| Costs of stroke in England | |||
| Cost (£million) | 2015 | 2025 | 2035 |
|---|---|---|---|
| Health care | 2,983 | 5,189 | 9,015 |
| Social care - Public | 2,148 | 4,163 | 7,936 |
| Social care - Private | 2,403 | 4,733 | 9,130 |
| Social care - Total | 13,675 | 21,453 | 37,300 |
| Unpaid care | 4,551 | 8,896 | 17,066 |
| Lost productivity | 1,305 | 2,012 | 3,106 |
| Total | 22,514 | 37,550 | 66,487 |
| Source: Stroke.org, 2018 | |||
Stroke
Healthy People
Physical Health Conditions
Stroke
Cardiovascular Disease
Atrial Fibrillation
Hypertension
Smoking
Obesity
Weight Management
Alcohol
Physical Activity
Diabetes
Introduction
A stroke occurs when the blood supply stops flowing to the brain, causing brain cells to die. 87% of strokes are ischemic, where a blockage in the brain has occurred, caused by a piece of plaque or blood clot. Plaque is made up of fat, cholesterol, calcium and other substances. This plaque builds on the lining of the arteries, causing the arteries to narrow, reducing or totally blocking the blood flow and oxygen to the heart, brain and other parts of the body. Where the blockage occurs in the brain this is known as thrombosis. If the clot has travelled from elsewhere in the body, this is known as embolism.1
The term mini stoke refers to a transient ischemic attack (TIA), which similarly to an ischemic stroke is caused by a blockage in the brain. This blockage is temporary, breaking up before causing lasting damage but can lead to a full stroke.
Symptoms of a stroke are well known via the acronym of FAST 2
- Face weakness- one side of the face my droop and it may be hard to smile
- Arm weakness- Difficulty or unable to raise both arms and keep them there due to weakness or numbness in 1 arm
- Speech problems- slurring or confusion when speaking.
- Time- to call 999
There are other signs and symptoms of stoke which may include:
- Numbness or weakness to 1 side of the body
- Blurred vision or loss of sight in 1 or both eyes
- Difficulty in speaking or thinking of words
- Confusion or memory loss
- Dizziness or falling over
- Severe headache
- Feeling sick (nausea or vomiting)
Symptoms can very amongst different people, may appear suddenly and may stop after a short time too, in any case urgent medical care should be sought.3
Risk factors of stroke can vary, with some being preventable (modifiable) and others (non-modifiable). Some of the preventable risk factors, which account for 82% to 90% of all strokes are linked to:
- High blood pressure (hypertension)
- Smoking
- Diabetes
- Diet
- Physical activity
- Obesity
With other lifestyle factors such as:
- Age
- Increased Stress/anxiety
- Environmental air pollution
- Alcohol
- Drug use
Comorbidities such as:
- Carotid artery disease
- Peripheral artery disease (PAD)
- Sickle cell disease
- And other heart related diseases4
Non modifiable risk factors such as:
- Family history
- Race
- Gender
- And previous health history of stroke, TIA’s or heart attack
Why is it important to Population Health?
Stroke is one of four known types of cardiovascular disease, along with coronary heart disease, peripheral arterial disease and aortic disease.
Cardiovascular disease causes a quarter of all deaths each year (170,000 deaths each year), equating to 480 deaths a day or one every 3 minutes. And with 7.6 million people in the Uk estimated to be living with cardiovascular disease the NHS have made cardiovascular disease a key priority and focus in recent years.5
Quality of life: Strokes are the biggest cause of severe disability in the UK, and cause around 34,000 deaths each year. People that have experienced and survived a stroke can be affected differently, from a quick recovery and little impact to lengthy recovery times and a significant impact on their lives and also those around them. 73% of people experience a fall in the first year following a severe stroke.6
Inequalities: Evidence suggests that older adults (over 50 years), people of black African-Caribbean or south Asian backgrounds are more at risk of an incident of stroke.
Costs: strokes are estimated to cost the NHS £2.98 billion annually, with additional social care costs of £4.55 billion.A quarter of all strokes occur in people of working age (Under 65), with a third of stroke survivors have to give up work, and a further 15% reducing their hours; the economic impact of which will be felt individually and to wider society.7
Burden: 1 in 12 stroke survivors are significantly impacted by its effects and have to move into a care home. The 2019-2024 NHS long term plan highlighted the importance of stroke care.
In 2018 Stroke.org predicted future costs of a stroke, aged 45 and over:8
Care UK estimate there are around 5.8 million unpaid carer in the UK, with 50% of stroke survivors requiring a carer.9
The Derbyshire Population Health Approach
The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.
When considering the topic of stroke within The Derbyshire Population Health Approach:
• Prevention
Prevention of stroke at a population level is largely targeted at raising awareness of the modifiable risk factors, through advertising and promoting resources, classes and programmes that can be accessed to educate and motivate individuals to undertake positive changes.
Derbyshire County Councils Live Life Better service offers support to those wanting to make lifestyle changes such as weight management, stopping smoking, physical activity and alcohol awareness, as well as mental health well-being.
Nationally, the NHS health check programme is aimed out early identification of risk factors that could lead to cardiovascular disease. NHS Health checks are available via the GP, and Derbyshire County Council currently offer delivery to workplaces in Derbyshire.10
Medication and rehabilitation also play key roles in preventing further strokes.
• Population
Public health is committed to supporting its ageing population by increasing healthy life expectancy through many targeted interventions. The public health approach also aims to break down barriers with minority populations, working with trusted voices in the community, to ensure they have access to relevant information and services.
• Evidence
Governmental policies continue to try and combat many of the identified risk factors for stroke. This includes a smoke free generation11, sugar tax on foods and drinks12, and the get active strategy.13
Public health relies on these national policies and associated funding to create localised policies and targeted projects to address and support the risk factors associated to stroke, as well as other health conditions.
• Causes
Research and evidence inform that people in lower income households are more at risk of a stroke, than those in higher income households. This is mainly due to a higher proportion of people in lower income households being inclined to smoke, drink alcohol and have a poor diet. The public health approach is to engage with these communities, sometimes via targeted interventions, and ensure that those at greater risk have access support services to reduce inequalities.
• Collaboration
Working together with partners and colleagues is crucial to establishing effective prevention strategies. Collaboration understands the value and joined up working of ICB, NHS, GP’s, public health and local and voluntary services in prevention, secondary prevention and recovery.
Primary, secondary and tertiary prevention require a coordinated approach to ensure that systems and people talk to each other, services developed and delivered are what’s needed, and those services are available and accessible to those that need them. Continuing to offer community-based care, support and services allows the barriers and inequalities to be reduced, reaching those that are more at risk.
Latest Derbyshire Data
Trend Data
Derbyshire Quilt
Prevalence Maps of Derbyshire
The maps below illustrate various geographies for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.