1 The Burden of Stroke in the Great Lakes States

2  Goal: assess the burden of stroke in the Great Lakes region.  Presents data on stroke for each Network state including: prevalence, age-adjusted mortality rate, distribution of risk factors, recognition of and response to stroke symptoms, pre-transport deaths, and hospital discharges.  Data will guide the Network.

3 The Burden of Stroke in the Great Lakes States Prevalence of Stroke Risk Factors Source: Behavioral Risk Factor Surveillance System, 2007.

4 The Burden of Stroke in the Great Lakes States Prevalence of Stroke Risk Factors Source: Behavioral Risk Factor Surveillance System, 2007.

5 The Burden of Stroke in the Great Lakes States Recognition of Stroke Symptoms IllinoisIndianaMichiganMinnesotaOhioWisconsin Severe headache52.0%64.7%56.7%60.0%56.9%59.4% Severe dizziness/imbalance/trouble walking 84.5%89.0%87.5%83.7%84.7%88.8% Sudden vision trouble66.2%73.2%72.7%68.3%67.4%71.9% Sudden numbness/ weakness 91.2%93.9%95.4%93.0%95.1%95.5% Sudden confusion/ trouble speaking 86.8%89.5%89.8%88.3%91.0%89.1% Sources: Illinois Point-In-Time Survey (based on BRFSS methodology), Minnesota, Wisconsin: Behavioral Risk Factor Surveillance System, Indiana, Ohio: Behavioral Risk Factor Surveillance System, Michigan Behavioral Risk Factor Surveillance System 2007 preliminary data.

6 The Burden of Stroke in the Great Lakes States Anticipated Response to Heart Attack and Stroke Symptoms Sources: Illinois Point-In-Time Survey based on BRFSS methodology, Minnesota, Wisconsin: Behavioral Risk Factor Surveillance System, Indiana, Ohio: Behavioral Risk Factor Surveillance System, Michigan: Behavioral Risk Factor Surveillance System, 2007 preliminary data. Those who refused to answer the question were excluded from the denominator.

7 The Burden of Stroke in the Great Lakes States Estimated Stroke Prevalence Estimated NumberPercentage Illinois270, Indiana138, Michigan213, Minnesota70, Ohio270, Wisconsin81, Great Lakes Region1,044, United States5,920, Sources: Stroke Prevalence (Ever Told Had a Stroke): BRFSS, Age18 and older population estimate: Estimates of the Population by Selected Age-groups for the United States, States, and Puerto Rico: July 1, 2007 (SC-EST ). Source: Population Division, U.S. Census Bureau. Release Date: May 1, 2008.

8 The Burden of Stroke in the Great Lakes States Stroke Prevalence by Race Source: Behavioral Risk Factor Surveillance System, 2007 * Median Percent Stroke Prevalence (51 States).

9 The Burden of Stroke in the Great Lakes States Stroke Prevalence by Gender Source: Behavioral Risk Factor Surveillance System, 2007 * Median Percent Stroke Prevalence (51 States)

10 The Burden of Stroke in the Great Lakes States Stroke Prevalence by Age Source: Behavioral Risk Factor Surveillance System, 2007 * Median Percent Stroke Prevalence (51 States)

11 The Burden of Stroke in the Great Lakes States Hospital Discharge Data Sources: Illinois, Indiana Discharge Data, (Total charges for stroke event discharges, 2006); Ohio State Hospital Discharge Data, 2003; Michigan Inpatient Database, 2006; Wisconsin Hospital Inpatient Discharge Data, (Total charges for stroke event discharges, 2006.)

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13 The Burden of Stroke in the Great Lakes States Stroke Mortality, 2005 Stroke Mortality Rate*Number of Stroke Deaths Illinois47.36,232 Indiana50.23,284 Michigan46.55,049 Minnesota41.92,372 Ohio48.36,280 Wisconsin45.62,952 Great Lakes Region ** ,223 United States ** ,579 Sources: State Reported: Illinois Department of Public Health, Vital Statistics, 2005; Indiana State Department of Health, Data Analysis Team, 2005; Michigan Department of Community Health, Vital Statistics, 2005; Minnesota Department of Health, Vital Statistics, 2005; Ohio Department of Health, Vital Statistics, 2005; Wisconsin Department of Health and Family Services, Vital Statistics, *Overall rate (per 100,000)age-adjusted to the 2000 US standard population. **CDC Wonder, 2005.

