One-third of adults in the US would not have the advisable stroke literacy abilities

About two-thirds of adults in the US know the 5 signs and symptoms of a stroke and the importance of calling emergency services after the stroke has started. This suggests that more outreach and education are needed to further reduce delays in getting adequate stroke care in place. This is based on data published in the MMWR’s weekly report on morbidity and mortality from the Centers for Disease Control and Prevention (CDC).

In the report, CDC officials highlight data from a 2017 National Health Interview Survey (NHIS) among 26,076 adults aged 20 years or older. Using this survey data, the researchers rated the overall prevalence of “recommended stroke knowledge,” also known as knowledge of the 5 signs and symptoms of stroke, and the immediate need to call 9-1-1. The 5 signs and symptoms are numbness of the face and extremities, confusion and difficulty speaking, sudden changes in vision, difficulty walking, and sudden severe headache.

Most of the NHIS respondents were able to identify at least 1 symptom and sign of a stroke, and the majority of participants knew they needed to call emergency services immediately after these signs / symptoms appeared (96.3%). Knowledge was highest for numbness of the face and extremities (94.4%), followed by confusion and difficulty speaking (93.6%), difficulty walking (90.8%), sudden visual disturbances (83.5 %) and sudden severe headache (76.5%). Overall, 69.1 percent of respondents knew all 5 signs and symptoms of stroke, and 67.5 percent of respondents knew all 5 signs and symptoms and knew to call 9-1-1.

The study researchers observed differences in recommended stroke knowledge between the subgroups, which ranged from 57.8% for Hispanic adults to 71.3% for non-Hispanic white adults. Additionally, the prevalence of recommended stroke knowledge ranged from 54.8% for adults with less than a high school education to 73.1% for college graduates. After multivariable fitting, there were still significant differences in recommended stroke knowledge.

Limitations of the CDC report included reliance on self-reported data, potential product recalls and prejudices about social desirability, the inability of questions to address all stroke signs and symptoms, the use of yes / no questions, and the lack of an established standard for stroke awareness.

The report suggests that “focused public health efforts, community engagement, innovative strategies to customize messaging, and continued advances in clinical care and coordination could help combat the deadlocked decline in stroke mortality” and that ” Awareness of the signs and symptoms of stroke continues to grow ”will be a national priority. ”


Jackson SL, Legvold B., Vahratian A. et al. Sociodemographic and geographic differences in awareness of stroke signs and symptoms in adults – US, 2017. MMWR Morb Mortal Wkly Rep. 2020; 69 (44): 1617-1621. doi: 10.15585 / mmwr.mm6944a1

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