CDC National Heart Disease and Stroke Prevention Program

Minnesota
Capacity Building

The Minnesota Department of Health began receiving funds from CDC in 2000 to support a state heart disease and stroke prevention program.

Burden of Heart Disease and Stroke

• Nearly 1 out of 4 deaths in Minnesota are due to heart disease. (National Vital Statistics Report, 2009.)
• 7,525 Minnesotans died from heart disease in 2006 (20.3% of total deaths in Minnesota). (National Vital Statistics Report, 2009.)
• 2,219 Minnesotans died from stroke in 2006 (6.0% of total deaths in Minnesota). (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, and the Great Lakes Regional Stroke Network report, The Burden of Stroke in the Great Lakes Region 2008, for more burden statistics.

• According to 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results, adults in Minnesota reported having the following risk factors for heart disease and stroke:
  
  • 21.4% had high blood pressure
  • 32.4% of those screened reported having high blood cholesterol
  • 5.7% had diabetes
  • 16.5% were current smokers
  • 62.0% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 51.1% reported no exercise in the prior 30 days
  • 80.6% 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 Heart Disease and Stroke urgency, the signs and symptoms of heart disease and stroke, and the need to call 9-1-1.

State Highlights

• In 2008, the Minnesota Heart Disease and Stroke Prevention (MHDSP) program partnered with The President’s Network (TPN), an organization of 80 Minnesota businesses, to focus on the development of work site policy and systems changes to advance cardiovascular health. The partnership identifies company leaders to promote statewide work site changes in small- to mid-sized businesses. The MHDSP program, the State Health Improvement Program (SHIP), the State Obesity Program, TPN, and Blue Cross Blue Shield are focused on establishing and maintaining work site initiatives that emphasize identification and control of high blood pressure and cholesterol. From 2010 through 2012, forums with the business community are being held in twelve cities and are followed by assisting companies to develop work site programs.  More than 200 small to mid-size companies will be involved in this project to help them implement, enhance, and sustain work site health initiatives.
• The MHDSP program is using funding for a project to prevent the recurrence of cardiac events—the number one cause of hospital admissions. This collaborative effort with HealthPartners, a Minnesota health plan, targets individuals who have been diagnosed with coronary artery disease or have experienced a heart attack, and focuses on high blood pressure and cholesterol control through medication management, adherence, and lifestyle changes. The intervention uses electronic health records and a decision management tool to monitor patients’ risk factors, disease management, and follow-up.  In addition, a community resource referral system links patients with appropriate resources for lifestyle changes.  The project has been piloted in two health centers and is expected to be extended to all 34 HealthPartners work sites by December 2011.
• The MHDSP program, in partnership with the Otto Bremer Foundation, one of the largest health plans in the state, piloted a community health worker (CHW) project in two Federally Qualified Health Clinics (FQHCs) that serve primarily American Indian and African American populations. The goals of the project were to improve patients’ management of cardiovascular disease through CHW support and to determine policy recommendations for the use of CHWs in other FQHCs across the state. The program’s intent is also to determine if the use of CHWs in FQHCs has a positive effect on managing high blood pressure and cholesterol for certain population groups. The FQHCs, comprising approximately 50 providers, have successfully established referral procedures for patients with high blood pressure and/or cholesterol. The results of the intervention are being analyzed and will be used to promote the use of CHWs in other health settings.
• To increase follow-up with patients diagnosed with high blood pressure, the MHDSP program has partnered with Metropolitan Health Plan (MHP), which serves a high need area in the Twin cities, to implement a blood pressure control pilot program.  A protocol for enrollment and follow-up in the program was developed, and nurses have been trained to incorporate this protocol into patient care. As of September 2010, 74 patients are enrolled in the intervention.
• The signs and symptoms of heart attack in the American Indian population project, Heart of Many Nations, addresses the MHDSP program priority of eliminating disparities. The MHDSP program has leveraged partnerships and obtained support for the project from the Padilla Speer Beardsly public relations firm, the American Heart Association, the Medica Foundation, and the Division of Indian Works in Minneapolis. The Heart of Many Nations: Heart Attack Prevention and Response curriculum has been developed, and community members are currently implementing training sessions for the American Indian population. To complement the curriculum, medical students from the University of Minnesota have volunteered to answer health related question for participants.
• The MHDSP program and the Paul Coverdell Stroke Registry partner to improve stroke care. Together, they have supported fact sheets about stroke in Minnesota, developed a training video for emergency medical system (EMS) providers, developed a Stroke Awareness and Evaluation Resource Toolkit for healthcare providers and the general public, and sponsored the 2010 Minnesota Stroke Conference.
• The MHDSP program collaborates with internal chronic disease partners, including Diabetes Prevention and Control program, the Obesity program, and the Tobacco Control program. These collaborative efforts include the following projects
  • Providing technical assistance on sodium reduction in nutrition messages supported by the American Reinvestment and Recovery Act grant.
  • In conjunction with the Minnesota Department of Health’s (MDH) Chronic Disease Risk Reduction Unit, developing a web page for health care providers and the general public on sodium as a risk factor for high blood pressure.
  • Collaborating with the Upper Sioux Tribe and MDH’s Tobacco Control program to design learning sessions to promote development and implementation of a referral process for smoking cessation among tribal members.
• The MHDSP program is coordinating an integrated chronic disease approach  focusing on risk factors and certain acute treatment intervention strategies.

For more information, visit the Minnesota Heart Disease and Stroke Prevention Unit Web site.

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