CDC National Heart Disease and Stroke Prevention Program

Massachusetts
Basic Implementation

The Massachusetts Department of Health began receiving funds from CDC in 2000 to support a state heart disease and stroke prevention program. The program received increased funding for basic implementation beginning in 2005.

Burden of Heart Disease and Stroke

• Nearly 1 out of 4 deaths in Massachusetts are due to heart disease. (National Vital Statistics Report, 2009.)
• 12,947 Massachusians died from heart disease in 2006 (24.2% of total deaths in Massachusetts). (National Vital Statistics Report, 2009.)
• 2,880 Massachusians died from stroke in 2006 (5.4% of total deaths in Massachusetts). (National Vital Statistics Report, 2009.)
• According to 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results, adults in Massachusetts reported having the following risk factors for heart disease and stroke:
  
  • 26.4% had high blood pressure
  • 35.6% of those screened reported having high blood cholesterol
  • 7.4% had diabetes
  • 16.4% were current smokers
  • 58.9% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 48.6% reported no exercise in the prior 30 days
  • 72.5% 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 sites, work sites, and communities.
• Provide training and technical assistance to public health, 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

• In January 2009, Massachusetts Governor Patrick signed Executive Order 509, which sets caloric, sodium, and other standards for foods purchased and meals served by government agencies within the executive department’s jurisdiction.
• The state Heart Disease and Stroke Prevention (HDSP) program is facilitating development of a statewide plan for reducing the sodium intake of residents. Representatives from the Commissioner’s Office, the Women, Infants and Children’s (WIC) program, and the Wellness Unit are working together in the development of an implementation plan for reducing sodium.
• The Massachusetts Association of Community Health Workers conducted a statewide study of community health workers and provided recommendations for building a sustainable workforce of these workers. Community health workers provide important follow-up to patients regarding clinical and risk reduction information.
• A successful pilot project, which changed policies and procedures to ensure consistent and accurate blood pressure measurements, was completed in seven Women’s Health Network sites in 2010. These seven sites serve approximately 1,000 patients daily and have 160 staff members trained in accurate blood pressure measurement. All sites implemented new policies and procedures consistent with nationally recognized guidelines for prevention, detection, and control of high blood pressure.
• The Heart Disease and Stroke Prevention and Control Program (HSPC), the Diabetes Prevention and Control Program, and the Tobacco Control Program are integrating efforts to reduce heart disease and stroke risk through the control of blood pressure, cholesterol, and type 2 diabetes, as well as tobacco use reduction. Tufts University staff visits primary care providers in high risk population areas and provides current guidelines and research on screening and treating hypertension, cholesterol, and diabetes, as well as smoking cessation. Interviews with Primary Care Providers (PCP) and focus groups with consumers and educators were conducted to design this population health management intervention in the Fall River and New Bedford areas. PCP practice-based interventions will address ways to improve the use of electronic medical health records to improve the management of chronic diseases.
•  As part of Governor Patrick’s HealthyMass initiative, the Massachusetts Department of Public Health leads the Working on Wellness initiative that targets employers. Public and private employers are implementing an evidence-based toolkit designed to guide development of an effective work site wellness program. Twenty-nine work sites are participating in the Working on Wellness initiative and using the Seven-Step Tool Kit to make policy and environmental changes, such as promoting chronic disease screening programs and organizational policies related to health care benefits and cost saving opportunities. For more information, the Creating a Culture of Health: Organizational Approaches to Promoting and Protecting Employee Health report is located on the Mass in Motion web site.
• Fourteen Emergency Medical Service (EMS) agencies are collecting stroke care data and regularly meeting to improve the quality of stroke care. These agencies employ nearly 800 emergency medical technicians and provide services to more than 12% of the Massachusetts population at risk for stroke (age 45 and older).
• Massachusetts is one of four Negotiated Agreement Pilot State programs. The HSPC program participates in the leadership and steering committees and is involved in the Integrated Demonstration Project that addresses increasing access to chronic disease prevention and control services for men of color. Five sites have been awarded funding.
• The state-level Partnership for a Heart Healthy and Stroke Free Massachusetts, developed in 2001, includes representatives from more than 100 organizations, agencies, and other coalitions committed to reducing heart disease, stroke, and associated risk factors through environmental and systems change. The partnership maintains a website to keep its members and the public connected.

For more information visit the Massachusetts Heart Disease and Stroke Prevention and Control Program.

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