Prevention Works : Promising Strategies for Heart-Healthy and Stroke-Free States

1. Prevention Works: Promising Strategies for Heart-Healthy and Stroke-Free States Thursday, March 31, 2005 2:00 p.m. EST Please wait. The Web conference will begin shortly. Thank you.

2. Trudi Matthews, Web conference moderator Associate Director for Health Policy The Council of State Governments

3. Healthy States Initiative • Complete information on Healthy States: www.healthystates.csg.org • Click on the Healthy States link on lower left and other resources listed. • Supported by the Centers for Disease Control and Prevention (CDC)

4. Upcoming Web conferences • 5 other topics planned this year, including: • HIV/AIDS and STDs coming in May • Cancer • Oral Health • Chronic Disease • Vaccines

5. Technical Problems? • For problems connecting to the Web, call 1.866.767.6902 • If you have any difficulty with audio or Web connections, press *0 for operator assistance.

6. Complete Evaluation at end • We need your help! • Please complete the evaluation poll at the end of the Web conference.

7. Darwin Labarthe, M.D., MPH Acting Chief, Cardiovascular Health Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC

8. Facts about Heart Disease and Stroke • Heart disease and stroke are the 1stand 3rd leading causes of death and a major cause of disability in the United States. • Ethnicity, low income, gender, and low educational attainment are important predictors of heart disease and stroke. • Blacks have higher death rates from diseases of the heart than do whites. • Heart disease and stroke are largely preventable. Source: Circulation 2005,111:1332-1336; Preventing Heart Disease and Stroke, CDC, 2004

9. Deaths from Diseases of the Heart, 1900-2002 Total CVD data are not available for much of the period covered by this chart. Source: CDC NCHS; AHA Statistical Update 2005

10. The Cost of Heart Disease and Stroke in the U.S., 2005 • Coronary heart disease is the leading cause of premature, permanent disability in the U.S. workforce. Stroke alone accounts for disability among more than 1 million Americans. • The total cost of heart disease and stroke in the United States is projected to be $394 billion in 2005. Source: AHA Statistical Update 2005

11. A Public Health Action Plan to Prevent Heart Disease and Stroke “…to chart a course for the Centers for Disease Control and Prevention (CDC) and collaborating public health agencies, with all interested partners and the public at large…”

12. Prevention Works Priorities of CDC's Cardiovascular Health Branch • Improving healthy behaviors • Controlling high blood pressure • Controlling high cholesterol • Knowing signs and symptoms, calling 9-1-1 • Improving emergency response • Improving the quality of care • Eliminating health disparities Source: Prevention Works: CDC Strategies for a Heart-Healthy and Stroke-Free America, 2004

13. CDC-CVH State Programs, 2004 District of Columbia Nofunding CapacityBuilding Basic Implementation

14. CDC State Funded Heart Disease and Stroke Prevention ProgramsEarly Program Outcomes • Health Care Setting: Statewide quality improvement initiative in Wisconsin 48% controlled high blood pressure in 2000 62% controlled high blood pressure in 2003 • Worksite: Heart Check assesses heart healthy policies and environments 75% increase in supports in New York • Blood pressure screenings available • Low-fat food choices and smoke-free policies

15. What State Legislators Can Do... Demonstrate Leadership • Host a statewide campaign on signs and symptoms of heart attack and stroke. • Implement life saving improvements in health services and medical response. • Ensure that all communities in your state have access to 9-1-1. Establish wireless, enhanced 9-1-1. • Improve coverage and use of preventive services in your communities. • Encourage primary care settings to institute improvements in the delivery of care for heart disease and stroke risk factors.

16. What State Legislators Can Do... • Ensure adequate authority and reach for your efforts. • Support policies to make heart attacks and acute strokes reportable conditions. • Implement policies and incentives so communities can engage in heart healthy behaviors. • Support tobacco-free policies such as prohibiting smoking in all enclosed workplaces, public places, government buildings, restaurants, bars, and gaming facilities.

17. North Dakota, Heart Disease Deaths1996 –2000

18. Conclusion • State legislatorscanplay a key role in reducing the burden of heart disease and stroke in communities. • Death and disabilities can be impacted through policy and environmental changes that make the right choices—food choice, physical activity, smoking cessation—the easier choices. • Health disparities are pervasive. An increase in programs and interventions for all Americans, especially for the priority populations will be essential to eliminate health disparities and increase the days of healthy life.  • CDC has heart disease and stroke prevention resources available to assist you. Please contact us.

19. North Carolina State SenatorWilliam R. Purcell, M.D. Chairman North Carolina’s Justus-Warren Heart Disease and Stroke Prevention Task Force

20. Justus-Warren Task Force Legislation ‘05 • Funding for “Strike Out Stroke”—a program targeting hypertension & stroke awareness in high risk groups • AEDs in high traffic locations—a pilot program

21. Other Heart-Healthy Legislation • Increasing cigarette excise tax • Increasing physical activity for kids • Funding diabetes education & awareness

22. What Can Legislators Do? • Invest in prevention • Push public health systems to address chronic disease prevention • Get involved • Make health a priority issue

23. Elizabeth M. (Libby) Puckett Executive Director North Carolina’s Justus-Warren Heart Disease and Stroke Prevention Task Force

24. 3000 2500 Stroke Registry Implementation Funding 2000 Tri-State Stroke Summit CDC Funding Awarded CDC Funds TSSN 1500 Thousands of $$s 1000 500 1st Legislative Day Convocation of Community Leaders 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 TF Established State Federal NC HDSP Funding Growth, 1995-2004

25. Hospital Charges for CVD, North Carolina, 1995-2003 Data Source: NC Hospital Discharge Database, NC Center for Health Statistics. ICD-9 Codes 390-459 as principal diagnosis only.

26. California • Adult prevalence declined at twice the US rate • Youth smoking down by 43% from 1995 to 1999 • 33,000 fewer deaths • $8 billion saved • Decreased lung cancer in women

27. CDC Advisory The Centers for Disease Control [CDC] has recently reported that "eating in a smokey restaurant" can trigger a fatal heart attack, and therefore: “All patients at increased risk of coronary heart disease or with known coronary artery disease should be advised to avoid all indoor environments that permit smoking.”

28. Then and now…... The function of protecting and developing health must rank even above that of restoring it when it is impaired. Hippocrates Preventing heart disease and stroke is both an urgent need and an unprecedented opportunity. Dr. Darwin Labarthe

29. Q & A session instructions • Submit questions either way: • Email: Use the question box on the bottom right portion of the web page • Phone: Press *1, let the operator know you have a question. The operator will unmute your line so you can ask your question directly to the panelists.

30. Prevention Works Panelists Elizabeth M. (Libby) Puckett, Executive Director, North Carolina's Justus-Warren Heart Disease and Stroke Prevention Task Force State Senator William R. Purcell, North Carolina, M.D., Chairman of the Justus-Warren Heart Disease and Stroke Prevention Task Force Darwin Labarthe, M.D., MPH, Acting Chief, Cardiovascular Health BranchDivision of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC

31. This concludes the Web conference • Please complete the evaluation poll which will pop up on your screen. • Go to www.healthystates.csg.org for complete information on Healthy States Initiative • Thanks for attending!