CDC National Heart Disease and Stroke Prevention Program

District of Columbia
Capacity Building

The District of Columbia Department of Health began receiving funds from CDC in 2001 to support a heart disease and stroke prevention program.

Burden of Heart Disease and Stroke

• More than 1 out of 4 deaths in the District of Columbia are due to heart disease. (National Vital Statistics Report, 2008.)
• 1,518 District of Columbia residents died from heart disease in 2005 (27.7% of total deaths in the District of Columbia). (National Vital Statistics Report, 2008.)
• 231 District of Columbia. residents died from stroke in 2005 (4.2% of total deaths in the District of Columbia). (National Vital Statistics Report, 2008.)
• According to 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results, adults in the District of Columbia reported the following risk factors for heart disease and stroke:
  
  • 28.6% had high blood pressure
  • 34.1% of those screened reported having high blood cholesterol
  • 8.1% had diabetes
  • 17.2% were current smokers
  • 55.3% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 46.1% reported no exercise in the prior 30 days
  • 75.6% ate fruit and vegetables less than 5 times a day

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 signs and symptoms of heart diseases and stroke, the urgency of early treatment for heart disease and stroke, and the need to call 9-1-1.

District Highlights

• The Cardiovascular Health Program (CHP), in conjunction with the American Heart Association (AHA), American Stroke Association, and the Washington Hospital Center, commenced an assessment of the District to support the development of a comprehensive stroke systems plan. As part of this assessment, the Acute Stroke Program of Interventions Addressing Racial and Ethnic Disparities (ASPIRE) program—a National Institutes of Health funded study—will review standards of care for stroke patients in the District, with a focus on underserved populations.
• The Bureau of Cancer and Chronic Disease, where the CHP resides, funds the development of the D.C. Chronic Care Initiative (CCI) and Chronic Care Coalition (CCC) via local tobacco settlement funds.  In 2009, nine chronic disease management projects were funded to redesign and promote high quality care and address systemic health care inequities.
• The CHP participated in the development of draft legislation entitled “The Food, Environmental, and Economic Development in the District of Columbia Act of 2010,” also known as the FEED Act. This legislation seeks to expand access to healthy foods in low-income areas, establish a commercial distribution system for fresh produce, and improve accessibility of the public nutrition benefits programs. This is one of many efforts to address factors related to the cardiovascular health and wellness of the city’s population.
• From July 2009 to June 2010, a stroke awareness program was piloted in 53 medically underserved locations, which resulted in 1,087 residents attending program trainings.
• In September 2010, 50 Stroke Educators were trained to facilitate 500 educational sessions throughout the District.
• The CHP developed a web-based policy and environmental assessment tool for District worksites. This tool surveys the status of worksite wellness activities amongst District employers.
• The CHP spearheaded the designation of the D.C. Department of Health (DOH) as an AHA “Fit Friendly Company.” To date, the DOH remains one of the few state health departments with this designation.
• The CHP funded the development of a stroke collaborative among seven acute care, adult-serving District hospitals to help standardize stroke treatment activities throughout the District. All hospitals have agreed to use the Joint Commission’s enhanced version of the American Heart Association’s Get with the Guidelines stroke tool. Currently, the three certified primary stroke centers are mentoring the four remaining hospitals and assisting in the credentialing process. The D.C. Hospital Association, AHA, and Delmarva (the area Quality Improvement organization) served as the leaders of this effort. Because of this project’s success, the D.C. Hospital Association is continuing the collaboration to institute quality improvements for other priority chronic disease conditions.

To view heart disease and stroke data by wards for the District of Columbia, visit our interactive map site.