Heart and Stroke Healthy Community

1. Heart and Stroke Healthy Community Improving heart and stroke health a community at a time May 14, 2009

2. Heart and Stroke Healthy Community Steering Committee • Lucinda Bryant, PhD – Co-chair • Mori Krantz, MD – Co-chair Cassie Bair (AHA/ASA) Erin Bertoli (AHA/ASA) * Thea Carruth (CCGC) * Jennifer Dunn, (CRHC) * Sally Foland (Kaiser Permanente) Michelle Hubbard-Pitts (AHA/ASA) * Laurie Konsella, (HHS – Region VIII) * Susan Moyer (Jeffco Health) Koral O’Brien (CDPHE) *Merrilee Phillips (HealthOne) Andrea Ponies (CDPHE) * Robin Rice (AHA/ASA) Mario Rivera (CDPHE) Laurie Scott (CDPHE) Sara Tobin (AHA/ASA) * Kris Wenzel (AHEC) * Meeting planning group

3. Thank you to….. • Indira Gujral Data • Mario Rivera Data • Ruth Ayala Copy, stuff, notebook • Susan Gantt Fiscal stuff • Laurie Scott Patience & hard work

4. Thank you to….. Barbara Boner & Novartis Pharmaceuticals Lunch

5. KeynoteMori Krantz, MD

7. Overview Marsha Wilde, MPH

8. Goals for the Day • Introduce the Heart and Stroke Healthy Community Initiative • How it came to be… • What it is based on… • What it is intended to do… • Provide description of the Goals and Measures along with examples of “how it can be done.” • Elicit feedback on the initiative.

9. Background: How it came to be… • Multiple activities in… • Multiple communities addressing… • Multiple aspects of Heart Disease and Stroke… • In many cases not knowing for sure if what we are doing is making a difference… • Or not knowing what others are doing… • So, over a cup of coffee and an idea…

10. Heart and Stroke Healthy Communities

11. Socio-Ecological Model-Looking Beyond the Individual-

12. Background: What it is based on… Data AKA: The Metrics

13. Data : Mortality Data

14. MI Death rates

15. Death rates for Stroke

16. Hospital Discharge: MI

17. Hospital Discharge: Stroke

18. Risk Factors for Heart Disease • Conditions • Blood Cholesterol Levels • High Blood Pressure (Hypertension) • Diabetes • Behavioral Factors • Tobacco • Diet • Physical Inactivity • Obesity • Alcohol

19. Conditions: Blood cholesterol

20. Conditions: High Blood Pressure

21. Conditions: Diabetes

22. Behavioral Factors: Tobacco

23. Behavioral Factors: Diet

24. Behavioral Factors:Physical Inactivity

25. Behavioral Factors: Obesity

26. Behavioral Factors: Alcohol

27. Effect Modification: Interactions Between Conditions and Risk Factors

28. Social Determinants as Risk Factors • Education • Income • Geography • Environmental Exposures • Built Environment • Access to Care

29. Social Determinant: Access to Care

30. Cost of Chronic Disease * Calculations for cost are based on the CDC cost calculator and uses estimates based on medicaid expenditures for Colorado

31. Cost of Hypertension

32. Cost of Heart Disease

33. Cost of Stroke

34. Chronic Disease Integration What we do about the risk factors for heart disease and stroke has an impact on other chronic diseases. • Diabetes • Kidney Disease • Peripheral Artery Disease • Retinopathy • Aortic Aneurysm

35. Heart and Stroke HealthCDC Priorities • Control high blood pressure • Control high blood cholesterol • Increase awareness of signs and call 9-1-1 • Improve emergency response • Improve quality of care • Eliminate disparities

36. Heart and Stroke HealthHealthy People 2010 Objectives • Goal: Improve cardiovascular health and quality of life through the prevention, detection, and treatment of risk factors; early identification and treatment of heart attacks and strokes; and prevention of recurrent cardiovascular events. • Objectives 1 – 12 are in the binder. • Related objectives from other focus areas.

37. Background:What it is intended to do… Bring us closer to realizing a vision for the future…

38. Action Framework For A Comprehensive Public Health Strategy To Prevent Heart Disease and Stroke Present Reality Unfavorable social and environmental conditions Adverse Behavioral Patterns Major risk factors First event/ sudden death Disability/risk of recurrence Fatal CVD complications/ decompensation A Vision of the Future Social and Environmental Conditions Favorable To Health Behavioral Patterns That Promote Health Full functional Capacity/ Low Risk of Recurrence Low Population Risk Few Events/Only rare Deaths Good Quality Of Life Until Death Heart and Stroke Healthy Community overarching goal: Increase quality and years of healthy life and Eliminate disparities Goal 1 Prevent the development of risk factors for heart disease and stroke. Goal 2 Detect and treat risk factors for heart disease and stroke. Goal 3 Early identification and treatment of heart disease and stroke. Goal 4 Prevent recurrence and complications of heart disease and stroke.

39. Structure • Each of the 4 Goal areas is divided into: • Community Organizations • Schools • Worksite • Health Care Delivery Systems

40. How to become a Heart and Stroke Healthy Community: • Define your community. • Assess your current activities. • Identify your disparities and plan how to eliminate them. • Meet the criteria listed. • Apply for recognition