The Kentucky Department for Public Health began receiving funds from CDC in 1998 to support capacity building of a state heart disease and stroke prevention program. It also received CDC funding to implement a demonstration public health project that addresses quality of care improvement by implementing statewide stroke systems of care.
Burden of Heart Disease and Stroke
- More than 1 out of 4 deaths in Kentucky are due to heart disease (National Vital Statistics Report, 2009.)
- 10,353 Kentuckians died from heart disease in 2006 (25.8% of total deaths in Kentucky). (National Vital Statistics Report, 2009.)
- 2,197 Kentuckians died from stroke in 2006 (5.5% of total deaths in Kentucky). (National Vital Statistics Report, 2009.)
See the Kentucky Department for Public Health report, Close to the Heart of Kentucky, 2004, [PDF–1.42M] for more burden statistics.
- According to 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results, adults in Kentucky reported having the following risk factors for heart disease and stroke:
- 30.0% had high blood pressure
- 38.5% of those screened reported having high blood cholesterol
- 9.9% had diabetes
- 28.2% were current smokers
- 69.1% were overweight or obese (Body Mass Index greater than or equal to 25.0)
- 55.8% reported no exercise in the prior 30 days.
- 81.6% ate fruit and vegetables less than 5 times a day.
|Risk Factor||Kentucky||Nationwide (States and D.C.)|
|Eat fruits and vegetables less than 5 times/day||81.6||75.6|
|Overweight or obese||69.1||62.9|
|No moderate or vigorous physical activity||55.8||50.5|
|High total blood cholesterol||38.5||37.6|
|High blood pressure||30.0||27.8|
- 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.
- In 2007, the Kentucky Heart Disease and Stroke Prevention (KHDSP) program partnered with Health Care Excel, the Kentucky Medicare Quality Improvement Organization, to create and distribute health care provider toolkits on blood pressure control. Toolkits were distributed to more than 200 Medicare providers in Kentucky, educating physicians on the Joint Commission blood pressure control guidelines.
The toolkits provided chart stickers for tracking patient blood pressure and cholesterol control, as well as patient information materials on controlling risk factors and recognizing the signs of heart attack and stroke. Toolkits were also provided to clinics in all 56 local health department agencies. Results through 2009 show that 65% of returning patients exposed to toolkits had improved blood pressure scores and 52.1% reported that they were “taking action” to reduce their blood pressure.
- The KHDSP program, in conjunction with the KHDSP Task Force, surveyed emergency medical services providers and hospital quality improvement staff regarding stroke education in the Commonwealth. The survey results showed a need for advanced education on pre-hospital stroke care and time-sensitive transport. As a result of the survey, the Kentucky Board of Emergency Medical Services and the KHDSP Task Force developed standardized transport protocols for stroke, which are now included in the Commonwealth of Kentucky patient care protocols. The KHDSP program contracted with the University of Louisville to conduct a train-the-trainer workshop to educate instructors on the National Stroke Association’s stroke rapid response course. Now being taught across the Commonwealth to emergency responders, more than 1,100 of the state’s 13,000 emergency responders have been educated as a result.
- The KHDSP program received funding to promote and improve the existing statewide stroke systems of care. The project’s goals are to
- Promote the existing statewide stroke system of care model—including the telemedicine model—to primary care providers, public health departments, emergency medical service providers, and air ambulance service providers.
- Educate health care providers on communicating to patients the signs and symptoms of a stroke, taking timely action, receiving immediate medical attention, and the availability of the telestroke system.
In the project’s first year, the number of stroke patients treated using this system increased from 169 to 488 patients. There was also a 77% increase in the percentage of stroke patients arriving at the hospital within a three-hour window. Patient discharge disposition showed an increase in positive indicators, including increase in patients’ discharge to their own home, rehabilitation center, or nursing home, as well as a decrease in mortality.
- The Stroke Encounter Quality Improvement Project (SEQIP) is a statewide quality improvement initiative of the KHDSP program and the KHDSP task force’s cardiovascular health delivery systems subcommittee. The SEQIP goal is to advance stroke care in Kentucky by implementing systems that ensure excellence in acute stroke treatment and ischemic stroke prevention. Through implementation of the American Heart Association’s Get With The Guidelines stroke module, SEQIP provides an opportunity for data collection and evaluation, as well as to determine areas for improvement related to stroke interventions, acute management of stroke, and secondary prevention. Seventeen hospitals across the Commonwealth currently participate in this effort.
For more information visit the Kentucky Heart Disease and Stroke Prevention Program.
To view county-level data, visit our interactive map site.