CDC National Heart Disease and Stroke Prevention Program

North Carolina
Basic Implementation

The North Carolina Department of Health and Human Services/Division of Public Health began receiving funds from CDC in 1998 to support a state heart disease and stroke prevention basic implementation program. The program also received additional CDC funding to lead the Tri-State Stroke Network.

Burden of Heart Disease and Stroke

• Nearly 1 out of 4 deaths in North Carolina are due to heart disease. (National Vital Statistics Report, 2009.)
• 17,271 North Carolinians died from heart disease in 2006 (23.1% of total deaths in North Carolina). (National Vital Statistics Report, 2009.)
• 4,572 North Carolinians died from stroke in 2006 (6.1% of total deaths in North Carolina). (National Vital Statistics Report, 2009.)

See the North Carolina Department of Health and Human Services report, The Burden of Cardiovascular Disease in North Carolina 2005, [PDF-1.2M] and the Tri-State Stroke Network report, The Impact of Stroke in the Southeast 2008, for more burden statistics.

• According to 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results, adults in North Carolina reported having the following risk factors for heart disease and stroke:
  
  • 28.8% had high blood pressure
  • 39.6% of those screened reported having high blood cholesterol
  • 9.1% had diabetes
  • 22.9% were current smokers
  • 64.6% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 56.0% reported no exercise in the prior 30 days
  • 78.4% 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.
• Support health care organizations system changes to assure quality of care and implementation of primary and secondary prevention for heart disease and stroke.
• Monitor, implement, and evaluate prevention strategies and programs in health care settings, work sites, and communities.
• Provide training and technical assistance for health care professionals, and partners to support primary and secondary prevention of heart disease and stroke.
• Monitor quality of care for primary and secondary prevention.

State Highlights

• The Justus-Warren Heart Disease and Stroke Prevention Task Force (JWTF) is a legislated state convener for heart disease and stroke partnerships in North Carolina. JWTF is staffed by the Heart Disease and Stroke Prevention (HDSP) Program.  Under its leadership, the HDSP Program played a key role in North Carolina’s initiative to combat secondhand smoke.  Legislation, which prohibits smoking in most public places (including restaurants and work sites), became law in January 2010.  The HDSP Program continues to educate the community on the benefits of this law.
• The HDSP Program worked with the Improving Performance in Practice (IPIP) initiative to improve hypertension control through practice redesign. The initiative helped participating state primary care practices that serve Medicaid patients.  The HDSP Program continues to expand this effort to other primary care practices via entities such as the North Carolina Community Health Center Association.
• With the increasing interest in prevention of risk factors for cardiovascular disease (CVD), a hypertension and sodium fact sheet packet with an emphasis on minority populations is being developed for primary healthcare providers and the general public. Two op-ed pieces on sodium and hypertension were developed and will be disseminated to community members and policy leaders.
• The establishment and growth of the Eastern North Carolina Stroke Network (ENCSN) has been a significant contributor in strengthening the capacity of eastern North Carolina’s stroke continuum.  A primary focus of the network is the continuing education of (and by) highly skilled practitioners through sharing evidenced based practices. Educational initiatives are aimed at improving the control of hypertension and cholesterol, as well as sodium reduction. 
• The HDSP Program collaborates with other programs within the Department of Public Health (DPH) (e.g. Tobacco Prevention and Control; Physical Activity, Nutrition and Obesity; Diabetes Prevention and Control; and WISEWOMAN) on common interests, such as controlling high blood pressure and cholesterol, reducing sodium intake, improving quality of care, improving emergency response, and eliminating health disparities. The HDSP Program also provides leadership in convening related DPH programs around common focus areas—such as data, healthcare systems, and policy—to maximize collaboration and efficient use of resources. 
• The HDSP Program was awarded a planning grant from the Association of State and Territorial Health Officials (ASTHO) to assist efforts to establish a statewide comprehensive system of stroke care by December 2010. 
• The HDSP Program was awarded a training grant from the National Association of Chronic Disease Directors (NACDD) to engage DPH chronic disease programs in a collaborative GIS mapping course conducted by Duke University.
• The HDSP Program utilizes multiple strategies to reduce health care disparities. The program partnered with
  • the Diabetes Prevention and Control Branch on a Chronic Disease Self Management project focused on African American men;
  • the North Carolina Office of Minority Health and Health Disparities on a cardiovascular education program for lay health workers;
  • the Old North State Medical Society (a historically African American Medical Society) to dialogue with physicians about current public health efforts to address cardiovascular health issues of disparate populations.
• In partnership with the North Carolina Office of Emergency Medical Services (EMS), the University of North Carolina Emergency Medical Department, and the EMS Performance Improvement Center, the HDSP Program developed an EMS stroke toolkit designed to improve EMS stroke care and response.

For more information on heart disease and stroke prevention in North Carolina, visit http://www.startwithyourheart.com/.

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