NEEDS ASSESSMENT OF ISCHEMIC STROKE IN AFRICAN AMERICAN WOMEN AGED 35-50 MISSISSIIPI
NEEDS ASSESSMENT OF ISCHEMIC STROKE IN AFRICAN AMERICAN WOMEN AGED 35-50 MISSISSIIPIOrder Description
Combating Ischemic Stroke in African American Women
Agency Partner : We will approach the National Stroke Association to implement an
initiative consistent with their mission is to “reduce the incidence and impact of stroke by
developing compelling education and programs focused on prevention, treatment,
rehabilitation and support for all impacted by stroke”(http://www.stroke.org/aboutus).
The National Stroke Association is a 501 (c) (3) nonprofit organization with a key focus
area for 20142015
that includes increasing awareness and understanding of stroke.
Funding sources for the programs of this agency includes donations and grants.
Health Objective : Decrease the incidence of ischemic stroke in African American
women, aged 3550,
residing in Mississippi, by 10 percent in 3 years of program
Funder : Genentech
The Genentech Foundation provides financial support to qualified nonprofit, U.S.based
charitable organizations. The Foundation awards grants in support of organizations that
undertake charitable activities in the areas of: health science education and community
civic initiatives. Genentech prioritizes and focuses funding towards programs and events
such as: Patient Services, Patient Outreach, Patient Education, Disease Education,
Fundraisers, Health Screenings, Scientific/Medical Meetings, Conferences, Seminars and
Symposia. This foundation was identified because of its history of donating to nonprofit
organizations and the nature of our objective is a communityfocused
project that we
believe appeals to the charitable interests of the foundation. Attached below is the
funding solicitation and details of the application process.
Funding Request Process
Registration & Application
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is required for particular funding types The next deadline for submission of
grant application is September 15, 2015.
National Stroke Association www.stroke.org
we are MPH candidate from George washington university , our plan is to implement program called step up healthier you in mississippi for african american women aged 35-40 with prevention from ischemic stroke, with a grant approval of $50,000
A stroke is a brain attack that occurs when a blood clot blocks an artery or a blood vessel breaks, interrupting blood flow to an area of the brain. Brain cells begin to die(http://www.stroke.org/sites/default/files/resources/AfricanAmericansAndStroke.pdf) African Americans are twice as likely to die from a stroke as whites. The rate of strokes in African Americans is almost double that of whites, and strokes occur earlier in life for African Americans than whites. In addition, African American stroke survivors are more likely to become disabled and experience difficulties with daily living and activities. African American women have a lower one-year survival following ischemic stroke (a stroke caused by a blood clot) compared with whites((http://www.stroke.org/sites/default/files/resources/AfricanAmericansAndStroke.pdf)
C Stroke (ICD/10 codes I60-I69) (ICD/9 codes 430-438) Among non-Hispanic blacks age 20 and older, 4.3% of men and 4.7% of women have had a stroke. Blacks have a risk of first-ever stroke that is almost twice that of whites. Between the 1990s and 2005, incidence rates of stroke decreased for whites, but not for blacks. The changes for whites were driven by a decline in ischemic strokes. There were no changes in incidence of ischemic stroke for blacks. In 2009 stroke caused the deaths of 6,962 black males and 8,916 black females. The 2009 overall death rate for stroke was 38.9. Death rates for blacks were 60.1 for males and 50.2 for females. ©2013 American Heart Association, Inc. All rights reserved.
Quality of life BRFSS/YRBSS Stroke alone is the third leading cause of death in Mississippi, accounting for 6.8 percent of all deaths in 2001, when 1,927 Mississippians died from stroke. Stroke mortality rates in Mississippi have declined, but remain significantly higher than national rates. In 2000, Mississippi’s stroke death rate was 22 percent higher than the U.S. rate (74.0 vs 60.8). This premature mortality due to CVD is greater for women and for African Americans than whites. • CVD death rates in Mississippi have fallen, but not as much as rates in the rest of the nation: national rates are declining more than twice as fast as rates in Mississippi
It is not known whether Mississippi’s high CVD mortality rates are due to high incidence (more new cases of CVD), more severe disease, poorer survival of persons with CVD, or some combination of these factors. Further decreases in CVD mortality rates will not be achieved unless racial/ethnic and geographic disparities are reduced. Also, primary prevention needs to be emphasized very strongly to reduce the prevalence of CVD risk factors in the population: more Mississippians need to stop smoking, become more active, lose weight, control their blood pressure, eat a healthier diet, and lower their blood cholesterol level. Currently, three-fourths of Mississippians have at least one CVD risk factor. The economic impact of CVD on the Mississippi health care system continues to grow as the population ages. Of all states, Mississippi has the fifth-highest percentage (22 percent) of adults aged 18-64 reporting no health care coverage. The estimated cost of CVD in Mississippi in 2001 was about $3.7 billion. This cost includes health care expenditures and lost wages. The largely preventable nature of CVD makes the deaths, disability, and costs attributable to this disease more tragic.
Of special concern in Mississippi are people with lower socioeconomic status, living in rural areas or under-served counties, women, and African Americans. Within this subset of persons, another group of note are those with underlying medical conditions that predispose them to heart disease and stroke, particularly those with high blood pressure, high cholesterol, obesity, and diabetes.
