Running Head: SOCIAL AND ECONOMIC IMPACT OF STROKES IN THE US 1

Social and Economic Impact of Strokes in the US

Steven Zhang

University of San Diego

SOCIAL AND ECONOMIC IMPACT OF STROKE IN THE US 2

Abstract

This paper explores stroke and it’s social and economic impact at a high level. It gives a basic

overview of the three different types of strokes-ischemic, hemorrhagic, and transient ischemic

stroke. This article also discusses the statistics of strokes and ways to prevent and lessen the

chances of suffering from a stroke. Lastly, this article discusses the social and financial impact

that stroke does to not only the patient but also to their families.

Americans have a basic understanding of strokes, but few Americans recognize the signs

of a stroke nor do they understand just how dangerous strokes are. This paper aims to provide a

high-level overview of what a stroke is, the impact to your body and how to prevent, reduce and

act on the during the first signs of a stroke- ultimately saving lives.

Background

Stroke is the third leading cause of death in America. Each year, more than 140,000

people die from the disease and nearly 800,000 more people will suffer a stroke each year. Stoke

is the leading cause for long-term disability in the United Sates (Centers for Disease Control

2016(CDC)). A stroke happens when blood flow to an area of the brain is cut off. The brain cells

die due to the lack of oxygen. The brain requires a massive amount of oxygen to function. 20%

body’s oxygen intake goes to the brain, when brain cells die due to a stroke, this may result in

permanent loss of speech, movement, memory and even death. (CDC, 2016)

There are three main types of strokes: ischemic stroke, hemorrhagic stroke and transient

ischemic attack (mini stroke). An ischemic stroke occurs when there is a blockage in the blood

vessels that lead to the brain. These blockages occur when plaque (fatty deposits) that builds up
SOCIAL AND ECONOMIC IMPACT OF STROKE IN THE US 3

in blood vessels that eventually blocks the blood vessels. Hemorrhagic stroke is when a blood

vessel burst inside the brain- the blood from the blood vessels seeps out and damages brain

tissues. A transient ischemic attack (TIA) is essentially the same as a ischemic stroke with the

only difference that the blockage clears itself about five minutes. However, one cannot

differentiate the difference between a TIA and an ischemic stroke. (CDC 2016)

Stroke risk increases as we age in addition to other risk factors such as high blood

pressure, cholesterol, obesity, high sodium diet, lack of exercise, smoking and alcohol all

contribute to stroke risk. Woman have a higher risk of stroke compared to men. According to the

CDC, six out of every ten stroke deaths are woman. (CDC, 2016) Interestingly, African

American woman and Hispanic woman have a twice as high stroke risk compared to European

American woman.

When someone is suspected of having a stroke, it is important to look for the following

symptoms and call emergency services immediately. Is the face droop on one side when a person

smile? Does one arm droop when raised upwards? Is their speech slurred or strange? If the

person is demonstrating any of these symptoms, please call emergency service immediately.

(Stroke Publications, 2017)

Social and Economic Impact

The social impact of strokes can be devastating to the family. Stroke is the leading cause

of long-term disability in the US (CDC 2016). When a family member is permanently disabled

due to a stroke, family members often miss or reduce work hours or leave the workforce entirely

to tend to their love one. If the stroke patient is the head of household, this will completely

change the family dynamic. The reorganization of family expectations and roles will create
SOCIAL AND ECONOMIC IMPACT OF STROKE IN THE US 4

additional stress to the family; in addition to the cultural aspect that plays a critical role in any

family dynamic. In addition to the family dynamic, if the stroke survivor is permanently

disabled, the survivor would no longer be able to interact with his/her social group and

participate in everyday social interaction with friends and other social settings. This lack of

social interaction may create additional mental stress which may lead to depression. It is

important during this time to speak with a social worker to get additional help and support.

