A Public Health Action Plan to Prevent Heart Disease and Stroke

Return to Table of Contents

Summary Recommendations

1. Develop policies for preventing heart disease and stroke at national, state, and local levels to assure effective public health action, including new knowledge on the efficacy and safety of therapies to reduce risk factors. Implement intervention programs in a timely manner and on a sufficient scale to permit rigorous evaluation and the rapid replication and dissemination of those most effective. 

   Active intervention is needed continually to develop and support policies (both in and beyond the health sector) that are favorable to health, change those that are unfavorable, and foster policy innovations when gaps are identified. Policies that adversely affect health should be identified because they can be major barriers to the social, environmental, and behavioral changes needed to improve population-wide health.
    

2. Promote cardiovascular health and prevent heart disease and stroke through interventions in multiple settings, for all age groups, and for the whole population, especially high–risk groups.

   This recommendation defines the scope of a comprehensive public health strategy to prevent heart disease and stroke. Such a strategy must 1) emphasize promotion of desirable social and environmental conditions and favorable population–wide and individual behavioral patterns to prevent major risk factors and 2) assure full accessibility and timely use of quality health services among people with risk factors or disease.

The Oklahoma Cardiovascular Health Program has developed rules to help emergency and hospital workers better serve stroke patients, based on American Heart Association and National Stroke Association guidelines.

3. Strengthen public health agencies to assure that they develop and maintain sufficient capacities and competencies, including their laboratories. 

   Public health agencies at state and local levels should establish specific programs designed to promote cardiovascular health and prevent heart disease and stroke. Skills are required in the new priority areas of policy and environmental change, population–wide health promotion through behavioral change, and risk factor prevention. Public health agencies must also be able to manage and use health data systems to effectively monitor and evaluate interventions and prevention programs. Laboratory capacity and standardization must be maintained to address new and continuing demands and opportunities.
    

4. Create opportunities for training, offer model standards for preventing chronic diseases, and make consultation and technical support continuously available to public health agencies, including their laboratories. 

   This plan demands new skills and competencies that can only be met through new training opportunities (see full document for details). Public health agencies can fulfill their responsibilities and function effectively in the new era of diverse partnerships by taking advantage of these opportunities.

The state–based Behavioral Risk Factor Surveillance System (BRFSS) is the largest telephone survey tool in the world. Data have been collected on the public's knowledge of the signs and symptoms of heart attack and stroke, their access to and participation in health care, and other issues related to quality of life. BRFSS data help health care professionals and policy makers effectively address the needs of specific populations and geographic areas.

5. Define criteria and standards for population–wide health data sources. Expand these sources as needed to assure adequate long–term monitoring of population measures related to heart disease and stroke.

   Such measures include mortality, incidence, and prevalence rates; selected biomarkers of CVD risk; risk factors and behaviors; economic conditions; community and environmental characteristics; sociodemographic factors (e.g., age, race/ethnicity, sex, place of residence); and leading health indicators. Appropriate criteria and standards can be defined through a national meeting of key stakeholders. In addition, they must conform to the National Health Information Infrastructure (www.health.gov/ncvhs-nhii) and the Standards for Privacy of Individually Identifiable Health Information, also called the Privacy Rule (www.hhs.gov/ocr/hipaa).
    

6. Upgrade and expand health data sources to allow systematic monitoring and evaluation of policy and program interventions. 

   To learn what works best, all programs funded by public health agencies should allocate resources for evaluation upfront, and staff must be trained to develop and apply evaluation methods. The resulting data must be communicated effectively to other agencies and to policy makers.
    

7. Emphasize the critical roles of atherosclerosis and high blood pressure, which are the dominant conditions underlying heart disease and stroke, within a broad prevention research agenda. 

   Prevention research on policy, environmental, and sociocultural determinants of risk factors, as well as potentially useful genetic and other biomarkers of risk, is critical, as is rapid translation of this information into health care practice. Policy makers must understand the value of such research. Such research should focus especially on children and adolescents because atherosclerosis and high blood pressure can begin early in life. The prevention research agenda should be developed and updated collaboratively among interested parties, taking current and planned research programs into account.
    

8. Develop innovative ways to monitor and evaluate policies and programs, especially for policy and environmental change and population–wide health promotion. 

   Public health agencies and their partners should conduct and promote research to improve surveillance methods in multiple areas, settings, and populations. Marketing research can be used to evaluate public knowledge and awareness of key health messages and to update these messages over time. Methodological research can help assess the impact of new technologies and regulations on surveillance systems. 
    

9. Reap the full benefit of shared knowledge and experience from regional and global partners through information exchange in the area of heart disease and stroke prevention. 

   Such communication will promote productive interactions among public health agencies in the United States and their counterparts elsewhere in the world addressing similar challenges. As a result, this nation will benefit from the investment of others by gaining valuable knowledge and experience in public health approaches to heart disease and stroke prevention.
    

10. Work with regional and global partners to develop prevention policies, formulate strategies for use of global media for health communications, and assess the impact of globalization on cardiovascular health. 

    With these partners, the U.S. public health community can explore new ways to enhance the skills and resources of global health agencies, apply new methods for monitoring and evaluating interventions, and further research by fostering replication of studies in diverse settings.

Next Section: Implementation

Return to Table of Contents

Date last reviewed: 05/12/2006
Content source: Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion