doing?

Cerebrovascular disease, or stroke, is the sixth leading cause of death in Alaska. In 2015, stroke claimed the lives of 178 Alaskans. Among the leading causes of death in Alaska, cerebrovascular disease ranked ninth in years of potential life lost with 1,307 years lost. On average, 7.3 years of life were lost prematurely for each stroke death.^5^ Since 2006, the age-adjusted rate has decreased 26.2 percent.^5^ Death rates for stroke in Alaska have declined from 65.6 per 100,000 in 2000 to 35.3 per 100,000 in 2015. There are major regional differences, with highest rates in the Southwest (80.2 per 100,000) and Northern (61.6 per 100,000) regions for the 5-year average from 2010-2014. Stroke mortality is generally higher among Alaska Native people, being 48.6 per 100,000 compared to 32.8 per 100,000 for all Alaskans in 2015. From 2001 to 2011 in the U.S., the relative rate of stroke death fell by 35.1% and the actual number of stroke deaths declined by 21.2%.^2^ These trends 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.^6^ Since 2002, the stroke mortality rate has been significantly higher for Alaska Native people than for Alaskans who were White.[[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. 5. 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]. 6. Lackland DT, Roccella EJ, Deutsch A, Fornage M, et. al. Factors influencing the decline in stroke mortality: a statement from the American Heart Association/American Stroke Association. Stroke 2014;45(1):315-53. }}

How Do We Compare With the U.S.?

Stroke was the 5th leading cause of death in the U.S. and 6th leading cause of death in Alaska in 2014. In Deaths: Final Data for 2014, Alaska had an age-adjusted mortality rate for cerebrovascular disease (stroke) of 32.3 deaths per 100,000 compared to the U.S. mortality rate for stroke of 36.5 deaths per 100,000.^7^ The decline in stroke mortality rates in the U.S. have been mirrored in Alaska, although Alaska generally has a higher rate. Stroke mortality was lower among females (35.6 per 100,000) than males (36.9 per 100,000) in the U.S. in 2013. There are also major national differences in stroke mortality rates per 100,000 between races: black - 49.7, white - 35.2, Asian/Pacific Islanders - 28.3, and American Indian/Alaska Native people - 25.4.^7^[[br]] [[br]] ---- {{class .SmallerFont 7. Kochanek KD, Murphy SL, Xu JQ, Tejada-Vera B. Deaths: final data for 2014. [http://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf]. Published June 30, 2016. Accessed October 4, 2016. }}

What Is Being Done?

Two Alaska hospitals are Joint-Commission certified as a Primary Stroke Centers and also participate in the American Heart Association's Get with the Guidelines-Stroke program to enhance stroke quality of care. In addition to these two primary stroke centers, 6 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 American Heart Association has defined and promotes 7 simple steps to a healthier heart to help individuals increase healthy behaviors. In 2012, the Centers for Medicaid and Medicare Services and the CDC launched Million Hearts, a national 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.

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]
Page Content Updated On 04/02/2018, Published on 04/02/2018
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 Sat, 21 July 2018 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: Mon, 2 Apr 2018 12:54:26 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 Sat, 21 July 2018 1:54:29 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: Mon, 2 Apr 2018 12:54:26 AKDT