(What Are the Social Consequences of Stroke for Working-Aged Adults, 2019)

The economic impact of a stroke could be staggering. Combined loss wages of both

parties (the stroke patient and the family member that is taking care of the patient) and the cost of

medical services, strokes cost the United States an estimated $34 billion dollars annually. (CDC

2016). Depending on the family’s insurance, stroke survivors may now need to live in a nursing

facility. If the stroke survivor is the primary wage earner, the impact of the stroke may lead to

additional financial hardships when the medical insurance is exhausted.

Telemedicine Components in Management/Treatment

Although strokes can happen at any age, people over the age of 65 on average have the

greatest risks. Having a healthy lifestyle and exercise can decrease the risk of a stroke. However,

when a stroke does occur, it is important to call emergency services and get to the hospital

quickly to reduce brain cell damage. According to the CDC, (2016) recognizing the signs and

symptoms of a stroke will improve the chances of a patient survival and reduce long-term

disability. Symptoms included a drooping on half of the face and arm and slurred and confusing

speech. The good news is that 80% of all strokes can be prevented through a healthier lifestyle.
SOCIAL AND ECONOMIC IMPACT OF STROKE IN THE US 5

The use of telemedicine in stroke (commonly referred to as Telestroke) is a new addition

to stroke management/treatment. Telestroke is primarily used at regional or rural healthcare

organizations in which a neurologist or a stroke specialist is not available on site. The use of

Telestroke enables access to specialist in areas that are otherwise not possible before- enhancing

the quality of care that the healthcare organization is able to provide to the stroke victim.

Telestroke is a compliment of traditional medicine, not a substitute (Telemedicine Quality and

Outcomes in Stroke, 2019).

Federal or State Programs

There are several federal and state programs within the US that focuses on stroke

prevention and stroke recovery. For federal programs sponsored by the CDC, there are the Paul

Coverdell National Acute Stroke Program, Million Hearts, CDC’s Heart Disease and Stroke

Prevention Program just to name a few. There are dedicated days and months that focuses on

stroke prevention and awareness. The month of May, 2019 will be national stroke awareness

month and October 28 of 2018 was world stroke day. These programs are designed to bring

awareness on the preventative measures of stroke management and the promotion of healthy

lifestyle. The CDC also provides a number of publications, articles for both the general public

and medical professional on the stroke and stroke management. For State programs there is the

California stroke registry that compliments the federal programs and a specific program designed

and implemented by regional HCO. (CDC 2016)

Conclusion

One in seven American will suffer a stroke in their lifetime. 80% of strokes are

preventable through a proper nutrition and an active lifestyle. Proper prevention and recognizing

the signs of a stroke will greatly improve survival reduce long term disability. In addition to the
SOCIAL AND ECONOMIC IMPACT OF STROKE IN THE US 6

damage to the body that a stroke can make, the social and economic impact to a stroke survivor

and their family can be as devasting as the disease itself. It is important to understand what the

patient needs in addition to medical care. There are three types of strokes; ischemic stroke,

hemorrhagic stroke and transient ischemic attack (mini stroke). It is a medical emergency when

someone experience symptoms of drooping face and arms, followed by slurred speech and

confusion. Only a medical professional will be able to diagnose a stroke. With the advent of

telemedicine (in this case Telestroke), the quality of care a stroke patient receives increases

dramatically when they have access to neurologists and stroke specialists. There are federal and

state programs dedicated to stroke education and prevention such as the Million Hearts and Paul

Coverdell registry. Medical advances have greatly improved the chances of surviving a stroke,

but the best treatment is prevention. Future research should be conducted on methods to predict

strokes and identify blood vessels that are in dangers of forming clots.
SOCIAL AND ECONOMIC IMPACT OF STROKE IN THE US 7

References

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Telemedicine Quality and Outcomes in Stroke: A Scientific Statement for Healthcare

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What Are the Social Consequences of Stroke for Working-Aged Adults? (n.d.). Retrieved March
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