Stroke Risk in the African American

CommunityTeam 5

Jennifer Housel, Miranda Lindsey, Theresa Maliskey, Rachal Trigger, Marcos Vergez

The purpose of this presentation is to discuss the stroke risk in the African American

population. Demographic data, risk factors, cultural and environmental characteristics, as

well as population statistics will be used to demonstrate high level of stroke in this

population. Additionally, the Health Belief Model will be used to support the central

focus of this presentation.

Introduction

What is the stroke belt? Stroke Belt States

AlabamaArkansasGeorgiaIndianaKentuckyLouisianaMississippiNorth CarolinaSouth CarolinaTennesseeVirginia*Stroke Belt State locations and definitions of the region have changed over the years (2008)*

The “Stroke Belt” of America

10 published explanations. Higher prevalence of hypertension and

diabetes. Socio-economic factors. Rural or urban nature of environment (2008). Environmental exposures (2008).

Micronutrients in the drinking water and food supply

Lifestyle choices (2008).Diet, exercise, cigarette smoking

Explanations for the Stroke Belt

Demographic Data Describing Cultural Population

Population estimated at 44.5 million

14.2% of the total US population

Largest concentrations in the South

38% of residents in Mississippi

Recent immigrants vs. Many generations

Genetics vs. Environment and Lifestyle

Poverty rate 3x greater (24.5%)

Cultural Descriptors that Impact Health Risk Factors

Medical Conditions History of stroke or

transient ischemic attack

Hypertension Hypercholesterolemia History of heart

disease Diabetes mellitus Sickle cell disease

Describe Health Risk Factors in Your Population

Behavior Diet high in fat,

cholesterol, and salt Physical inactivity Obesity Alcohol use Tobacco use

Other Family history of stroke Age Race or ethnicity

The stroke mortality rate for African Americans aged 45 to 64 years is 3 to 4 times higher than for whites of the same age.

Stroke mortality rates are approximately 50% higher in African Americans than in whites.

The black-to-white stroke mortality ratio was consistently higher for southern states, with an average black-to-white stroke mortality ratio that ranged from 6% to 21% higher among southern states than in non-southern states

Statistics Related to Population and Health Risk Factors

Lack of access to medical care Lack of access to medications Lack of grocery stores/grocery stores with

limited selections Large number of fast food restaurants Poor economic conditions Lack of access to recreational facilities High rate of unemployment Social conflict leading to stress

Environmental or Community Risk Factors

Health Belief Model

Excerpt from British Dental Journal, 1999

Educate on healthy eating/cooking habitsPrint healthy recipes on pharmacy bags, back of

receipts Encourage early screening for risk factors

Conduct health fairs and set up booths at local event to help identify & educate the public

Educate on warning signs & importance of immediate action in event of stroke symptomsPublic service advertisements on local tv & radio

stations

Plan of Action to Address Health Issue and How to Implement Action Idea

Content of Presentation Related to Goals of Healthy People 2020

Improve Cardiovascular HealthPrevention of modifiable risk factorsDetection of risk factorsTreatment of risk factors for a stroke

Improve Quality of LifeEarly identification to improve outcomesTreatment Prevention of repeat cardiovascular events

The increased stroke risk in the African American community is rising at a startling

rate. It is critical to improve direct healthcare education, access to healthcare, and

treatment of early risk factors for stroke. While a large effort is needed to curve these

statistics in the adult African American population, it is of vital importance to begin health education during the early childhood

years.

Conclusion

Ashford, R., & Blinkhorm, A. (1999). Marketing dental care to the reluctant patient. British Dental Journal, 186, 436. doi: doi:10.1038/sj.bdj.4800135

Center for Disease Control and Prevention (CDC). (2014). Black or African American populations. Examples of important health disparities. Retrieved from http://www.cdc.gov/minorityhealth/populations/remp/black.html#Demographics

Centers for Disease Control and Prevention. (2014). Heart healthy and stroke free. Retrieved from http://www.cdc.gov/dhdsp/seh_handbook.htm

Centers for Disease Control and Prevention. (2014). Risk factors. Retrieved from http://www.cdc.gov/stroke/risk_factors.htm

Fashionbrew. (2013). Inspiring: Two beauty pageant winners promote African fashion during their humanitarian missions [Photograph]. Retrieved from http://www.thefashionbrewery.com/2013/11/two-beauty-pageant-winners-display- cultural-fashions-in-the-forefront-during-their-humanitarian-missions/

Healthy People 2020. (2013). Heart disease and stroke. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=21

Howard, G., Labarthe, D., Hu, J., Yoon, S., & Howard, V. (2008). Regional differences in African Americans’ high risk for stroke: the remarkable burden of stroke for southern African Americans. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1995237

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References