Burden in Illinois

1
Burden in Illinois

• Illinois Department of Public Health
• Heart Disease and Stroke Prevention Program

Illinois Critical Access Hospital Network
(ICAHN) American Heart Association/American
Stroke Association Illinois Department of Public
Health Office of Womens Health Center for
Minority Health Services Heart Disease and Stroke
Prevention Program
2
Risk Factors for Stroke

• High Blood Pressure 120/80
• Cigarette Smoking
• Heart Disease
• Diabetes
• Transient Ischemic Attacks (TIAs)

3
Counties with the highest rates of adults with
high blood pressure Alexander Franklin Massac
Saline White.
4
Counties with the highest smoking prevalence
rates Franklin (32.3 percent) White (32.3
percent) Mason (33.5 percent) Pulaski (34.5
percent) Hardin (36.1 percent)
5
Highest Diabetes Prevalence Rate Pulaski (11.1
percent) Franklin (11.2 percent) Pope (11.4
percent) White (11.6 percent) Gallatin (12.2
percent) Alexander (14.3 percent)
6
Champaign, Jo Daviess, Kendall, Pike and Putnam,
counties have the lowest age-adjusted mortality
rates due to heart disease all less than 410.0
deaths/100,000 (Figure 10). Calhoun, Hamilton,
Hardin, Saline and Schuyler counties had the
highest heart disease mortality rates ranging
from 648.9 to 702.3/100,000. The counties
bordering, or near, Indiana, Kentucky and
Missouri have the areas with the highest rates of
heart disease death.
7
Clinton, Grundy, Hamilton, Johnson and White
counties have the lowest age-adjusted stroke
mortality rates in the state all under
84.0/100,000. Brown, Clay, Edgar, Montgomery and
Pulaski counties have the highest age-adjusted
mortality rates, ranging from 166.9/100,000 to
186.6/100,000. High stroke age-adjusted
mortality rates can be found along the mid-lower
Illinois-Indiana border.
8
Warning Signs of a Stroke

• Sudden numbness or weakness of face, arm or leg,
  especially on one side of the body.
• Sudden confusion or trouble speaking or
  understanding speech.
• Sudden severe headache with no known cause.
• Sudden trouble walking, dizziness, or loss of
  balance or coordination.
•  
• Sudden trouble seeing in one or both eyes.

9
EMS Take Action in Your Community

• Heather Gavras, MPH
• American Heart Association/American Stroke
  Association

Illinois Critical Access Hospital Network
(ICAHN) American Heart Association/American
Stroke Association Illinois Department of Public
Health Office of Womens Health Center for
Minority Health Services Heart Disease and Stroke
Prevention Program
10
People Do Not Know the Warning Signs or Call
9-1-1 for Prompt Care
There is a Need for Community Education

• American Heart Association/American Stroke
  Association
• Give Me Five for Stroke
• Power to End Stroke
• 2009 Stroke Community Awareness Kit

11
Improving Stroke Response

• Increasing stroke symptom awareness and saving
  lives

12
Walk Is their balance off?

• Are they able to stand straight and tall?
• Or do they slump to one side?
• Do they appear to have lost strength on one side
  of their body?
• Are they leaning to one side when they try to
  walk?
• Are they veering off to one side?
• Are they dragging the foot on the side they are
  leaning toward?
• Can they tell you whether they can feel the side
  that they are leaning toward?

13
TALK   IS THEIR SPEECH SLURRED OR FACE DROOPY?

• Are they having problems speaking?
• Are they having problems "getting their words
  out?"
• Do they sound like they have something in their
  mouth when they speak?
• Are they saying the appropriate words (do their
  words make sense) when they speak?
• Does one side of their mouth droop down?

14
REACH   IS ONE SIDE WEAK OR NUMB?

• Ask the person to raise both their arms up
  together. Does one arm begin to fall down?
• Ask the person to squeeze your fingers with each
  hand is one hand weaker than the other?
• If you ask the person to try to hold something
  like a pen, can they do it without any
  difficulty?
• Can the person feel you touch them on their arm?
  Lightly touch them on the skin of both arms, and
  ask them if the feeling is the same on each side.

15
SEE   IS THEIR VISION ALL OR PARTLY LOST?

• Ask the person about their vision. Do they
  normally wear glasses or contact lenses, or do
  they normally not use either of these?
• Ask the person to try to describe any changes in
  their vision.
• Is their vision clear or is it blurry?
• Can they see everything in their field of vision?
  Does the person see everything or just part of
  the visual field?
• Does the person see double?

