Promising Programs in Racial and Ethnic Disparities in Health and Health Care Addressing...

Cardiovascular Disease

researched and compiled by Sarah McCloskey and Erin Kennedy December 2004 and updated November 2007

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Background
Cardiovascular disease (CVD) is the leading cause of death for all minority and ethnic groups in the United States. Multiple conditions, including hypertension, Promising Programs to Eliminate Racial and Ethnic Health Disparities 11 heart disease, and stroke, contributed to 79 million cases of CVD on 2004. Over $400 billion dollars are spent on CVD-related health care each year. Racial minorities develop the conditions that lead to CVD more frequently, at a younger age, and they are less likely to seek treatment. For instance, about 47 percent of African-American men have some form of CVD, compared to 37 percent of white men. Similar statistics exist among ethnic groups for women. Mortality from coronary heart disease also varies by ethnic group, with mortality rates 20 percent higher for African Americans compared to the total adult population in the U.S.* In 2002, Delaware’s CVD mortality rates per 100,000 people were 233 for whites, compared to 256 for African Americans.**

*American Heart Association www.americanheart.org/presenter.jhtml?identifier=1200000
**Data provided by the Kaiser Family Foundation State Health Facts Online. www.statehealthfacts.org

State Programs
Most states have some CVD-related programs, ranging from general education and awareness programs to those specifically aimed at reducing disparities in CVD development and treatment. Due to the nature of CVD and its importance as a healthcare issue, many programs collaborate with employers, academic, and community organizations.

Maine

Worksite High-Blood-Pressure Programs – The Maine Board of Health helps to fund and establish new programs at worksites that do not provide bloodpressure screening. The screenings detect high blood pressure and make referrals to physicians so employees can control blood pressure. The Board of Health will also periodically evaluate the effectiveness of the program. janus.state.me.us/legis/statutes/22/title22sec1697.html

Community-Based Heart Attack– and Stroke-Prevention Programs – These programs provide education in schools, the community, and the workplace on how to prevent heart attacks and strokes. Programs that promote healthy behaviors, such as smoking cessation programs and blood-pressure and cholesterol screenings, are also offered to the public. janus.state.me.us/legis/statutes/22/title22sec1699.html

Illinois

Stroke Task Force – Stroke prevention education is presented to high-risk populations and areas with high incidence of stroke. Educational efforts concentrate mostly on the prevention, identification, and treatment of strokes. (20 ILCS 2310-372) www.ilga.gov/legislation/publicacts/pubact92/acts/92-0710.html. For an updated report on the program, visit www.idph.state.il.us//public/press05/6.3.05.htm.

Atherosclerosis Prevention Act – Illinois enacted this legislation to increase efforts to prevent and reduce the incidence of, disability from, and death from atherosclerosis (a deadly heart condition). (410 ILCS 3/) www.ilga.gov/legislation/publicacts/pubact91/acts/91-0343.html

Employee Wellness Program Grant – Grants are given to employers for healthpromotion programs. These can reduce the risk factors associated with CVD, and programs can include aerobic exercise, blood-pressure or cholesterol screenings, smoking cessation, weight-loss programs, and blood-pressure or nutrition education. Benefits from these programs include an increase in the overall health of the population and, consequently, lower healthcare costs. (30 ILCS 770/) www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=571&ChapAct=30%26nbsp%3BILCS%26nbsp%3B770
%2F&ChapterID=7&ChapterName=FINANCE&ActName=Employee+Wellness+Program+Grant+Act

Massachusetts

Cherishing Our Hearts and Souls Coalition – Created by the Harvard School of Public Health to reduce CVD among the African-American community, the coalition develops strategies to reduce risk factors, address racism, and enhance stress coping skills. It provides instruction through after school programs and trainings for healthcare providers. This program has been evaluated and extremely successful in educating not only the public but also community healthcare providers, about the issues of racism and heart disease. This is an APHA Statistics to Solutions program example. For more information, contact Autumn Allen at 617-496-8073.
www.hsph.harvard.edu/academics/public-health-practice/research-and-initiatives/program-to-eliminate-health-disparities-new/cohs.html

Oregon

Changing Community Norms to Address Cardiovascular Disease in African Americans – The African American Health Coalition Inc., was created to address alarming differences in CVD rates between blacks and whites in Oregon. The state launched multiple programs to target the root cause of this gap. One program promotes physical activity and other heart-healthy behaviors among African Americans. Entitled “Lookin’ Tight, Livin’ Right,” it uses the relationships between beauty shop and barbershop operators and their clients to assess readiness to change and promote health behaviors. Another program, “HOLLA,” trains high school students to educate their peers about cardiovascular disease and the risk factors associated with it. Finally a program called “Wellness Within REACH” offers free physical activity classes to African Americans in order to help reduce some barriers to an active lifestyle. CDC Exemplary Program: REACH www.aahc-portland.org

Maryland

Hair, Heart, and Health Initiative, Baltimore – A joint program of the CareFirst Blue Cross Blue Shield and the University of Maryland School of Medicine, the Hair, Heart, and Health Initiative seeks to deliver preventative cardiovascular care to Baltimore residents. The main targets of this initiative are African Americans who are more likely to suffer from coronary heart disease. Health care professionals have been recruited to train barbers and hair dressers in six high risk communities to discuss the risk of cardiovascular disease with clients, and measure blood pressure. As of the end of 2006, 579 people were screened and 14% have been to a health care provider for followup medical care. This initiative hopes to expand to other businesses in 2007. www.carefirstcommunity.com/commitment_gaps_hairheart.php

New York

Bronx Healthy Hearts – Partners with Bronx Health Reach, Bronx Healthy Hearts worries about the cardio vascular health of many people in the Bronx, an area heavily populated with minority residents, many of whom already suffer from obesity and diabetes. In order to promote heart health, Bronx Healthy Hearts has created grocer outreach initiatives such as “Healthy Bodega’s”, which through services and community focus groups has convinced five grocers to promote low fat milk and accept coupons to get 50 cents off any size low fat milk. In addition, Restaurant Week in which restaurants participate and give away healthy food alternatives. This also encourages local restaurants to alter menus or add healthier, more heart conscious options. www.institute2000.org/bhr/work/nutrition_and_fitness/bronx_healthy_hearts

Robert Wood Johnson Foundation

Expecting Success: Excellence in Cardiac Care – This joint initiative between the Robert Wood Johnson Foundation and the George Washington University Medical Center awarded 10 hospitals nation wide the opportunity to participate in this program, which seeks to research, develop, test, and document cardiac care in their respected facility. Through this, the hospitals are expected to create a network in which information can be shared and methods to eliminate cardio vascular disparities can be collectively created. www.expectingsuccess.org Also visit www.montefiore.org/whoweare/stories/rwjf_grant for a complete story of one of the hospitals participating in this grant.

For more information, contact Eric Jacobson (302-831-1711).

photo on this page courtesy of the Administration on Aging

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