CDC National Heart Disease and Stroke Prevention Program

North Dakota
Capacity Building

The North Dakota Department of Health, Division of Chronic Disease began receiving funds from CDC in 2003 to support a state heart disease and stroke prevention program.

Burden of Heart Disease and Stroke

• More than 1 out of 4 deaths in North Dakota are due to heart disease. (National Vital Statistics Report 2009).
• 1,527 North Dakotans died from heart disease in 2006 (National Vital Statistics Report 2009).
• 428 North Dakotans died from stroke in 2006 (7.3 percent of total deaths in North Dakota). (National Vital Statistics Report 2009).

See The Burden of Cardiovascular Disease in North Dakota [PDF-321K] for more burden statistics.

• According to 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results, adults in North Dakota reported having the following risk factors for heart disease and stroke—
  
  • 26.0% had high blood pressure
  • 37.1% of those screened reported having high blood cholesterol
  • 6.3% had diabetes
  • 20.9% were current smokers
  • 64.9% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 47.3% reported no exercise in the prior 30 days
  • 78.1% 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, unions, school systems, priority population organizations, and emergency response agencies.
• Define the heart disease and stroke burden and assess existing population–based strategies for primary and secondary heart disease and stroke prevention within the state.
• Develop and update a comprehensive state plan for heart disease and stroke prevention with emphasis on developing heart–healthy policies, changing physical and social environments, and eliminating disparities (e.g., based on geography, gender, race or ethnicity, or income).
• Identify culturally appropriate approaches to promote cardiovascular health with 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.

State Highlights

• The North Dakota Heart Disease and Stroke Prevention Program (HDSPP) continues to work with the North Dakota Diabetes Prevention and Control Program (DPCP) and BlueCross BlueShield of North Dakota to implement MediQHome (MQH). MQH is a free, web-based clinical information system available to all health care providers within the state. The system addresses hypertension, coronary artery disease, chronic heart failure, diabetes, and other priority conditions. The HDSPP and the DPCP provide technical and limited financial support for the project. Just over 50%  of all counties have MQH participating providers. As of September 2010, 551 providers have designated themselves as medical homes and nearly 400,000 patients have been assigned a medical home. This health delivery system change allows providers to deliver highly personalized care faster and more effectively and offers patients a way to participate in managing their care. Better disease management should lead to better quality of life and medical cost containment.
• In 2009, the North Dakota Legislature appropriated $472,700 to the HDSPP to implement a state stroke registry program. Funds included support for
  
  • Local hospitals to purchase a web-based registry.
  • Chart entry grant for regional coordinators to provide technical assistance.
  • Pre-hospital and hospital personnel training.
  • A public education and awareness campaign to increase awareness of signs for stroke and the importance of timely care.

  As of December 2010, just over 75% of the eligible hospitals are enrolled in the state stroke registry program. Using data from the robust registry, hospitals and the HDSPP are able to assess adherence to evidence-based care of patients hospitalized with stroke and to identify opportunities to improve quality of care. Better compliance to best practice guidelines should lead to enhanced patient outcomes and lives saved.

• The North Dakota State Department of Health established a stroke system of care task force in 2009. This group was charged with creating and maintaining an inclusive and coordinated statewide system of care and education that continuously improves the knowledge, diagnosis, treatment, and rehabilitation of stroke patients and reduces the overall stroke risk for all North Dakotans. In March 2010, initial recommendations were submitted to the state health officer. The task force continues work on developing recommendations for protocols on the triage, stabilization, and appropriate routing of stroke patients by emergency medical services operations in rural areas.
• Upon recommendation from the stroke system of care task force, the health department adopted the Cincinnati Prehospital Stroke Scale as its standardized stroke-triage assessment tool. As a term of licensure, each licensed Emergency Medical Services (EMS) operation must adopt and implement a stroke-triage assessment tool that is similar to the standardized stroke-triage assessment tool adopted by the health department. The HDSPP continues its collaborative efforts with EMS partners to develop and offer training courses on use of the standardized stroke-triage assessment tool for local EMS operators. This will help ensure equal quality of stroke detection across the state and should have a dramatic effect of the mortality and morbidity of patients.
• The HDSPP is developing health communication resources using the F-A-S-T test, a proven indicator in predicting stroke even when used by non pre-hospital personnel. Similar to knowing the warning signs, F-A-S-T is a helpful tool that can be used by co-workers, family, and friends to reduce the time to treatment. Using similar messages for pre-hospital personnel and untrained observers should lead to improved stroke patient outcomes.
• The HDSPP continues its efforts to provide public health leadership to improve cardiovascular health of North Dakotans by facilitating coordination among concerned parties for the implementation of the North Dakota state plan to reduce heart disease and stroke. Efforts are also underway to develop and implement a heart disease and stroke surveillance system. This will enhance the HDSPP in monitoring critical aspects of cardiovascular disease (CVD) and evaluating effective strategies to reduce CVD and related risk factors.

For more information visit the heart disease and stroke prevention program in North Dakota.

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