CDC National Heart Disease and Stroke Prevention Program

South Carolina
Basic Implementation

The South Carolina Department of Health and Environmental Control began receiving funds from CDC in 1998 to support a state heart disease and stroke prevention program. The program received increased funding for basic implementation beginning in 2001.

Burden of Heart Disease and Stroke

• Nearly 1 out of 4 deaths in South Carolina are due to heart disease. (National Vital Statistics Report, 2009.)
• 9,030 South Carolinians died from heart disease in 2006 (23.3% of total deaths in South Carolina). (National Vital Statistics Report, 2009.)
• 2,291 South Carolinians died from stroke in 2006 (5.9% of total deaths in South Carolina. (National Vital Statistics Report, 2009.)

See the South Carolina Department of Health and Environmental Control report, The Burden of Heart Disease and Stroke in South Carolina 2006, [PDF–3M] 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 South Carolina reported having the following risk factors for heart disease and stroke:
  
  • 30.4% had high blood pressure
  • 39.2% of those screened reported having high blood cholesterol
  • 9.6% had diabetes
  • 21.9% were current smokers
  • 65.3% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 53.5% reported no exercise in the prior 30 days
  • 81.3% 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 South Carolina Department of Health and Environmental Control’s Heart Disease and Stroke Prevention (HDSP) program is working to improve hypertension control within primary care settings. In collaboration with the Medical University of South Carolina (MUSC), the American Society of Hypertension (ASH), the Consortium of Southeastern Hypertension Control (COSEHC), and other partners, HDSP is improving hypertension management through evidence-based protocols and best practices. Through recruitment of health care providers serving high risk populations—which include low-income, uninsured or underinsured adults aged 35 and over, rural residents, and African Americans—more than 1,250 providers in South Carolina, who serve more than 240,000 hypertensive patients, are engaged in this effort.
  
  

  Health care providers that demonstrate quality-focused hypertension management can become designated as Certified Hypertension Experts by ASH or COSEHC.  Currently, South Carolina has 50 practicing hypertension specialists in clinical hypertension. HDSP will prioritize the certification of minority providers and providers serving Federally Qualified Health Centers (FQHCs) as hypertension specialists.

• The HDSP program is piloting a replica of the “Asheville Project Model” which is a patient focused, pharmacy – based program that emphasizes self-management of chronic conditions within two of its eight public health regions. The program is partnering with the Municipal Association of South Carolina and other key stakeholders to implement this pilot work site initiative.
• The HDSP program collaborated with the state’s Emergency Medical Services (EMS) Division to support implementation of a statewide electronic EMS reporting system. This system includes data for heart attack, stroke, and other health conditions that can be enhanced through pre-hospital data analysis to improve systems of care. The improved data collection will be used to support policy development, identification of EMS training needs, enhanced reporting and monitoring, and quality improvement in patient care. All 208 licensed EMS agencies in South Carolina are submitting data to the reporting system and incoming health event information covers nearly all of South Carolina’s population.
• The HDSP program has funded an EMS data linkage project, which will enable statewide pre-hospital medical records to be linked with hospital medical records.  This will permit EMS to evaluate the impact of their care on the overall outcomes of patients. 
• The HDSP program partners with the South Carolina Hospital Association, the American Heart Association (AHA), and the American Stroke Association (ASA), to improve patient outcomes for stroke, coronary artery disease, and heart failure. This partnership promotes electronic patient management tools as part of the Get With The Guidelines (GWTG) quality improvement initiative. The initiative supports hospitals’ efforts to become certified as primary stroke centers.  As of September 2010, there are eight accredited primary stroke centers in South Carolina. Twenty of the state’s 64 hospitals have implemented at least one GWTG module since this initiative launched in 2004.
• South Carolina’s Public Health Regions are engaging faith-based organizations and other partners to create alliances that address health inequities among high-risk African-Americans. One of the strategies used to address disparities is the American Heart Association’s Search Your Heart, an educational initiative for African American faith communities. This initiative stresses healthy lifestyle choices, monitoring blood pressure and cholesterol levels, working with a doctor to control risks of high levels, and increasing awareness of the signs and symptoms for heart attack and stroke.
• The South Carolina work site toolkit was launched on the HDSP program’s website in July 2010. The toolkit will assist employers in the selection of best practices, as well as evidence-based strategies and interventions to improve employee health.

For more information visit the South Carolina Heart Disease and Stroke Prevention Division Web site.

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