14 The Burden of Stroke in the Great Lakes States Stroke Mortality Rate* (per 100,000) by Gender and Race, Sources: Illinois Department of Public Health, Vital Statistics, 2005; Indiana State Department of Health, Data Analysis Team, 2005; Michigan Department of Community Health, Vital Statistics, 2005; Minnesota Department of Health, Vital Statistics, 2005; Ohio Department of Health, Vital Statistics, 2005; Wisconsin Department of Health and Family Services, Vital Statistics, *Overall age-adjusted to the 2000 US standard population (as reported by states). **Illinois stroke mortality data for race/ethnicity are grouped as “white” and “non-white” For comparison purposes, Illinois data provided here taken from the CDC Wonder Data ¶ CDC Wonder, 2005.

15 The Burden of Stroke in the Great Lakes States Stroke Mortality Trends for Women by Race, 35 years and older, in the Great Lakes Region compared to the US. Source: CDC Wonder, (Age-adjusted Rates, 2000 U.S. Standard Population).

16 The Burden of Stroke in the Great Lakes States Stroke Mortality Trends for Men by Race, 35 years and older, in the Great Lakes Region compared to the U.S. Source: CDC Wonder, (Age-adjusted Rates, 2000 U.S. Standard Population).

17 Survivor Stories  A stroke face on the numbers.  Stroke survivor stories from our region.  Identified with help from the AHA/ASA, NSA and other partners.

18 The Burden of Stroke in the Great Lakes States Summary  In 2007, the estimated stroke prevalence ranged from 1.8 percent (Minnesota) to 3.1 percent (Ohio);  In 2005, the age-adjusted stroke mortality rate per 100,000 ranged from 41.9 (Minnesota) to 50.2 (Indiana), with Indiana, Ohio, and Illinois having a higher rate than the U.S. age-adjusted rate of 46.6 per 100,000;  In 2005, black men had the highest age-adjusted stroke mortality rates, ranging from 61.7 (Ohio) to 74.3 (Illinois) per 100,000;  According to the 2007 Behavioral Risk Factor Surveillance System survey, sudden severe headache and sudden vision trouble are the least recognized symptoms of stroke among adults ages 18 and older;  More than 157,043 stroke patients were discharged from hospitals in the region with total hospital charges over $3.3 billion.

19 The Burden of Stroke in the Great Lakes States Limitations  Data for stroke prevalence, recognition of and anticipated response to stroke symptoms and hospital discharge data are from different years.  Data on incidence and quality and costs of medical care are lacking.  Challenging to find reliable data on American Indian/Alaskan Native, Asian, Hawaiian/Pacific Islander and Hispanic populations.  Difficult to compare states within the Great Lakes region and the region with other regions in the United States.  Better coordination and timely data analysis are needed to improve efforts to reduce the burden of stroke in the Great Lakes region.

20 The Burden of Stroke in the Great Lakes States Data Sources  U.S. Census, Population Division, Population Estimates, July 1 st  U.S. Census, American Community Survey,  U.S. Census, Current Population Survey, 2007 ASEC.  Behavioral Risk Factor Surveillance System (BRFSS),  Illinois Point-In-Time Survey,  CDC Wonder,  National Center for Health Statistics,  Vital Statistics (from each state health department),  Joint Commission,  Hospital Discharge Data (from each state),  CDC Morbidity and Mortality Reports,

21 The Burden of Stroke in the Great Lakes States Contact Information The Burden of Stroke in the Great Lakes States report is available on the GLRSN web site or call to request a copy of the report on CD. Dilip Pandey, MD, PhD Principal Investigator Angela Bray Hedworth, MS, RHEd, CHES Program Manager Great Lakes Regional Stroke Network Center for Stroke Research University of Illinois at Chicago 1645 W. Jackson Blvd., Suite 400 Chicago, IL Phone: 312/ Web: