CDC National Heart Disease and Stroke Prevention Program

Michigan
Capacity Building

In 2007, the Michigan Department of Community Health received CDC funds to support a state heart disease and stroke prevention program. It also received CDC funding to implement a demonstration public health project that addresses improvement of emergency response.

Burden of Heart Disease and Stroke

• More than 1 out of 4 deaths in Michigan are due to heart disease. (National Vital Statistics Report, 2009.)
• 24,255 Michiganders died from heart disease in 2006 (28.2% of total deaths in Michigan). (National Vital Statistics Report, 2009.)
• 4,752 Michiganders died from stroke in 2006 (5.5% of total deaths in Michigan). (National Vital Statistics Report, 2009.)

See the Michigan Department of Community Health report, Impact of Heart Disease and Stroke in Michigan: 2008 Report on Surveillance [PDF–4.5M], and the Great Lakes Regional Stroke Network report, The Burden of Stroke in the Great Lakes Region 2008, [PDF–746K] for more burden statistics.

• According to 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results, adults in Michigan reported the following risk factors for heart disease and stroke:
  
  • 28.6% had high blood pressure
  • 39.9% of those screened reported having high blood cholesterol
  • 8.8% had diabetes
  • 21.1% were current smokers
  • 64.3% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 49.3% reported no exercise in the prior 30 days
  • 78.7% 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.
• Update and report on 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.
• Disseminate and implement 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 and control 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.
• Promote quality improvement activities in stroke and heart disease care.

Success Story

• Michigan NHDSP Program Success Story: New Trauma Care System Funding Will Improve Heart Attack and Stroke Response [PDF-395K]

State Highlights

• The Michigan Heart Disease and Stroke Prevention (MHDSP) program has several efforts focused on identification and control of hypertension
  • The MHDSP program, in collaboration with the Michigan Society of Cardiovascular and Pulmonary Rehabilitation, supports quality improvement initiatives in 30 cardiac rehabilitation centers around the state. The project focuses on assessment and quality improvement activities for cardiac rehabilitation patients, with a focus on high blood pressure and cholesterol control. Michigan is part of a consortium of several states, led by the Montana Heart Disease and Stroke Program, collecting information on secondary events and promoting quality improvement initiatives.
    
  • The MHDSP program is promoting high blood pressure control through its High Blood Pressure University (HBPU). The HBPU is a website that provides a catalogue of high blood pressure resources and tools for health care providers, patients, and community-based organizations. Tools include the “Michigan Hypertension Core Curriculum,” resources on sodium reduction and the DASH diet, office management tools, blood pressure management guidelines, patient education materials, and links to other websites on this topic.
  • The MHDSP program is working with Federally Qualified Health Centers (FQHCs) to reduce high blood pressure (HBP) and high cholesterol (HC).  Three FQHCs have used materials from the HBPU, received assistance from the MHDSP program, and developed quality improvement initiatives. These developments aim to improve treatment protocols, patient adherence, and follow-up for HBP and HC control. Lessons learned by the three sites will be shared through the Michigan Primary Care Association with other FQHCs.
  • MHDSP, in partnership with the National Kidney Foundation of Michigan and the Hypertension Expert Work Group, developed the Michigan Hypertension Core Curriculum. This comprehensive guide for identifying and treating hypertension is distributed to professionals through academic organizations and conferences.
• From 2007-2010, the MHDSP program used Centers for Disease Control and Prevention funding to collaborate with the state trauma systems section to
  • Develop a comprehensive partnership representing stakeholders in the continuum of EMS care.
  • Assess the state's cardiac and stroke EMS care.
  • Develop and advocate quality improvement recommendations.

  Legislation supporting EMS regionalization for the state passed the Michigan Legislature in December 2010; it provides funding to implement 2007 rules, expand the trauma registry to include stroke and acute cardiac events, and to support eight regional EMS coordinators, a part-time EMS medical director, a trauma registrar, administrative support, and quality improvement staff.

• The MHDSP program has partnered with businesses to promote development of work site health programs, based on the Purchasers Guide to Clinical Preventive Services and Successful Business Strategies, through the Michigan Cardiovascular Business Alliance. Mini-grants supported initiatives to promote use of the Purchasers Guide in health care coverage decisions by employers. The MHDSP program also hosts a free health risk appraisal and policy and environmental assessment for work sites called Designing Healthy Environments at Work. These resources can be found at www.michigan.gov/cvh on the Healthy Businesses page.  A new “signs and symptoms” awareness and emergency plan and response project was implemented in 10 work sites and is being evaluated.
• The MHDSP program is working with other partners, such as Healthy Kids Healthy Michigan, to promote sodium reduction in school nutrition guidelines. The MHDSP program is also working with the WISEWOMAN program to promote messages about stroke and heart attack signs and symptoms, and with genomics to implement recommendations from the Impact of Sudden Cardiac Death in the Young report, a document that can be found on the program web site on the burden page.  This report provided information to colleagues about the importance of this problem and identifies action sets focusing on pre-participation sports screening, healthcare provider education, public and community awareness, emergency response and medical examiner protocols.

For more information visit Michigan's Heart Disease and Stroke Prevention program.

To view county-level data, visit our interactive map site.