You’re two times more likely to die from a stroke in Humboldt County than rest of California

You’re more likely to die from a stroke in Humboldt County than if you live elsewhere in the state, but that doesn’t have to be the case, local doctors say.

The risk of dying from a stroke in Humboldt County is almost double the state average at 67.6 deaths per 100,000 people compared with the rest of the state at 36.3 deaths per 100,000 people between 2015 and 2017, according to the 2019 county health status profiles prepared by the state Department of Public Health.

“Stroke mortality in Humboldt County is one of the worst,” said County Health Officer Donald Baird. “We currently have the highest stroke mortality rate in the state.”

This might be in part because the community has more retirees and older people who are more at risk for strokes, but Baird said the data was corrected to account for age.

Dr. Stephanie Dittmer, president of the Humboldt-Del Norte County Medical Society, said doctors are still trying to tease out the variables that could be driving higher levels of stroke mortality in Humboldt.

“When you look at data, you have to look at what’s driving that data and what are the other factors that are playing into it,” Dittmer said. “It’s not simply age that’s pushing that data. It’s likely, quite honestly, related to the overall health factors in our population.”

Humboldt County residents have a high rate of experiencing multiple health problems at once, such as high blood pressure and diabetes, which can exacerbate stroke risk, Dittmer said.

That also includes social determinants of health, such as adverse childhood experiences, Dittmer said. A person with four or more adverse childhood experiences, about a third of county residents, is 2.4 times more likely to have a stroke, according to the 2018 county health assessment.

“There’s a lot of pieces of this puzzle that, hopefully, we’ll be able to tease out over time,” Dittmer said.

There are two broad categories of strokes. Some are caused by blood flow being restricted to the brain either by a blood clot or a buildup of cholesterol plaque in the blood vessels, Dittmer said, while others are the result of an artery bursting and causing bleeding.

“There’s a difference in our ability to treat different types of strokes,” Dittmer said.

Currently, the county is only equipped to handle the former and anyone who has the latter is transferred out of the county to medical facilities better equipped to handle those kinds of strokes.

For strokes caused by a blockage, it’s important to get to an emergency room as soon as you recognize you’re experiencing a stroke symptom, the doctors said. Preferably within two or three hours, but the sooner the better.

Stroke symptoms can present themselves in a variety of ways, including sudden onset of weakness of an arm or leg, possibly having a headache, difficulty speaking, asymmetry in a person’s face, and abrupt or sudden changes in function.

“There’s no one symptom and it can mimic many other conditions,” Baird said, “which is why if you’re not sure, go to a hospital and have a physician sort this out.”

However, the doctors said getting to a hospital in time can be a challenge in the county.

“Where people live and where they access care puts them up against real timelines that don’t allow for the treatments that exist to be given,” Dittmer said.

After being treated for a clot, patients still need to be able to travel to a facility that has the capabilities to treat additional clots that may be in the vessels leading up to the brain before they do more damage, Baird said. Usually, that’s in the Bay Area.

Places where these facilities are present, such as Marin County, have among the lowest stroke death rates, Baird said.

But all hope isn’t lost. The county was among the worst in the state for cardiovascular deaths a few years ago, but as of last year, Baird said “we’re right in the middle.”

That progress was made because of St. Joseph Hospital’s cardiac program, as well as public education regarding recognition of heart attack symptoms, Baird said.

The county is currently working with emergency responders on transferring stroke patients to the hospital and developing better policies in the hospitals to expedite and streamline recognition and treatment of possible stroke symptoms, Baird said.

“Many of these protocols are already in place and they’re being refined,” Baird said.

But prevention is also key, the doctors said. Dittmer emphasized the need to quit smoking tobacco, which is also a risk for cancer, and to see a primary care physician who can catch any issues on the horizon early.

“We’re trying to have people come in sooner,” Dittmer said. “People live with their symptoms much longer than they should.”

A person might experience numbness or tingling in their hand and won’t come in until eight hours later once they’re slurring their words. Even if a person feels fine, a primary care physician can help them catch high blood pressure and other problematic symptoms.

In addition to not smoking and seeing a primary care physician, it’s also important to maintain healthy blood pressure and cholesterol levels.

Diabetes is a major risk factor for stroke, so Baird said managing it is essential, along with getting a good night’s sleep, exercising and eating nutritious food.

“Avoid processed foods,” Baird said. “Eat more plant-based foods. You don’t have to be a vegetarian, just eat more plant-based.”

There is a culture in Humboldt County of being wary of medication and waiting to see a doctor until it’s too late that needs to change, too, Dittmer said. Evidence has shown taking some of the medicine doctors are prescribing can save lives, she said.

“There’s a lot of things people can do individually to decrease their risk,” Baird said. “I think it’s one thing to make our treatment systems better, but it’s even better to prevent the need for them in the first place.”

Sonia Waraich can be reached at 707-441-0506.