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A
Public Health Action Plan to Prevent Heart Disease and Stroke
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Summary Recommendations
"To reach minority populations, the American Heart Association
created Search Your Heart. This faith–based program is established
primarily in the inner cities for the medically underserved,
high–risk segment of our population. Important cardiovascular
health messages are delivered through the 5,000 places of worship
enrolled in this program nationwide."
Robert O. Bonow, MD,
President, American Heart Association |
- 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.
- 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. |
- 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.
- 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. |
- 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).
- 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.
- 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.
- 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.
- 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.
- 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
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Date last reviewed:
05/12/2006
Content source: Division for Heart Disease and Stroke
Prevention,
National Center for Chronic Disease Prevention and
Health Promotion |
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