Healthy Communities- May 2nd, 2014

May is American Stroke Month
Knowing these three things may save a life from stroke

During American Stroke Month in May, the American Heart Association/American Stroke Association asks all Oregonians to learn three things that may save a life.

  1. Know if you are at risk for stroke.
  2. Know the stroke warning signs.
  3. What to do in a stroke emergency.

Stroke is the No. 1 preventable cause of disability and the fourth leading cause of death in Oregon. Someone in the United States has a stroke every 40 seconds, yet 80 percent of strokes are preventable.

“Knowing if you are at risk for stroke is extremely important, because many risk factors can be modified and controlled,” said Sarice L. Bassin, MD, Director of the Stroke Program at PeaceHealth Southwest in Vancouver, WA and Board Member, American Heart Association / American Stroke Association – Oregon & SW Washington Division.  “The number one stroke risk factor is high blood pressure.  Nearly 78 million Americans have high blood pressure and many more aren’t even aware that they have it.  It’s important to check your blood pressure regularly and talk to your doctor about what is healthy for you.”

Oregon stroke death rates have historically been higher than national average, but Oregon recently took a strong step to address this issue. In 2013, the American Stroke Association successfully advocated for the creation of a statewide Stroke Care Committee and Stroke Data Collections System (SB 375) in the state legislature. Designating a stroke database and analyzing aggregate data on stroke care will be key to getting the information to help inform stroke providers and the Oregon Public Health Division on best practices for stroke care.

Through the American Stroke Association’s national Together to End Stroke initiative, the association provides information and tools to help people to prevent, treat and beat stroke. A free stroke risk assessment, available at, helps individuals to evaluate their personal stroke risk and to work with their doctor to begin a prevention plan.


Voices for Healthy Kids Competitive Foods Toolkit Available
Voices for Healthy Kids (VFHK), working with the Robert Wood Johnson Foundation and the American Heart Association, released a toolkit with sample materials and guidance on how to build, engage, and mobilize a social change movement on school foods. VFHK offers other toolkits designed to help coalitions work toward a vision of healthy and safe homes, schools, and communities.

Reports and Atricles
Saturday, in the park, I think it was the 3d of July Parks and Health: Aligning Incentives to Create Innovations in Chronic Disease Prevention
Meredith A. Barrett, PhD; Daphne Miller, MD; Howard Frumkin, MD, DrPH
Suggested citation for this article: Barrett MA, Miller D, Frumkin H. Parks and Health: Aligning Incentives to Create Innovations in Chronic Disease Prevention. Prev Chronic Dis 2014;11:130407. DOI:

Federal, state, and local park agencies across the nation have faced budget cuts in recent years as a result of the economic downturn and sequestration, resulting in park closures, reduced hours, staffing cuts, and deferred maintenance. For example, California faced closure of 70 state parks in 2012 to trim $22 million from the strapped state budget. Although most parks were saved by contributions from various partners, future funding remains tenuous. Perhaps the initial proposal to shutter 25% of California’s state parks to save 0.14% of the state budget deficit would not have been made if we valued these lands not only for recreation and conservation but also as a critical public health resource. With health care reform shifting incentives toward prevention, now is the time to look for low-cost, high-yield wellness opportunities, such as those offered by parks and other green spaces.

Up to 40 percent of annual deaths from each of five leading US causes are preventable
Premature deaths from each cause due to modifiable risks

Each year, nearly 900,000 Americans die prematurely from the five leading causes of death – yet 20 percent to 40 percent of the deaths from each cause could be prevented, according to a study from the Centers for Disease Control and Prevention.

The five leading causes of death in the United States are heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries. Together they accounted for 63 percent of all U.S. deaths in 2010, with rates for each cause varying greatly from state to state. The report, in this week’s issue of CDC’s weekly journal, Morbidity and Mortality Weekly Report, analyzed premature deaths (before age 80) from each cause for each state from 2008 to 2010. The authors then calculated the number of deaths from each cause that would have been prevented if all states had same death rate as the states with the lowest rates.

The study suggests that, if all states had the lowest death rate observed for each cause, it would be possible to prevent:

  • 34 percent of premature deaths from heart diseases, prolonging about 92,000 lives
  • 21 percent of premature cancer deaths, prolonging about 84,500 lives
  • 39 percent of premature deaths from chronic lower respiratory diseases, prolonging about 29,000 lives
  • 33 percent of premature stroke deaths, prolonging about 17,000 lives
  • 39 percent of premature deaths from unintentional injuries, prolonging about 37,000 lives

Rates of Childhood Obesity Keeps Rising, Especially Among the Most Obese
A recent study out of the University of North Carolina (UNC) finds that childhood obesity is up for all classes of obesity in U.S. children over the past 14 years, with more severe forms of obesity—a body mass index (BMI) 120 to 140 percent higher than the averages—seeing the greatest increase. The study appeared in JAMA Pediatrics. “An increase in more severe forms of obesity in children is particularly troubling,” said Asheley Cockrell Skinner, PhD, lead author of the study and assistant professor of pediatrics in the UNC School of Medicine, in a release. “Extreme obesity is more clearly associated with heart disease and diabetes risk in children and adolescents, and is more difficult to treat.” Researchers analyzed data on 26,690 children ages 2-19 years from 1999 to 2012 collected as part of the National Health and Nutrition Examination Survey (NHANES).

