Ontario Health Promotion E-bulletin -
II Stroke can happen at any age
III Improvements in care and treatment
IV Coordinated care
V Specialized units, specialized care
VI The power of technology
IX Involving patients and families
--submitted by Ian Joiner, Patrice Lindsay and Stephanie Lawrence
Stroke care has come a long way in Canada. More is known about its causes and effects, and stroke services have improved and expanded in many regions. Patient outcomes are also much better. Now one-third fewer people admitted to hospital for stroke die compared with ten years ago. And on top of this, there are fewer hospitalizations from stroke in some provinces, as a result of both fewer strokes happening but also because people with mild strokes can now get appropriate services in the community. Canadians are also developing a better understanding of stroke including recognizing its signs and how to prevent it.
However, this is only part of the story and only today’s story. Stroke remains a serious health issue that affects thousands of Canadians and their loved ones. It is the second leading cause of death in the world. There are an estimated 50,000 strokes in Canada every year, or one every 10 minutes. And 315,000 Canadians are living with the effects of stroke, which can include a range of disabilities.
Gains that have been made in stroke treatment and care are about to be challenged by an aging population, more stroke patients with more complex needs, and an increase in strokes among people under 70, as well as an increase in all stroke risk factors for younger adults (aged 30–50).
The Canadian population is aging, and stroke is an age-related disease. Put simply, as more people get older, there will be more strokes. And the profile of the typical stroke patient is changing. More stroke patients arrive at hospital with multiple conditions such as hypertension, diabetes, coronary artery disease and cancer, making their treatment more complex. In fact two-thirds of stroke patients now have one or more chronic conditions and this trend is only expected to increase.
“We have seen great success when looking at stroke rates declining but as physicians, we do not treat rates, we treat patients,” says Dr. Michael Hill, Director of the Stroke Unit, Calgary Stroke Program and Heart and Stroke Foundation spokesperson. “As our population gets older there will be more strokes and more patients to treat; many of these patients will be sicker, so there will be a bigger burden on the healthcare system, on society and on families.”
II Stroke can happen at any age
At the other end of the age spectrum, strokes among younger people are increasing. Most strokes occur in people over 70, but the escalation among those under 70 is alarming. According to the new data gathered for this report, over the past decade strokes in people in their 50s have increased by 24 per cent, and for those in their 60s by 13 per cent. Even more troubling, recent international studies predict a doubling of stroke rates among younger people (defined as ages 24–64) within the next 15 years.
This poses some serious questions for our existing health system, services and resources. The Public Health Agency of Canada reports that stroke costs the Canadian economy $3.6 billion a year in physician services, hospital costs, lost wages, and decreased productivity (even more when you count indirect costs).The anticipated increase in the number of strokes will place a bigger burden on the system and families. As more stroke survivors are created, there will be a need for more services to support them throughout their recovery. Will we be able to keep up with increased demand and provide Canadians with the care and support they need?
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