The California Action Plan To Prevent Cardiovascular Disease

Purpose of the plan: To chart a course for the Centers for Disease Control and Prevention (CDC) and collaborating public health agencies, with all interested partners and the public at large, to help in promoting achievement of national goals for preventing heart disease and stroke over the next two decades-through 2020 and beyond. Heart disease and stroke are among the nation's leading causes of death and major causes of disability, projected to cost more than $351 billion in 2003. In the next two decades, these conditions can be expected to increase sharply as this country's "baby boom" generation ages. The current disease burden, recent trends, and growing disparities among certain populations reinforce this projection. Yet these conditions are largely preventable. As expressed in the Steps to a HealthierUS initiative from Secretary of Health and Human Services Tommy G. Thompson, the long-term solution for our nation's health care crisis requires embracing prevention as the first step. To reverse the epidemic of heart disease and stroke through increasingly effective prevention, action is needed now. A Public Health Action Plan to Prevent Heart Disease and Stroke addresses this urgent need for action. Key partners, public health experts, and heart disease and stroke prevention specialists came together to develop targeted recommendations and specific action steps toward achievement of this goal, through a process convened by CDC and its parent agency, the U.S. Department of Health and Human Services (HHS). CDC and public health partners will provide national leadership to assure meaningful progress in implementing the plan. This includes bringing the public health community together with new and existing partners representing every interested segment of society. An important aspect of this process is continuing coordination between CDC and the National Institutes of Health (NIH), HHS, which is the co-lead agency with CDC for the heart disease and stroke focus area of Healthy People 2010. Today, support for public health programs to prevent heart disease and stroke remains low, constituting less than 3% of the aggregate budget of our state public health agencies. Despite substantial public health gains in recent years, the failure to halt and reverse the epidemic has been extremely costly. Numbers of victims and health care expenses will only escalate unless the epidemic is reversed. Fortunately, a new promise of success exists today. We have knowledge from decades of research and experience, especially because of the contributions of NIH and the American Heart Association. We also have a growing commitment to prevention, exemplified by the Secretary's Steps to a HealthierUS initiative. And we have the potential collaboration of many major national partners. The Action Plan represents a comprehensive public health strategy to assist in addressing the Healthy People 2010 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. This strategy depends on a balanced investment in all available intervention approaches, from policy and environmental changes designed to prevent risk factors to assurance of quality care for the victims of heart disease and stroke, and it includes education to support individual efforts to prevent or control risk factors. To successfully implement the plan, two fundamental requirements must be met. First, we must communicate to the public at large and to policy makers the urgent need and unprecedented opportunity to prevent heart disease and stroke. Second, we must transform the nation's public health infrastructure to provide leadership and to develop and maintain effective partnerships and collaborations to support the needed actions.

Provides guidance in evaluating community-based programs to prevent & control cardiovascular diseases. Includes tools & strategies for measuring the products, effects & outcomes of these initiatives. Introduces the user to CVD & community-based prevention & evaluation, key evaluation questions for CVD prevention initiatives, & the framework for monitoring & improving programs Presents each component of the evaluation system, its application, & sample tools; & discusses integrating the information to address key questions & communicate information about a CVD prevention initiative.

Cardiovascular disease (CVD), once thought to be confined primarily to industrialized nations, has emerged as a major health threat in developing countries. Cardiovascular disease now accounts for nearly 30 percent of deaths in low and middle income countries each year, and is accompanied by significant economic repercussions. Yet most governments, global health institutions, and development agencies have largely overlooked CVD as they have invested in health in developing countries. Recognizing the gap between the compelling evidence of the global CVD burden and the investment needed to prevent and control CVD, the National Heart, Lung, and Blood Institute (NHLBI) turned to the IOM for advice on how to catalyze change. In this report, the IOM recommends that the NHLBI, development agencies, nongovernmental organizations, and governments work toward two essential goals: creating environments that promote heart healthy lifestyle choices and help reduce the risk of chronic diseases, and building public health infrastructure and health systems with the capacity to implement programs that will effectively detect and reduce risk and manage CVD. To meet these goals, the IOM recommends several steps, including improving cooperation and collaboration; implementing effective and feasible strategies; and informing efforts through research and health surveillance. Without better efforts to promote cardiovascular health, global health as a whole will be undermined.