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Health Care Final 11-16-11 -   3.2 - Stroke: Rate of Deaths per 100,000

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Health Care Final 11-16-11
Healthy State
Action Plan

3.2 - Stroke: Rate of Deaths per 100,000
What is the trend for stroke death rate in Washington?


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Data Notes
Data Source: DOH Vital Statistics, 1999-2010, available annually in February. National data from CDC WONDER compressed death files, 1999-2007 and Deaths: Preliminary Data 2009. National Vital Statistics Report; vol 59 no 4. Hyattsville, MD: National Center for Health Statistics. 2011.
Measure Definition: Numerator is number of deaths of Washington residents with an underlying (or first listed) cause of stroke. Denominator is the total number of Washington residents. Data is age-adjusted.
Target Rationale: Target setting method—projection (a 1.5 percent improvement per year from 2010 based on HP2020 target setting method). Given current resources, a modest decrease to 35 deaths per 100,000 persons by 2013 is achievable. The Healthy People national target is 34 deaths per 100,000 people by 2020 (a 20 percent improvement from 2007).
Link to Agency Strategic Plan:

Goal #1:  Improve health outcomes for the people of Washington.

Objective #1: Increase our focus on chronic disease and injury prevention.

Strategy #3:  Get people the right care in the right place, in the right amount of time, by establishing a comprehensive emergency cardiac and stroke care system.

Relevance: Stroke deaths are dropping in Washington and nationwide but they're still among the top causes of health care costs and hospitalizations, disabilities, and deaths.
Notes: (optional)

For many decades, stroke was always the third leading cause of death in Washington State and stroke death rates were consistently higher than rates in the United States. In 2005, the National Center for Health Statistics instructed states to code multi-infarct dementia (ICD-10: F011) and vascular dementia (ICD-10: F019) as mental disorders in death certificates instead of as death from stroke (ICD-10: I60-I69) where it had been coded previously. After this coding change, a large decline in stroke deaths occurred between 2004 and 2005 and the rate of death became (and continues to be) similar to the national stroke death rate.  

Also Available
Action Plan: Yes
Extended Analysis: No

 Drill Down Measures

 Summary Analysis

  • Rates of death from stroke have declined by 48 percent since 1999 from 70 to 37 per 100,000 persons in 2010. Because we reached the previous 2013 target of 44 deaths per 100,000 people ahead of schedule, we reset the target to 35 deaths per 100,000 people by 2013.
  • Since 1999, stroke has always been the third leading cause of death in Washington State. Starting in 2007, stroke began dropping from the third to its current rank as the sixth leading cause of death in 2009. Alzheimer's disease is now third, chronic lower respiratory disease is now fourth, and unintentional injury (accident) is now fifth. Similarly in the United States, stroke dropped from the third to the fourth leading cause of death between 2007 and 2008.
  • Continuing decreases in stroke deaths may be in part to improved prevention, and in part to the improved quality of care for stroke patients by hospitals, including the increased use of clot-busting drugs known as thrombolytics and the provision of medications demonstrated effective in preventing recurrent strokes.
  • Washington death rates for stroke are similar to the United States (age-adjusted rate of 38 deaths per 100,000 people compared to 39 deaths per 100,000 people in 2009--latest data available for US). 
  • In Washington, death from stroke dramatically increases with age and is more likely in men age 65-74 years, Blacks, Asians, Pacific Islanders, and American Indian/Alaska Natives (females only) and adults with lower levels of education.

 Action Plan 
         What:  Develop standards for stroke treatment for use by emergency medical services and hospital staff.

Who:   Kelley/DOH, Schmitt/DOH, Klein/DOH; Emergency Cardiac and Stroke Technical Advisory Committee 

When: December 2012