1. Why Stroke Surveillance in the English speaking Caribbean ? Dr. Glennis Andall-Brereton Epidemiologist Caribbean Epidemiology Centre (CAREC/PAHO/WHO)

2. Outline Background and context Contribution of Non-Communicable to the Disease Burden Analysis of the stroke situation Assessing trends based on mortality Risk factors for Stroke Modifiable risk factors in the Caribbean Responding to the challenge stroke prevention and control

3. Background and context Epidemiological transition in the Caribbean Non-communicable disease now leading causes of death Caribbean has the worst epidemic of chronic diseases in the Americas Premature and preventable loss of life Lost productivity Spiraling health care costs

4. Includes 21 Caribbean Countries

5. Crude Mortality Rate (per 100,000 population) for leading causes of death (broad groupings), 2004 ¥ Excluding Grenada (2000) and Jamaica (2000-2004)

6. Crude Mortality Rates (per 100,000 population) for CARICOM Member Countries ¥ for Leading Causes of Death by Gender, 2000 & 2004 ¥ Excluding Grenada (2000) and Jamaica (2000-2004)

8. Analysis of the stroke situation Assessing trends based on Mortality

9. Mortality from Stroke Trends in Males

10. Mortality from Stroke Trends in Females

11. Mortality from Stroke Trends in Aruba

12. Risk Factors of Stroke Hypertension Diabetes Psychosocial Stress Depression Cardiac problems Cholesterol levels Smoking Overweight and obesity Abdominal obesity Lack of physical activity Unhealthy diets Excessive use of alcohol Source: NHS news: http://www.nhs.uk/news

13. Modifiable Risk Factors in the Caribbean

14. Prevalence of Current Smokers in selected CAREC Member Countries

15. Prevalence of Exposure to Second Hand Smoke in selected CAREC Member Countries By Place of ExposureBy Gender

16. Prevalence of Current Drinkers by Gender in selected CAREC Member Countries

17. Prevalence of Binge Drinking by Gender in selected CAREC Member Countries

18. Comparison of the Prevalence of Current Drinkers and of Binge (harmful) Drinking

19. Prevalence of Overweight Persons (BMI ≥25 kg/m 2 ) by Gender in selected CAREC Member Countries

20. Comparison of Physical Activity and Overweight Prevalence

21. Mean Daily Servings of Fruits and Vegetables in Selected CAREC Member Countries

22. Responding to the Challenge Stroke prevention and control

23. Planning and Programming Gathering the evidence and monitoring trends Systems for surveillance of risk factors Stroke Registries

24. Thank You