Skip to main content
SpringerLink
Log in

Stroke Awareness Among Low Literacy Latinos Living in the South Carolina Low Country

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

Background Little is known about stroke awareness in Latinos with low literacy and living in regions with high stroke rates. Methods We surveyed a convenience sample of 60 adult Latinos living in Charleston South Carolina to examine recognition of 4 common warning signs of stroke and appropriate first action to call 9-1-1. Results Forty-six percent of the participants recognized sudden facial, arm, or leg weakness; 39% recognized sudden vision loss; 43% recognized sudden trouble walking; 45% recognized sudden headache; 17% recognized all four warning signs. Twenty-seven percent of the participants incorrectly identified chest pain as a warning sign of stroke. Participants at the lowest literacy levels recognized three of the four warning signs more frequently than the participants at higher literacy levels. Discussion Overall, awareness of stroke warning signs was considerably low in this high-risk population. The relationship between low-literacy and stroke awareness was unclear in this sample.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Rosamond W, et al. Heart disease and stroke statistics—2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115(5):e69–171.

    Article  PubMed  Google Scholar 

  2. Horner RD, et al. Racial variations in ischemic stroke-related physical and functional impairments. Stroke. 1991;22(12):1497–501.

    CAS  PubMed  Google Scholar 

  3. Jones MR, et al. Racial variation in initial stroke severity. Stroke. 2000;31(3):563–7.

    CAS  PubMed  Google Scholar 

  4. Kuhlemeier KV, Stiens SA. Racial disparities in severity of cerebrovascular events. Stroke. 1994;25(11):2126–31.

    CAS  PubMed  Google Scholar 

  5. Lisabeth LD, et al. Ethnic differences in stroke recurrence. Ann Neurol. 2006;60(4):469–75.

    Article  PubMed  Google Scholar 

  6. Shen JJ, Washington EL, Aponte-Soto L. Racial disparities in the pathogenesis and outcomes for patients with ischemic stroke. Manag Care Interface. 2004;17(3):28–34.

    PubMed  Google Scholar 

  7. Brown DL, et al. Projected costs of ischemic stroke in the United States. Neurology. 2006;67(8):1390–5.

    Article  CAS  PubMed  Google Scholar 

  8. Greenlund KJ, et al. Low public recognition of major stroke symptoms. Am J Prev Med. 2003;25(4):315–9.

    Article  PubMed  Google Scholar 

  9. Pancioli AM, et al. Public perception of stroke warning signs and knowledge of potential risk factors. JAMA. 1998;279(16):1288–92.

    Article  CAS  PubMed  Google Scholar 

  10. Schneider AT, et al. Trends in community knowledge of the warning signs and risk factors for stroke. JAMA. 2003;289(3):343–6.

    Article  PubMed  Google Scholar 

  11. Reeves MJ, Hogan JG, Rafferty AP. Knowledge of stroke risk factors and warning signs among Michigan adults. Neurology. 2002;59(10):1547–52.

    PubMed  Google Scholar 

  12. DuBard CA, Garrett J, Gizlice Z. Effect of language on heart attack and stroke awareness among U.S. Hispanics. Am J Prev Med. 2006;30(3):189–96.

    Article  PubMed  Google Scholar 

  13. Travis LH, et al. Awareness of stroke risk factors, symptoms, and treatment is poor in people at highest risk. J Stroke Cerebrovasc Dis. 2003;12(5):221–7.

    Article  PubMed  Google Scholar 

  14. Guzman B. The Hispanic Population: Census 2000 Brief. U.S. Department of Commerce, Economics and Statistics Administration. U.S. Census Bureau. Washington, DC, in 2001, p. 1–8. Retrieved October 4, 2007 from: http://www.census.gov/prod/2001/pubs/c2kbr01-3.pdf.

  15. Young R. The growing Hispanic population in South Carolina: trends and issues 2005;9:1–24.

  16. Sheinart KF, et al. Stroke recurrence is more frequent in Blacks and Hispanics. Neuroepidemiology. 1998;17(4):188–98.

    Article  CAS  PubMed  Google Scholar 

  17. Sacco RL, et al. Stroke incidence among white, black, and Hispanic residents of an urban community: the Northern Manhattan Stroke Study. Am J Epidemiol. 1998;147(3):259–68.

    CAS  PubMed  Google Scholar 

  18. Morgenstern LB, et al. Excess stroke in Mexican Americans compared with non-Hispanic Whites: the Brain Attack Surveillance in Corpus Christi Project. Am J Epidemiol. 2004;160(4):376–83.

    Article  PubMed  Google Scholar 

  19. Gillum RF. Epidemiology of stroke in Hispanic Americans. Stroke. 1995;26(9):1707–12.

    CAS  PubMed  Google Scholar 

  20. Morgenstern LB, et al. Barriers to acute stroke therapy and stroke prevention in Mexican Americans. Stroke. 2001;32(6):1360–4.

    CAS  PubMed  Google Scholar 

  21. Howard G, et al. Is the stroke belt disappearing? An analysis of racial, temporal, and age effects. Stroke. 1995;26(7):1153–8.

    CAS  PubMed  Google Scholar 

  22. Howard G, Howard VJ. The end of the stroke belt? It may be too early to declare victory!. Stroke. 1995;26(7):1150–2.

    CAS  PubMed  Google Scholar 

  23. Casper ML, et al. The shifting stroke belt. Changes in the geographic pattern of stroke mortality in the United States 1962 to 1988. Stroke. 1995;26(5):755–60.

    CAS  PubMed  Google Scholar 

  24. US Department of Education. Institute of Education Sciences (IES). National Center for Education Statistics, National Assessment of Adult Literacy. A first look at the literacy of America’s adults in the 21st century (NcES 2006-470). Washington, DC: IES 2005 December. Retrieved October 4, 2007 from: http://www.ahrq.gov/qual/nhdr06/nhdr06.htm. 2003.