DATA MORBIDITY /MORTALITY For Young Women, What’s Your Stroke Risk?
Although most strokes occur in people older than 50, about one in 5,000 women ages 15 to 49 suffers a stroke each year, according to the National Institute of Neurological Disorders and Stroke (NINDS).
A stroke occurs when brain cells die because the brain is deprived of oxygen. The most common cause of stroke is a blockage in an artery, a blood vessel that brings oxygen-rich blood to the brain. This type of stroke is called an ischemic stroke. The blockage is nearly always because of a blood clot that has formed in the artery and becomes so big that it stops or greatly decreases the amount of blood that can flow past it. The blockage can also be caused by a dislodged fragment of a clot from elsewhere in the body that has become wedged in an artery too narrow for it pass through.
Another type of stroke occurs when a tear in the wall of an artery in the brain allows blood to flow out of the artery. The blood leakage deprives the brain of oxygen. This type of stroke is called a hemorrhagic stroke.
How a stroke affects a person depends on where in the brain it has occurred and how many brain cells have died.
Risks for stroke in women
In younger women, the risk factors for stroke are obesity, high blood pressure (hypertension), type 2 diabetes and cardiovascular disease. An older study, published in 1997 in the Journal of the American Medical Association, found that women who are obese or who have gained more than 44 pounds since they were 18 years old are about 2-1/2 times more likely to have an ischemic stroke than lean women who have not gained a lot of weight.
Smoking or using oral contraceptives also increases the risk for stroke. The stroke risk is increased even for women who use low-estrogen contraceptives. Women who smoke, are older than 35 and use oral contraceptives are at higher risk of stroke.
Healthy women ages 45 to 64 can cut their risk for ischemic stroke by exercising regularly, eating a healthy diet, drinking only moderate amounts of alcohol, not smoking and controlling high blood pressure, according to a 2006 study by the Harvard School of Public Health.
A woman’s weight at birth may increase the risk for stroke, a study by the published by the American Heart Association study says. Women who weighed 5.5 pounds or less at birth have double the risk for stroke as women who weighed at least 8 pounds at birth.
Other Stroke risk factors:
In general, African American women are up to three times more likely that have a stroke than white women. For both African American and white women ages 15 to 49, however, having a particular gene boosts the risk for ischemic stroke. The gene, phosphodiesterase 4D, encourages both the buildup of plaque in arteries and the formation of blood clots. It also raises the risk for hemorrhagic stroke. If you smoke and have a certain variation of this gene, you are at especially high risk for stroke, the NINDS says.
Pregnancy can slightly increase the risk for ischemic stroke. It is more of a risk for women with high blood pressure linked to pregnancy, a condition called preeclampsia, and for women undergoing cesarean delivery. A woman with preeclampsia during pregnancy is also at risk in the days just after delivery, possibly because of shifting hormone levels, according to a 2006 study in the journal Stroke.
Younger women who use cocaine or methamphetamine are at greater risk for stroke.
Young African Americans have a 2-3 fold greater likelihood of having an ischemic stroke, suffer greater physical disability after a stroke, and adults are more likely to die from a stroke than are members of other major racial groups in the US that have been studied. Risk is increased for both ischemic and hemorrhagic strokes. The estimated age-adjusted prevalence of stroke is greater in African American women than in men.
Up to 40% of adult African Americans have hypertension, almost twice as many as adult Hispanic and non-Hispanic whites. The form of hypertension in many African Americans may have an earlier onset, be more severe, and be more sensitive to dietary salt intake than that seen in the other groups. (Recently, a gene has been described that may be responsible for this increased salt sensitivity but much remains to be investigated.)
The prevalence of physician-diagnosed diabetes in African American adults age 20 and older is 7.6% of men and 9.5% of women (in non-Hispanic whites the prevalence is 5.4% of men and 4.7% of women).
However, in at least one study, the relative risk of stroke among African Americans was higher, even when the statistics were adjusted for age, hypertension, and diabetes.
In African Americans, atherosclerotic plaque tends to deposit more often in the intracranial branches of the major arteries, especially the carotid, while extracranial lesions occur more frequently in whites. The significance of this difference is unclear at present.
African Americans who live in the so-called Stroke Belt in the southeast US have the highest death rates from stroke in the US. The Stroke Belt includes Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Virginia. Although not a state, Washington DC has also been identified as part of the Stroke Belt. In addition, African Americans living in these regions have the greatest prevalence of high blood pressure. Whites who live in the Stroke Belt also have somewhat increased incidence of hypertension and stroke.
In the US, most people with sickle cell disease are African-American. Sickle cell disease is strongly associated with stroke, especially in children. In these individuals, the vascular endothelium may be damaged by repeated episodes of red cell sickling, making it prone to thrombus formation. Long-term exchange transfusion or bone marrow transplants can prevent the vascular pathology from progressing, and therefore decrease the risk of stroke. If a child with sickle cell disease has a stroke, he or she often recovers quite well, thanks perhaps to the increased plasticity of the young nervous system. However, without therapy these children remain at high risk for additional strokes that may produce a lifetime of disability.