16
FEEL   IS THEIR HEADACHE SEVERE?

• Do they have a headache? On a scale of 1-10, 10
  being the worst, ask them to rate their headache.
  
• Do they normally have headaches? If so, is this
  headache any different from their usual headache?
  
• Does this feel like the worst headache of their
  life?
• Does light bother or hurt their eyes?
• Does a sound or loud noise make the headache
  worse?

17
Power To End Stroke

• The American Stroke Association is charged with
  reducing stroke and risk by 25 by 2010. To
  reach this goal, an aggressive education and
  awareness campaign is being delivered to reach
  African Americans.
• Power To End Stroke
• You Are the Power

18
Power To End Stroke Goals

• To create a movement around the serious health
  disparity issue of stroke in African Americans
  --- and to drive the message that stroke is
  largely preventable
• To increase awareness of high blood pressure and
  diabetes in African Americans
• To promote adherence to primary and secondary
  prevention guidelines

19
Target Audience

• Primary
• African Americans age 30-64
• Secondary/Channels
• Public officials
• Healthcare professionals
• Churches
• Caregivers
• Role models with
  affluence and/or
  influence

20
Campaign Materials
Pledge card tri-fold cards encourage people to
join the movement, request stroke-related
information, and share knowledge. Triggers
fulfillment for supporting materials. Shape Your
Family History brochure an easy way for people
to track their family medical history and
recognize their risk. Church Fan perfect for
places
of worship, local events and
seminars.
Includes stroke facts,
stroke warning signs and

inspirational quotes.
21
Stroke Community Education Awareness Kit

• Developed each year by the American Heart
  Association\American Stroke Association
• Web-based tool offering flyers, handouts and
  other tools for public education
• http//www.americanheart.org/presenter.jhtml?qStr
  okeMonthKitidentifier10000015submit.x29subm
  it.y13

22
Increasing the Use of 911

• Large community intervention studies using mass
  media have had mixed effects
• Measuring the impact of a campaign can be
  difficult
• While people may know to call 911 for a heart
  attack or stroke, they do not recognize the signs
  and symptoms, causing delay.

23
What do we know

• Targeted interventions such as workplace
  campaigns are effective in increasing awareness
• Awareness campaigns are slightly more effective
  with older and younger participants and slightly
  greater with women than men

24
Other Strategies that work

• Target high risk groups
• Address emotional barriers- denial
• Address social barriers include family members
  in education process
• Education on signs and symptoms
• Teaching the physiologic consequences of delay
  and the benefit of time sensitive new treatments

25
Strategies What Works

• Developing messages specific to men and specific
  to women
• Teaching the benefits of what EMS services offer
  fast response, on-board treatment options,
  pre-hospital notification
• Stories
• Stories of success
• Stories of dangers of driving yourself or a
  family member

26
Most Important Strategy

• Keep sending the message
• You never know when someone will get the message
  and need it only hours or days later
• Repetition is a good thing

27
Become an Ambassador for Stroke

• You personally or your organization can become a
  community Ambassador
• At least 3 times per year provide a community
  awareness service
• Share your personal stories and successes with us
• Sign up for Youre the Cure to keep your elected
  officials informed
• www.americanheart/yourethecure

28
Resources American Stroke Association www.strokea
ssociation.org Stroke Pre-hospital
On-line Acute Stroke On-line Soon to be
released Rapid STEMI ID web training www.OnlineA
HA.org National Stroke Association www.stroke.org
National Institute of Neurological Disorders
and Stroke www.ninds.nih.gov/ Burden of Heart
Disease and Stroke in Illinois Mortality,
Morbidity and Risk Factors February
2007
29
All of us at the American Heart Association and
the Illinois Department of Public Health, want
to say THANK YOU FOR ALL YOU DO PROVIDING
CRITICAL MEDICAL SERVICES TO YOUR COMMUNITY!
30
For more Information Contact

• American Stroke Association
• www.strokeassociation.org
• Heather.Gavras_at_heart.org
• Illinois Department of Public Health
• TTY 800-547-0466
• Office of Womens Health
• Womens Health Line
• 888-522-1282
• Center for Minority Health Services
• 217-785-4311
• Heart Disease and Stroke Prevention Program
• 217-782-3300