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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
Key Responsibilities
- Facilitate collaboration among public and private sector
partners, such as managed care organizations, health
insurers, federally funded health centers, businesses,
priority population organizations, and emergency response
agencies.
- Define the burden of heart disease and stroke and assess
existing population-based strategies for primary and
secondary prevention of heart disease and stroke within the
state.
- Develop and update a comprehensive state plan for heart
disease and stroke prevention with emphasis on heart-healthy
policies development, physical and social environments
change, and disparities elimination (e.g., based on
geography, gender, race or ethnicity, or socioeconomic
status).
- Identify culturally appropriate approaches to promote
heart disease and stroke prevention among racial, ethnic,
and other priority populations.
- Use population-based public health strategies to
increase public awareness of the heart disease and stroke
urgency, the signs and symptoms of heart disease and stroke,
and the need to call 9–1–1.
- Support health care organizations system changes to
assure quality of care and implementation of primary and
secondary prevention for heart disease and stroke.
- Monitor, implement, and evaluate prevention strategies
and programs in health care settings, work sites, and
communities.
- Provide training and technical assistance for health
care professionals, and partners to support primary and
secondary prevention of heart disease and stroke.
- Monitor quality of care for primary and secondary
prevention.
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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
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