Description

Every year more than 795,000 people in the United States have a stroke. On average, that’s 1 person every 40 seconds. On average, 1 American dies from a stroke every 3 minutes and 14 seconds. Approximately 9.4 million American adults ≥20 years of age self-report having had a stroke. These data are disturbing, more so as 80% of strokes are preventable.Prevention begins with implementing equity-focused systems and interventions that assist populations at the highest risk in detecting and managing cardiovascular disease (CVD) and mitigating systemic social conditions that contribute to the increased prevalence of CVD. Roughly 1 in 10 (9.9% ≈ 28.6 million) adults in the US have at least 1 type of CVD, including coronary heart disease, heart failure, or stroke. This number excludes hypertension, a risk factor for and cause of CVD but not a type of CVD. However, hypertension or high blood pressure is a critical risk factor for stroke. An estimated 120 million American adults (48.1%) have it, most (3 in 4) don’t have it controlled, and 1 in 5 adults is unaware they have hypertension. High blood cholesterol, smoking, obesity, and diabetes also contribute to stroke risk.Heart disease, stroke, and their modifiable risk factors are experienced disproportionately throughout the US population based on race and ethnicity, social factors, and geography. Non-Hispanic Black Americans have a higher prevalence and highest death rate from stroke than any other racial group. While non-Hispanic Blacks had the highest age-adjusted stroke death among all races and ethnicities (59.6 per 100,000) in 2021, the age-adjusted stroke death rate for individuals across the board increased from 38.8 per 100,000 in 2020 to 41.1 per 100,000 in 2021. Stroke deaths also increased in southern states, where populations at a higher risk, specifically communities of color, exist. These numbers highlight the critical need to improve access to quality care for those at the highest risk of stroke and for stroke patients.In 2001, Congress provided funding to CDC to establish the Paul Coverdell National Acute Stroke Registry, named after the late US Senator Paul Coverdell of Georgia, who suffered a fatal stroke in 2000 while serving in Congress. In 2012, as the program expanded, the name changed to the Paul Coverdell National Acute Stroke Program. The aim has been to support the implementation of comprehensive stroke systems for individuals at the highest risk of stroke and for stroke patients across the continuum of care from the onset of stroke symptoms through rehabilitation and recovery.This new iteration of Coverdell supports state stroke systems in partnerships with learning collaboratives or coalitions to improve state-level stroke care for those at the highest risk. Recipients will be required to execute a dual approach to addressing stroke in the coordinated systems of care and the implementation of prevention activities in community settings. Recipients will continue their collection and analysis of in-hospital stroke data for those who have experienced a stroke while adding a deep focus on understanding and mitigating the stroke risks among individuals in their communities, also ensuring post-discharge follow-up in either rehabilitation facilities or other community-supportive recovery services.This NOFO requires Coverdell recipients to integrate their work with CDC’s other funded programs in states where they exist to mitigate systemic inequities and reduce the prevalence of CVD and hypertension so that another person doesn’t die from a stroke every 3 minutes and 14 seconds.