  25. Graham EA, et al. Health services utilization by low-income limited English proficient adults. J Immigr Minor Health. 2007.

  26. Wilson E, et al. Effects of limited English proficiency and physician language on health care comprehension. J Gen Intern Med. 2005;20(9):800–6.

    Article  PubMed  Google Scholar 

  27. Lasater LM, et al. Glycemic control in English- vs Spanish-speaking Hispanic patients with type 2 diabetes mellitus. Arch Intern Med. 2001;161(1):77–82.

    Article  CAS  PubMed  Google Scholar 

  28. Williams MV, et al. Relationship of functional health literacy to patients’ knowledge of their chronic disease. A study of patients with hypertension and diabetes. Arch Intern Med. 1998;158(2):166–72.

    Article  CAS  PubMed  Google Scholar 

  29. Center for Applied Linguistics, Basic English Skills Test (BEST): BEST literacy 1987.

  30. Centers for Disease Control and Prevention (CDC), The behavioral risk factor surveillance system user’s guide. Atlanta, GA: U.S. Department of Health and Human Services. 2003.

  31. Statistical Package for the Social Sciences (SPSS 14.0). Chicago, IL: SPSS Inc.; 2006.

  32. Schroeder EB, et al. Determinants of use of emergency medical services in a population with stroke symptoms: the Second Delay in Accessing Stroke Healthcare (DASH II) Study. Stroke. 2000;31(11):2591–6.

    CAS  PubMed  Google Scholar 

  33. Morris DL, et al. Time delays in accessing stroke care in the emergency department. Acad Emerg Med. 1999;6(3):218–23.

    Article  CAS  PubMed  Google Scholar 

  34. Williams JE, Rosamond WD, Morris DL. Stroke symptom attribution and time to emergency department arrival: the delay in accessing stroke healthcare study. Acad Emerg Med. 2000;7(1):93–6.

    Article  CAS  PubMed  Google Scholar 

  35. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333(24):1581–7.

    Article  Google Scholar 

  36. Lacy CR, et al. Delay in presentation and evaluation for acute stroke: Stroke Time Registry for Outcomes Knowledge and Epidemiology (S.T.R.O.K.E). Stroke. 2001;32(1):63–9.

    CAS  PubMed  Google Scholar 

  37. Smith MA, et al. Delayed hospital arrival for acute stroke: the Minnesota Stroke Survey. Ann Intern Med. 1998;129(3):190–6.

    CAS  PubMed  Google Scholar 

  38. Morris DL, et al. Prehospital and emergency department delays after acute stroke: the Genentech Stroke Presentation Survey. Stroke. 2000;31(11):2585–90.

    CAS  PubMed  Google Scholar 

  39. Moser DK, et al. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on cardiovascular nursing and stroke council. Circulation. 2006;114(2):168–82.

    Article  PubMed  Google Scholar 

  40. Wallace L. Patients’ health literacy skills: the missing demographic variable in primary care research. Ann Fam Med. 2006;4(1):85–6.

    Article  PubMed  Google Scholar 

  41. Baker DW, et al. The health care experience of patients with low literacy. Arch Fam Med. 1996;5(6):329–34.

    Article  CAS  PubMed  Google Scholar 

  42. Parikh N, et al. Shame and health literacy: the unspoken connection. Patient Educ Couns. 1996;27:33–39.

    Article  CAS  PubMed  Google Scholar 

  43. Lee PP. Why literacy matters. Links between reading ability and health. Arch Ophthalmol. 1999;117(1):100–3.

    CAS  PubMed  Google Scholar 

  44. Agency for Healthcare Research and Quality, 2006 National Healthcare Disparities Report. U.S. Department of Health and Human Services. Rockville, MD, 2006. Retrieved October 4, 2007 from: http://www.ahrq.gov/qual/nhdr06/nhdr06.htm.

  45. Collins DR, McCormack PM, O’Neill D. General perception of stroke. Poor knowledge of stroke can be improved by simple measures. Br Med J. 2002;325(7360):392.

    Article  CAS  Google Scholar 

  46. National Institute of Neurological Disorders and Stroke (NINDS), Ataque cerebral: Conozca los síntomas y actúe a tiempo. 2005.

  47. Kleindorfer DO, et al. Designing a message for public education regarding stroke does FAST capture enough stroke? Stroke. 2007;38(10):2864–8.

    Article  PubMed  Google Scholar 

  48. Hodgson CS. To FAST or not to FAST? Stroke. 2007;38(10):2631–2.

    Article  PubMed  Google Scholar 

  49. Fahs PS. Raising stroke awareness in rural communities. Am J Nurs. 2006;106(11):42.

    PubMed  Google Scholar 

  50. Dressman LA, Hunter J. Stroke awareness and knowledge retention in children: The Brain Child Project. Stroke. 2002;33(2):623–5.

    Article  PubMed  Google Scholar 

  51. Morgenstern LB, et al. A randomized controlled trial to teach middle school children to recognize stroke and call 911: the kids identifying and defeating stroke project. Stroke. 2007;38(11):2972–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Rehabilitation Sciences, Medical University of South Carolina, 151-B Rutledge Avenue, Charleston, SC, 29425, USA

    Charles Ellis, Joanna Wolff & Amanda Wyse

Authors
  1. Charles Ellis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joanna Wolff
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amanda Wyse
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charles Ellis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ellis, C., Wolff, J. & Wyse, A. Stroke Awareness Among Low Literacy Latinos Living in the South Carolina Low Country. J Immigrant Minority Health 11, 499–504 (2009). https://doi.org/10.1007/s10903-008-9182-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-008-9182-y

Keywords

Search

Navigation