State Program: North Carolina
Basic Implementation

The North Carolina Department of Health and Human Services/Division of Public Health began receiving funds from CDC in 1998 to support a state heart disease and stroke prevention program and received additional CDC funding to lead the Tri-State Stroke Network.

Burden of Heart Disease and Stroke

• Heart disease is the leading cause of death in North Carolina, accounting for 18,524 deaths or approximately 26% of the state's deaths in 2002. (National Vital Statistics Report 2004;53(5)).

• Stroke is the third leading cause of death, accounting for 5,259 deaths or approximately 7% of the state's deaths in 2002. (National Vital Statistics Report 2004;53(5)).

• According to Behavioral Risk Factor Surveillance System (BRFSS) survey results in 2005, adults in North Carolina reported having the following risk factors for heart disease and stroke:
   
  • 29.2% had high blood pressure
  • 36.3% of those screened reported having high blood cholesterol

  In 2006,
   

  • 9.1% had diabetes
  • 22.1% were current smokers
  • 62.8% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 23.8% reported no exercise in the prior 30 days

State Highlights

• North Carolina received CDC funding to lead the Tri-State Stroke Network, which also includes Georgia and South Carolina. The Network is expected to increase the ability of members to work across state boundaries and leverage efforts within the region to encourage stroke-related activities in the states, with emphasis on partnerships, education, training, policy and systems-change strategies.
   
• The program coordinates the activities of the Tri-State Stroke Network. The Network includes public health and medical professionals, policy makers and advocates from North Carolina, Georgia and South Carolina. The Network and its three subcommittees—Awareness and Advocacy, Prevention and Control, and Epidemiology and Data—meet quarterly via telephone conference calls. Once a year there is a face-to-face meeting hosted by a different state each year.
   
• The North Carolina Heart Disease and Stroke Prevention (HDSP) Program is working with the Improving Performance in Practice (IPIP) initiative to improve health care. With sponsorship from the American Board of Medical Specialties (ABMS) and funding from the Robert Wood Johnson Foundation, the three-year IPIP pilot program will help physicians in North Carolina measure clinical performance and assemble outcomes data on asthma, diabetes, and hypertension. In addition, all participating physicians will receive support from the IPIP National Center for Design, Development and Evaluation at Cincinnati Children's Hospital Medical Center in the form of educational resources, networking opportunities with other physicians, free-of-charge consultation on practice redesign, and credit for continuing medical education and maintaining board certification. IPIP works with Community Care of North Carolina, a coalition of Medicaid providers comprising fourteen networks across the state to assist with integration of the Chronic Care Model into treatment for diabetes, asthma, and hypertension. The HDSP program provides funding for two local health departments in Pitt and Henderson Counties to support the IPIP initiative. Local health departments link practices participating in IPIP with local resources to support management of hypertension in high-risk patients.
   
• The North Carolina HDSP Branch implemented the Stomp Out Stroke (SOS) program to help increase awareness in the African American community, of the importance of knowing the signs and symptoms of stroke, and the need to call 9–1–1. The program has demonstrated some success in increasing African Americans’ knowledge of the lesser known symptoms of stroke, according to pre- and post-telephone surveys in 2006.
   
• The North Carolina HDSP program and partners were successful in developing an Emergency Medical Services (EMS) Stroke Toolkit, in partnership with the North Carolina Office of Emergency Medical Services, University of North Carolina Emergency Medical Department and the EMS Performance Improvement Center. This toolkit is designed to improve EMS stroke care and response performance through a variety of means. Of particular significance is a component that will have county EMS professionals participate in community awareness activities in order to increase knowledge of the signs and symptoms of stroke, and the need to call 9–1–1.
   
• The North Carolina Institute of Medicine (IOM) Health Literacy Task Force is addressing the high percentage of North Carolinian’s with low literacy, which has significant health implications for the state. Individuals with lower literacy skills are more likely to have lower health literacy abilities. As such, low health literacy is a major contributor to health disparities. HDSP staff participates in the NC IOM Health Literacy Task Force and ensures that recommendations under development have the greatest potential for addressing health disparities.
   

For more information on heart disease and stroke prevention in North Carolina, visit http://www.startwithyourheart.com.

To view county–level data, visit our interactive map site at http://www.cdc.gov/dhdsp/library/maps/statemaps.htm.

Page last reviewed: December 5, 2007
Page last modified: December 5, 2007
Content source: Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion