CDC National Heart Disease and Stroke Prevention Program

Texas
Capacity Building

The Texas Department of Health began receiving funds from CDC in 2002 to support a state heart disease and stroke prevention program.

Burden of Heart Disease and Stroke

• Nearly 1 out of 4 deaths in Texas are due to heart disease. (National Vital Statistics Report, 2009.)
• 38,782 Texans died from heart disease in 2006 (24.7% of total deaths in Texas). (National Vital Statistics Report, 2009.)
• 9,366 Texans died from stroke in 2006 (6.0% of total deaths in Texas). (National Vital Statistics Report, 2009.)

See the Texas Department of State Health Services’ The Burden Report: Cardiovascular Disease and Stroke in Texas 2009 [PDF–12.8M] for more burden statistics.

• According to 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results, adults in Texas reported having the following risk factors for heart disease and stroke:
  
  • 27.8% had high blood pressure
  • 38.5% of those screened reported having high blood cholesterol
  • 10.3% had diabetes
  • 19.3% were current smokers
  • 65.8% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 53.5% reported no exercise in the prior 30 days
  • 74.8% 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 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 Texas Cardiovascular Disease and Stroke (TCVDS) Program supports the Heart and Stroke Healthy City (HSHC) Recognition Program, which assesses small, mid-sized, and metropolitan cities on 10 indicators related to policy, system, and environmental features that support heart and stroke health and emergency response to cardiovascular events. This initiative is implemented by the TCVDS Program and the Texas Council on Cardiovascular Disease and Stroke. Results of this assessment and a corresponding award (honorable mention, bronze, silver, or gold) are presented to local public health agencies and city councils. The program reassesses each of the cities after a three-year period to determine whether cities have implemented improvements. The HSHC Recognition Program has been a successful tool for educating and motivating community-level decision makers to implement policy, system, and environmental changes shown to support heart and brain health.
• The TCVDS Program’s Value-Based Benefits Design project is in its final year of working with the local health departments in the cities of San Antonio and Austin-Travis County to build and support employer consortiums focusing on employee benefit packages that include adequate coverage for secondary prevention services and quality treatment for heart disease and stroke. Both cities have developed partnerships with work site wellness groups and the business communities. The participating cities have surveyed employers on work site wellness, provided tools for health risk assessments, and provided learning on topics such as mental health services and tobacco use and cessation. Local health department staff work with employers to collect and analyze employee health risk and biometric data and to make informed decisions regarding benefit changes that will increase participation in prevention behaviors. The selected cities will eventually serve as mentors to other cities in the state in implementing value-based benefits design.
• The Program’s Stroke Initiative is working with the DSHS Office of Emergency Medical Services (EMS) and the Governor’s EMS and Trauma Advisory Council to create improvements in the acute stroke care system in Texas. The Program is working with EMS Advisory committees at the regional level to implement components identified as critical to a quality system of care, including stroke transport protocols, access to a primary stroke center, and stroke public education campaigns. Efforts are also under way to assess state-level capacity and make recommendations for a stroke surveillance system.
• The Program continues to support several projects of the Texas Council on Cardiovascular Disease and Stroke, including two ongoing secondary prevention projects involving Medicaid clients at community health centers and several new projects with local health departments working to improve their scores in the HSHC Recognition Program.
• The Program published the Texas Plan to Reduce Cardiovascular Disease and Stroke 2008 after a two-year assessment and strategic planning process. A tracking survey continuously collects information from stakeholders around Texas regarding their efforts to implement the state plan.
• The Program works to build and maintain a statewide partnership whose mission is “Partners working together to implement the Texas Plan to Reduce Cardiovascular Disease and Stroke.” The Partnership is led by a steering committee of more than 80 stakeholders working through four “Plan Goal” committees to implement objectives from the Plan. The Partnership held its yearly conference June 15–17 in Austin, entitled Building Bridges: Improving Health Through Program Integration. Dr. Ursula Bauer, Director of the National Center for Chronic Disease Prevention and Health Promotion of the Centers for Disease Control and Prevention, was a plenary speaker.
• The Program is working with a contractor to analyze the processes used by two primary stroke centers in Texas that received Gold Level Recognition from the American Heart Association’s Get With The Guidelines–Stroke. The final report will be used to describe best practice approaches for successful implementation of stroke care quality improvement programs.

For more information visit the Texas Cardiovascular Health and Wellness Program Web site.

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