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<div class="WordSection1">
<p class="MsoNormal"><span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri","sans-serif";color:#404040">Good morning.
</span><span style="font-size:14.0pt;font-family:"Calibri","sans-serif""><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif""><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif"">As you know, May is National Stroke Awareness Month and we are growing awareness in Oregon communities through the release of a combined chronic disease report with a specific
volume related to stroke, <a href="http://public.health.oregon.gov/DiseasesConditions/ChronicDisease/HeartDiseaseStroke/Documents/volume5.pdf">
“The Burden of Stroke in Oregon 2013.” </a><span style="mso-spacerun:yes"> </span><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif""><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">During the past 20 years, stroke prevalence, hospitalizations and mortality have consistently declined in both Oregon and nationally.
However, stroke is still the fourth leading cause of death in Oregon and the third leading cause of death in the United States overall. In 2011, an estimated 86,000 Oregon adults reported having a stroke, and there were 7,762 hospitalizations due to stroke
with a total cost of nearly $254 million. <o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman""><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">The report confirms that stroke affects some Oregonian communities more than others. A higher percentage of African American (4.8%)
and American Indian/Alaska Native (4.2%) persons reported having a history of stroke compared to white (2.5%) and Asian/Pacific Islander (3.5%) persons.<span style="mso-spacerun:yes">
</span>In addition, Oregon adults with an annual household income of less than $20,000 (4.6%) were nearly four times more likely to report ever having a stroke than Oregon adults in households with an annual income of $50,000 or more (1.2%).<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman""><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">Common risk factors for stroke are prevalent among Oregonians.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman""><o:p> </o:p></span></p>
<p class="MsoNormal"><i style="mso-bidi-font-style:normal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">High blood pressure and high cholesterol:</span></i><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">
Among the general population of Oregon adults, 28% reported high blood pressure and 32% high cholesterol. Among adults who reported a history of stroke, the proportion with high blood pressure nearly doubled at 51%, and the proportion with high cholesterol
more than doubled at 70%.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman""><o:p> </o:p></span></p>
<p class="MsoNormal"><i style="mso-bidi-font-style:normal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">Obesity</span></i><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">:
More than one-quarter of adults in Oregon are obese. Among adults who report having a stroke, 35% are obese<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman""><o:p> </o:p></span></p>
<p class="MsoNormal"><i style="mso-bidi-font-style:normal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">Cigarette smokers:</span></i><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">
Approximately one-in-three adults who reported a history of stroke were current cigarette smokers, compared to 20% of adults overall.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman""><o:p> </o:p></span></p>
<p class="MsoNormal"><i style="mso-bidi-font-style:normal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">Lack of physical activity:</span></i><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">
Nearly half of adults who reported a history of stroke got inadequate physical activity, compared to 20% of adults overall<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman""><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">Oregon is committed to preventing stroke through a wide range of evidence-based practices. The Health Promotion and Chronic Disease
Prevention Section of the Oregon Public Health Division is working with local and state partners to:<o:p></o:p></span></p>
<p class="MsoListParagraph" style="text-indent:-.25in;mso-list:l0 level1 lfo2"><![if !supportLists]><span style="font-size:14.0pt;font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:14.0pt;mso-fareast-font-family:"Times New Roman"">Increase availability of healthy foods and beverages in child care facilities, schools, worksites and neighborhoods;<o:p></o:p></span></p>
<p class="MsoListParagraph" style="text-indent:-.25in;mso-list:l0 level1 lfo2"><![if !supportLists]><span style="font-size:14.0pt;font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:14.0pt;mso-fareast-font-family:"Times New Roman"">Increase places where people can move more safely;<o:p></o:p></span></p>
<p class="MsoListParagraph" style="text-indent:-.25in;mso-list:l0 level1 lfo2"><![if !supportLists]><span style="font-size:14.0pt;font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:14.0pt;mso-fareast-font-family:"Times New Roman"">Increase the number of environments that are tobacco-free;<o:p></o:p></span></p>
<p class="MsoListParagraph" style="text-indent:-.25in;mso-list:l0 level1 lfo2"><![if !supportLists]><span style="font-size:14.0pt;font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:14.0pt;mso-fareast-font-family:"Times New Roman"">Increase referrals to self-management programs so that people with chronic disease can live well and take care of themselves;<o:p></o:p></span></p>
<p class="MsoListParagraph" style="text-indent:-.25in;mso-list:l0 level1 lfo2"><![if !supportLists]><span style="font-size:14.0pt;font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:14.0pt;mso-fareast-font-family:"Times New Roman"">Improve delivery and use of quality health care services through the physician promotion of the ABCS — appropriate
<i style="mso-bidi-font-style:normal">A</i>spirin therapy, <i style="mso-bidi-font-style:normal">
B</i>lood pressure control, <i style="mso-bidi-font-style:normal">C</i>holesterol control,
<i style="mso-bidi-font-style:normal">S</i>moking cessation and reduced <i style="mso-bidi-font-style:normal">
S</i>odium consumption. <o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman""><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">This comprehensive, community-wide approach makes it easier for all Oregonians to eat better, move more and live tobacco-free wherever
they live, work, play and learn.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman""><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman"">We welcome your review of the report and the attached infographics.<span style="mso-spacerun:yes">
</span>Please let us know if you have any questions or comments.<span style="mso-spacerun:yes">
</span>We look forward to working with you to grow awareness about stroke, the communities most affected by stroke, and addressing the underlying risk factors that contribute to stroke.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif";mso-fareast-font-family:"Times New Roman""><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri","sans-serif";mso-bidi-font-family:"Times New Roman";color:#404040">Best regards,
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;font-family:"Calibri","sans-serif";mso-bidi-font-family:"Times New Roman";color:#404040"><o:p> </o:p></span></p>
<p class="MsoNormal"><i style="mso-bidi-font-style:normal"><span style="font-family:"Calibri","sans-serif";color:#404040;mso-no-proof:yes">Terresa White</span></i><i style="mso-bidi-font-style:normal"><span style="font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman";color:#404040;mso-no-proof:yes"><br>
</span></i><i style="mso-bidi-font-style:normal"><span style="font-family:"Calibri","sans-serif";color:#404040;mso-no-proof:yes">Heart Disease and Stroke
</span></i><i style="mso-bidi-font-style:normal"><span style="font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman";color:#404040;mso-no-proof:yes">Prevention
</span></i><i style="mso-bidi-font-style:normal"><span style="font-family:"Calibri","sans-serif";color:#404040;mso-no-proof:yes">Program</span></i><i style="mso-bidi-font-style:normal"><span style="font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman";color:#404040;mso-no-proof:yes">
</span></i><i style="mso-bidi-font-style:normal"><span style="font-family:"Calibri","sans-serif";color:#404040;mso-no-proof:yes">Analyst<br>
Community Programs Liaison<o:p></o:p></span></i></p>
<p class="MsoNormal"><i style="mso-bidi-font-style:normal"><span style="font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:"Times New Roman";color:#404040;mso-no-proof:yes">Health Promotion and Chronic Disease
Prevention | Center for Prevention and Health Promotion | Public Health Division | Oregon Health Authority | 800 NE Oregon Street, Suite 730 | Portland OR 97232 | Phone 971-673-1080 | E-mail
<a href="mailto:terresa.l.white@state.or.us"><span style="color:blue">terresa.l.white@state.or.us</span></a></span></i><i style="mso-bidi-font-style:normal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:"Times New Roman";color:#404040;mso-no-proof:yes"><o:p></o:p></span></i></p>
<p class="MsoNormal"><o:p> </o:p></p>
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