Healthy People Consortium Meeting
"Implementing Healthy People 2010"
November 11, 2000

Summary of Breakout Group Discussion Concerning:
Heart Disease and Stroke

1.  What does implementing Healthy People 2010 mean to you? 
Presentation: Elizabeth Hackbarth, AHA (handouts distributed)

• AHA has focused its strategy plan on 2010 rather than 2008. 
• Aiming for a 25 percent reduction with primary focus on disease management and acute care.
• National level partnership with NIH, HHS, and CDC.
• State-level advocacy and services to communities.
• Resource materials include consumer publications, One of a Kind program on Web site (health risk appraisal and feedback).
• Operation Heartbeat/Stroke addresses signs and symptoms of heart disease and stroke; will implement in 100 MSAs first.
• Connection with Emergency Medical Services and Emergency Rooms/hospitals, use of AEDs.
• Connection of above program to Healthy People 2010 objectives.
• Physical activity is included in disease management and should have partnership with NCPPA and AAHPERD. Project Get Fit in North Carolina is being implemented.

Discussion

• In New York, at local level, do not see the American Heart Association staff at the table. Someone mentioned that AHA is hiring coordinators in States to be involved with the CDC State CVH (Cardiovascular Health) Program.
• One of a Kind will miss addressing disparities.
• Get with the Guidelines is another AHA program working with HCFA on treatment protocols. Pharmaceutical Round Table concerned with compliance issues. AHA tool kit materials could be useful, provide questions for patients, physicians, and pharmacists. Patient education materials are in process of being updated at AHA.
• Where are the incentives to help promote change in medical practitioners' behaviors?
• Monitoring process and quality assurance measures.
• Need systems change with incentives that support patient education, reimbursement for activity.
• Need clinical practice guidelines for physician assistants.
• There is an overabundance of resources and information; need to develop ways to bring things together and reduce time required to locate the resources. 

2. Presentation: Ellen Magnis, ASA

• ASA is a division of the American Heart Association (AHA/ASA).
• Has educational materials and products.
• Call to Action Campaign addresses consumer awareness.
• National-level Brain Attack Coalition.
• Operation Stroke developing coordination in health care system, EMS and ER in 45 sites to examine for best practices.
• Educational programs in Senior Centers.
• Managed care organizations are receiving ASA materials. AHA Web site lists all products and materials.

Discussion

• Who is at the table? Where is the table?
  • There are many activities such as Healthy Communities, national and State coalitions for physical activity. Things are happening in the private sector, the public sector, and civic activities.
  • We need to make sure the table exists with Healthy People 2010 focus. The HHS regional offices are working on implementation.
    National, State, and community "tables" need to be linked; variety of topics and issues need to be connected.
• What are the challenges and barriers to meeting the Healthy People 2010 objectives?
  • Resources at the county level are lacking.
  • Research has money, and a balance is needed to put money to the application of research to practice in order to get results!
  • Capacity building at the community level is needed, so they can move forward. BRFSS data are available to document State needs. 
  • Need to apply what we know!
  • We get volunteers excited about things like Healthy People 2010, and then there are no resources available. We have the evidence and know what needs to be fixed, but funding is always short term. Resources are available, but there is a need to force us to address policies/legislation/quality assurance in service delivery...we need incentives to do the right thing!
  • The Best Practices Guidelines for Comprehensive Tobacco Control that CDC did is very useful for communities. A work group at CDC is looking at development of a similar document for chronic disease prevention and control.
  • The Task Force on Community Preventive Services will have a report that will be useful.
  • Education of legislators is essential.
  • Need to understand and address the social determinants of health.
  • Where is the public demand? It needs to be created and visible before resources are forthcoming.
  • Media have to be involved, create opportunities to get information in front of people.
  • State-based plans will be useful tools in educating legislators.
  • State health departments have multiple chronic disease programs and State and local coalitions that can be allies, e.g., diabetes. Many may develop their own Healthy People 2010 objectives and strategies that can be important in meeting the national objectives.
• Elimination of disparities
  • National Medical Association is partnering with many national organizations to address disparities.
  • Tracking book for Healthy People 2010 has measures that can be used to show trends over time.
  • Access to care is an issue that needs to be addressed. Need enhanced 911, transportation over distances to care and treatment, establish chest pain clinics in ERs to educate patients, reduce hospital system barriers.
  • Need to increase programs in worksites; increase partnerships between public health and business.
  • Need better data for priority populations.
  • Need to use data better for advocacy; need to share data and work together to collect better data.

   

Emmeline Ochiai
HHS-ODPHP

N. Burgess Record
Franklin Memorial Hospital 

Linda C. Degutis
Society for Academic Emergency Medicine

Nicole Bates
CDC/NCCDPHP 

Elizabeth Hackbarth
American Heart Association (AHA) 

Ellen Magnis
American Stroke Association (ASA) 

Todd Harwell
Montana Department of PHHS 

Pamela Witting
Honeywell 

Edward Baum
Crozer Keystone Health System 

Phil Haberstre
NYS Physical Activity Coalition 

Van Hubbard
NIH

Yvonne Fuller
National Medical Association 

Jeanette Guyton-Krishnan
CDC/NCHS
ezg2@cdc.gov

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