The National Physical Activity Plan (NPAP*) today released the 2014 U.S. Report Card on Physical Activity for Children and Youth
The primary goal of the 2014 U.S. Report Card on Physical Activity for Children and Youth (the Report Card) is to assess levels of physical activity and sedentary behaviors in American children and youth, facilitators and barriers for physical activity, and related health outcomes. The Report Card is an authoritative, evidence-based document providing a comprehensive evaluation of the physical activity levels and the indicators influencing physical activity among children and youth in the United States (U.S.).

The Report Card takes an “ecological approach” to the problem of physical inactivity. The Ecological Model of Active Living illustrates how policy and the environment influence active behavior, including transportation, occupation, household, and recreation. Tracking these behaviors across the multiple levels of influence (policy, behavior settings, perceived environment, and intrapersonal factors) reveals how components within each level can influence active living. Recognizing and understanding how multiple levels of influence can affect behavior change toward a more active lifestyle is imperative to plan effective interventions and programs.

Review: Sugary drinks may raise risk of high blood pressure
An analysis of 12 studies on nearly 410,000 individuals aged 12 and older showed that drinking sugar-sweetened beverages was associated with a 26% to 70% higher risk of high blood pressure levels. Teens who consumed such drinks three or more times each day were 87% more likely to develop high blood pressure than peers who did not drink sugary beverages, one study found. The findings were published in the American Journal of Cardiology.

High-calorie foods are common at restaurants in poorer areas
Data published in the American Journal of Health Behavior showed that about 75% of items offered at restaurants near public-housing developments were high in fat and calories and low in whole grains, vegetables and fruits. Researchers found table-service establishments were more likely to offer healthier items than fast-food restaurants, which tended to push super-sized menu items. U.S. News & World Report/HealthDay News (4/18)

American Indian and Alaska Native death rates nearly 50 percent greater than those of non-Hispanic whites
Death records show that American Indian and Alaska Native (AI/AN) death rates for both men and women combined were nearly 50 percent greater than rates among non-Hispanic whites during 1999-2009. The new findings were announced through a series of CDC reports released online today by the American Journal of Public Health.
CDC’s Division of Cancer Prevention and Control led the project and collaborated with CDC’s National Center for Health Statistics and other CDC researchers, the Indian Health Service, partners from tribal groups, universities, and state health departments.

Key findings:

  • Among AI/AN people, cancer is the leading cause of death followed by heart disease. Among other races, it is the opposite.
  • Death rates from lung cancer have shown little improvement in AI/AN populations. AI/AN people have the highest prevalence of tobacco use of any population in the United States.
  • Deaths from injuries were higher among AI/AN people compared to non-Hispanic whites.
  • Suicide rates were nearly 50 percent higher for AI/AN people compared to non-Hispanic whites, and more frequent among AI/AN males and persons younger than age 25.
  • Death rates from motor vehicle crashes, poisoning, and falls were two times higher among AI/AN people than for non-Hispanic whites.
  • Death rates were higher among AI/AN infants compared to non-Hispanic whites infants. Sudden infant death syndrome and unintentional injuries were more common.  AI/AN infants were four times more likely to die from pneumonia and influenza.
  • By region, the greatest death rates were in the Northern Plains and Southern Plains. The lowest death rates were in the East and the Southwest.

CDC’s Salt e-Update
Majority of Consumers Support Restrictions on the Addition of Excess Sodium to Foods
Results from a new study published today in the American Journal of Preventive Medicine found that 56% of consumers agree it is a good idea for government to restrict food manufacturers from adding excess salt to foods. About half agreed it is a good idea for government to restrict restaurants from adding excess salt to foods, and 81.5% reported support for sodium reduction in Quick Service Restaurants. Odds of agreement/support were higher for non-Hispanic blacks and those with incomes <$40,000 were more likely to support these policies compared with non-Hispanic whites and those with incomes ≥$60,000.

The study, “Consumer Sentiment on Actions Reducing Sodium in Processed and Restaurant Foods, ConsumerStyles 2010” may be found here:

Lifestyle Changes in England Leading to Reduced Mortality
Improvements in lifestyle from 2003 to 2011 in England led to a 42% reduction in stroke mortality and 40% reduction in Ischemic Heart Disease (IHD) mortality, a new study published in the British Medical Journal found. During this time period in England, salt intake declined by 1.4 grams per day (a 15% reduction) in adults age 19 – 64; study authors indicate that the reduction in salt intake likely occurred across the whole population since it was primarily achieved by a gradual reduction in the amount of salt added to processed foods. The following changes also occurred during this time period – Blood pressure was reduced by 3.0/1.4 mm Hg.
Cholesterol declined by 0.4 mmol/L.
Smoking prevalence declined from 19% to 14%.
Fruit and vegetable intake increased by 0.2 portions per day.

The study, “Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality” may be found here:

Self-reported Taste Preference Affects Daily Sodium Intake, New Study Finds
Taste preference for homemade cooking is a defining feature of daily sodium intake, results of a recent study published in the Journal of the Academy of Nutrition and Dietetics found. The study, “Self-Reported Taste Preference Can Be a Proxy for Daily Sodium Intake in Middle-Aged Japanese Adults” analyzed the difference in daily sodium intake based on self-reported taste preference for miso soup as typically prepared at home, among 143 middle-aged urban Japanese adults. Results indicate that participants reporting a stronger taste preference for miso soup were more likely to have a higher 24-hour urinary sodium excretion and higher sodium intake.


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