EXHIBIT D.1 Risk Factors Man Women for Stroke Total Ag0 25-40 Aged 45-64 Aged 65+ Age 25 44 Aged 44-6a Aged 65+ in Eastern Freq. Freq. Freq. Rabe...

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The Queen's Health Policy Research Unit (QHPRU) estimated the need for stroke services in Eastern Ontario, Canada, using measures of prevalence and incidence of (1) modifiable and nonmodifiable risk factors for stroke; (2) acute cases of stroke; (3) chronic stroke and disability (Hunter et al. 2000; Hunter et al. 2004). QHPRU chose stroke because of the burden of illness in Canada due to this disease; because incidence and prevalence data were readily available; and because disease prevention, treatment, and rehabilitation interventions have been shown to be effective. They identified the effective health services that are targeted at risk factors for acute and chronic stroke and the number of residents with these risk factors for whom these interventions would be appropriate. They compared the estimate of need food for health services to compiled measures of levels of stroke-related health services in Eastern Ontario to see if there was a gap (unmet need) or surplus (overmet need) of these services.

Questions

1. Risk factors for stroke include heavy alcohol consumption, atrial fibrillation, diabetes, hypercholesterolemia, hypertension, obesity, low physical activity, smoking, ischemic heart disease, and transient ischemic attack. Use Exhibit D.1 as a template to calculate the prevalence rates (per 100) by gender and age category for each of these risk factors.

2. Calculate the prevalence ratios (men to women) for each age category and risk factor using Exhibit D.2 as a template.

3. What is the prevalence ratio of hypertension for those aged 25 to 44 (males to females)? Please interpret.

4. Among the 25- to 44-year-olds, what top two risk factors are much more prevalent among men? Please interpret.

5. Among those 45 to 64 years old, how much more prevalent are obesity and smoking among men versus women?

6. Are transient ischemic attacks (TIA) more common among men or women who are 65 and older?

• Attachment 1
• Attachment 2

EXHIBIT D.1Risk FactorsManWomenfor StrokeTotalAg0 25-40Aged 45-64Aged 65+Age 25 44Aged 44-6aAged 65+in EasternFreq.Freq.Freq.Rabefadod snopwud way parejwoolRisk fosterRateRateFreq.RoleRateFreq.Fireg.Ontario,Hypertension203,00036,80049,00025.600150042,10040,5061996Low physical activity397.00697.90072.10030.50084.10059.300Obesity343,10075.40077,4003940051,500Smoking281.50092.10045,1009,200Ro, Boo38,20017-100Heavy alcohol use35.50018,Boo8,5093.0001,000Hypercholesterol mia177.20029.50034-30017.20012,90042,40041,900Atrial fibrillation17 8006,300Ischemic heart$5,2003,30010,50016,0005.300Transient ischemic19.6003.9003.8002.7003,200attackClubries mellitus41.2002.8009.300B, ROD1.7007.00010,60oNote: Population for men: 25-44 (250.345), 49-64 [163.914), 65+ (Bo, or7): population for womerc 25-44 (248,745). 45-640166, 248), 65-(12 58:); and total (1,021,ga3). ? . estimates unavailable.Source: With permission from Hunter Djw, Spasoff RA, Dorland jL, Purdue MPH, Dains N. "Determining the Need and Provision of Health Servicesfor Stroke in Eastern Ontario: An Epidemiologic Approach to Needs Assessment." Health Information Partnership. Eastern Ontario Region, 2000.