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National Center for Chronic Disease Prevention and Health Promotion
Chronic Disease Prevention
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National Center for Chronic Disease Prevention and Health Promotion Chronic Disease Prevention Home | Contact Us |
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CENTERS FOR
DISEASE CONTROL AND PREVENTION Public Health Action Plan Charts Course for Preventing Heart Disease and Stroke
Like the national Steps initiative, the Action Plan recognizes the need to put prevention first, move from a disease care system to a health care system, and educate policy makers about the importance of prevention. The Action Plan charts a course—for CDC, other public health agencies, partners, and the public at large—for achieving national goals to prevent heart disease and stroke over the next two decades. “The high rates and costs of heart disease and stroke in this country are all too familiar to the organizations and agencies that are working to do something about them,” said Darwin Labarthe, MD, MPH, PhD, Associate Director for Cardiovascular Health Policy and Research at CDC. “The Action Plan offers specific recommendations and action steps that we can follow to prevent heart disease and stroke, and this guidance comes from a large group of experts from public health practice, academia, other federal agencies, and an array of national and international organizations.” The Action Plan embraces three Healthy People 2010 goals. In addition to the two overarching Healthy People 2010 goals of increasing quality and years of healthy life and eliminating health disparities, the plan addresses the specific goal of improving cardiovascular health through the prevention, detection, and treatment of risk factors; early identification and treatment of heart attacks and strokes; and prevention of recurrent cardiovascular events. CDC and the National Institutes of Health (NIH) are the co-lead agencies charged with addressing this third goal. To achieve these goals, the Action Plan calls for a comprehensive public health strategy that includes an array of approaches, such as supporting policy and environmental changes that prevent risk factors, helping people reduce or control their risk factors, and ensuring quality of acute and long-term care for the victims of heart disease and stroke. The plan’s comprehensive strategy is outlined in 22 specific recommendations and more than 60 related action steps needed to implement these recommendations. Promoting the Plan The Action Plan was developed by three major partners—CDC, American Heart Association/ American Stroke Association (AHA /ASA), and Association of State and Territorial Health Officials (ASTHO). Thirteen additional partners contributed, including two NIH agencies, ASTHO affiliates, and national and international cardiovascular health groups. Since the Action Plan’s release, CDC and its partners have distributed more than 25,000 copies and promoted the plan through presentations at national, regional, and state conferences and meetings. Reactions have been positive from all levels, and requests for copies and presentations continue to come in. ASTHO, which includes the chief public health official in every state and U.S. territory, will play a vital role in promoting the Action Plan throughout the country.
“We work on state teams that address chronic disease issues, where we can discuss the challenges and relevance of heart disease and stroke and the need for public health programs and strong, effective interventions,” said Kathleen Nolan, MPH, formerly Senior Director of Prevention Policy at ASTHO. “We also can prepare our members to speak to policy makers at state and national levels in language they will understand.” AHA/ASA also is active in educating policy makers and the public about issues related to heart disease and stroke and how to prevent these conditions—making it an ideal partner for developing and promoting the Action Plan. “Devising a national action plan was an inspired concept,” said Rose Marie Robertson, MD, Chief Science Officer and a former AHA President. “AHA was pleased to be involved because we have always used careful strategic planning in our own organization. We also saw the Action Plan as a perfect fit with the missions outlined in Healthy People 2010 and the upcoming Healthy People 2020.” Action Plan Provides Guidance for State Prevention Programs For the Action Plan to have the anticipated effect, its message and strategies must take hold at the state level. In fact, this was the main reason for developing the plan. In 1998, Congress funded CDC to help states develop the capacity, commitment, and resources necessary for comprehensive heart disease and stroke programs at the state level. As expected, this program has continued to grow—from $8.1 million for 8 states the first year to $45.7 million for 32 states and the District of Columbia in fiscal year 2004. The Action Plan provides guidance and a long-term vision for activities in this area. In North Carolina, for example, health officials are using the plan to update their own state plan, which was released in 1999. (State CVH Programs: The Heart of the Matter.) State legislators established a heart disease and stroke task force in 1995 to profile the state’s disease burden, publicize this burden and its preventability, and develop a comprehensive state plan for prevention. In 1998, North Carolina was one of only two states to receive comprehensive funding from CDC for a state heart disease and stroke prevention program. “We’re currently updating the original burden document and state plan,” said Elizabeth Puckett, PT, Head of the Heart Disease and Stroke Prevention Branch of the North Carolina Department of Health and Human Services. “The framework outlined in the Action Plan has really helped us in thinking through how we’re going to do this. We’re using it to develop a truly comprehensive plan for our state.” North Carolina health officials also have distributed hundreds of copies of the Action Plan to partner organizations and legislative leaders at local, state, and regional levels. National Forum Unites Partners and Promotes Implementation The Action Plan was developed through a process that included key partners, public health experts, and specialists in preventing heart disease and stroke who participated in a working group, one of five expert panels, or a national forum. The national forum will continue to meet annually to assess progress, identify areas where additional efforts are needed, and maintain the necessary momentum for implementing the plan. For the Action Plan to succeed, CDC and its partners must prioritize the recommended action steps, determine which partners are willing and able to take on which steps, commit to specific time lines, and decide how to evaluate new policies and programs. During the past year, national forum members were asked to rate each action step on how well it matched their organizations’ missions and to indicate which action steps their organizations were capable of addressing. The working group used this information to establish a list of about 20 priority action steps that could be implemented over the next year. This list was reviewed at the April 2004 2nd National Forum meeting, cosponsored by CDC, AHA/ASA, and ASTHO. About 75 national and international organizations and agencies participated in the meeting. The outcome of the 2nd National Forum included identification of concrete tasks to be completed before convening the 3rd National Forum in April 2005. For example, in the fundamental area of effective communication, the task is to establish and activate the needed task force to present its strategic plan for communications. The challenge now is how to implement the Action Plan efficiently and cost-effectively. Real change will take time, effort, and resources.
“One concern that we all have is that all of the groups working on this problem are working as hard as they can just to keep up with where we are now,” Dr. Robertson said. “All of the resources that we have now in all of our nonprofit, nongovernmental, and governmental organizations are not enough. Progress will not be made unless this is perceived to be a national emergency.” In 2004, heart disease and stroke will cost an estimated $368.4 billion, both in direct health expenditures and lost productivity. Much of this cost could be saved if more resources were devoted to prevention. Although people who suffer heart attacks, strokes, or other debilitating or life-threatening cardiovascular conditions will always need treatment, prevention will save lives, improve quality of life, and save money. And meeting this challenge to improving the health of our nation will require effort from individuals as well as health officials. “We know quite a bit about the clinical aspects of heart disease and stroke, but prevention is a lot newer,” Ms. Nolan said. “There are less well-known successes on getting populations to change their diet and exercise habits, which is key to preventing heart disease and stroke. This isn’t a once-in-a-lifetime or once-a-year behavioral change— like getting people immunized. It’s an entire lifestyle change, and that’s much more challenging.” For more information or copies of the Action Plan, visit http://www.cdc.gov/cvh/Action_Plan. |
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Privacy
Policy | Accessibility This page last reviewed August 30, 2004 United
States Department of Health and Human Services |
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Concerned public health officials facing a growing national epidemic of
heart disease and stroke now have a strategy to counter expected increases
in death and disability from cardiovascular illness. A Public
Health Action Plan to Prevent Heart Disease and Stroke, released in
April 2003 alongside HHS Secretary Tommy G. Thompson’s Steps to a
HealthierUS initiative, emphasizes the role of prevention and the need
for urgent action to reduce the burden of heart disease and stroke.