Policy and law can help change systems and environments and scale up evidence-based interventions that improve population health. The Division for Heart Disease and Stroke Prevention produces policy related products across a policy research continuum that spans evidence assessment, policy surveillance, implementation and impact studies, approaches to rate policies, and tools for dissemination for use by state and local grantees and others considering policy change or scale-up as a strategy to improve cardiovascular health. This webpage provides resources across the policy research continuum addressing policies relevant to improving community-clinical linkages and health systems transformation, such as stroke systems of care, public access defibrillation, nurse practitioner and pharmacist scopes of practice, and community health worker workforce development.
State Policy Analysis
- A Summary of Primary Stroke Center Policy in the United States [PDF-2M]
This summary provides an overview laws and regulations related to primary stroke centers in the United States through mid-2010. It includes a summary and synthesis of policy action across states as well as an individual report for each state.
- A Summary of Public Access Defibrillation Laws, United States, 2010
This summary reviews each state’s legal requirements for recommended public access defibrillation(PAD) program elements and concludes that PAD programs in many states are at risk of failure because critical elements such as maintenance, medical oversight, emergency medical service notification, and continuous quality improvement are not required. The summary suggests that policy makers consider strengthening PAD policies by enacting laws that can reduce the time from collapse to shock, such as requiring the strategic placement of AEDs in high-risk locations or mandatory PAD registries that are coordinated with local EMS and dispatch centers.
- Chronic Disease State Policy Tracking System
Our state law data is moving! The Division for Heart Disease and Stroke Prevention (DHDSP) tracks state law data (including statutes, regulations, and executive directives) in all 50 states and Washington, D.C. along with health topics relevant to heart disease and stroke. Data is available for historical purposes only (current up to December 2014) in the Chronic Disease State Policy Tracking System (CDSPTS)—a state-based searchable database that provides policy information relevant to the prevention and control of chronic diseases. DHDSP is currently in the process of moving state law data to a new platform in order to create a more user-friendly application. Data will be updated once the new system is launched (expected launch date of summer, 2016). Please monitor this web page for updates.
State Law Fact Sheets
Law can serve as an important tool in improving public health.1 Given that heart disease and stroke are among the leading causes of death, disability, and health expenditures in the United States, an understanding of the legal interventions available to state and local authorities could assist decision makers when assessing policy options to reduce the burden of cardiovascular disease. State Law Fact Sheets describe the scientific evidence in support of particular legal interventions, and describe the extent to which states have enacted such laws. Such information can be useful to state and local public health practitioners, researchers, and decision makers.
- A Summary of State Patient-Centered Medical Home Laws, December 2013 [PDF-423K]
- Prescription Drug Cost-Sharing and Antihypertensive Drug Access among State Medicaid Fee for Service Plans, 2012 [PDF-284K]
- Select Features of State Pharmacist Collaborative Practice Laws [PDF-232K]
- A Summary of State Community Health Worker Laws [PDF-680K]
Policy Evidence Assessment Reports
Policy Evidence Assessment Reports summarize the evidence bases for components of chronic disease policy. Evidence-based policy can be used to prevent, control, and improve the outcomes of chronic disease, but the strength of the evidence for many components of policy is unknown. The Policy Evidence Assessment Reports are intended to inform researchers, evaluators, and practitioners about the strengths and limitations of the evidence bases for individual components of chronic disease policy. These reports can be used during consideration of policy options to improve chronic disease outcomes, as well as to understand how enacted state laws incorporate evidence-based policy.
- What Could Be Addressed in an Evidence-Informed State Workplace Health Promotion Law? [PDF-2M]
The Policy Evidence Assessment Report What Could Be Addressed in an Evidence Informed State Workplace Health Promotion Law assesses the evidence for 21 types of workplace health promotion interventions addressed in state laws to inform policy decision makers, researchers, and program coordinators.
- Infographic: What Could Be Addressed in an Evidence-Informed State Workplace Health Promotion Law? [PDF-1.2M]
This infographic provides a one page summary of the full Policy Evidence Assessment Report What Could Be Addressed in an Evidence Informed State Workplace Health Promotion Law?
- Community Health Worker Policy Evidence Assessment Report [PDF-843K]
The Community Health Worker Policy Evidence Assessment Report assesses the evidence for 14 types of interventions addressed in state CHW laws to inform policy decision makers, researchers, and community and health organizations.
- Community Health Worker Policy Evidence Assessment Report One-Pager [PDF-231K]
This one-pager provides a summary of the full Community Health Worker Policy Evidence Assessment Report.
- What Evidence Supports State Laws to Establish Community Health Worker Scope of Practice and Certification? [PDF – 471 KB]
This report updates the evidence for 2 of the 14 types of interventions from the Community Health Worker Policy Evidence Assessment Report: State CHW Certification and State CHW Scope of Practice, which are seen as important first steps towards building a better-prepared and more sustainable CHW workforce.
Guides, Recommendations, Tools
Collaborative Practice Agreements and Pharmacists’ Patient Care Services Resources
This set of guides informs health care providers, decision-makers, insurers, and pharmacists about the role of pharmacists in team based care. The guides help put science into practice by including strategies and case examples of how pharmacists and other health care providers can better serve patients through collaborative practice agreements and collaborative drug therapy management.
- For Nurses, Physician Assistants, and Other Providers [PDF-301K]
- For Pharmacists [PDF-308K]
- For Government and Private Payers [PDF-303K]
- For Decision Makers [PDF-307K]
- El Rio Policy Case Study [PDF-655K]
- Osterhaus Policy Case Study [PDF-350K]
- Addressing Chronic Disease through Community Health Workers: A Policy and Systems-Level Approach [PDF-924K]
This document provides guidance and resources for implementing recommendations to integrate community health workers (CHWs) into community-based efforts to prevent chronic disease. It sets forth evidence demonstrating the value and impact of CHWs in preventing and managing chronic diseases and describes comprehensive state policies, programs that engage CHWs, and resources to assist state health departments and others.
- Primary Stroke Center Policy: Recommendations for Policy Implementation [PDF-1M]
This document identifies the key components, facilitators, and barriers to Primary Stroke Center Policy implementation for states.
- Improving the Food Environment Through Nutrition Standards: A Guide for Government Procurement [PDF-682K]
Developed by the Centers for Disease Control and Prevention (CDC), this procurement guide provides practical guidance to states and local governments for developing, adopting, implementing, and evaluating a food procurement policy. This guide also provides valuable insight into the appropriateness and acceptability of these policies in other worksite settings.
- Online Procurement Resources [PDF-682K]
The Division for Heart Disease and Stroke Prevention (DHDSP) provides resources to help organizations implement food service guidelines and strategies to reduce sodium. This document provides an overview of several resources related to food procurement, including guides, publications, and webinars.
- Under Pressure: Strategies for Sodium Reduction in the Hospital Environment [PDF-735K]
This document examines the importance of healthy foods in hospital environments and provides strategies to improve health through sodium reduction in foods served at hospitals.
- Under Pressure: Strategies for Sodium Reduction in the School Environment [PDF-1.8M]
This document examines the importance of providing healthy school meals to children in schools and provides strategies to for sodium reduction in the school environment.
- Under Pressure: Strategies for Sodium Reduction in Worksites [PDF-1.3M]
This document examines the importance of healthy foods at worksites and provides strategies to improve health through sodium reduction in foods available at worksites.
- Science-in-Briefs: Turning Science Into Action
Science-in-Briefs are concise and user-friendly publication summaries intended to enhance the understanding and application of current research findings. Science-in-Briefs provide a short synopsis of newly published articles summing up the findings and how these findings might be applied to the work in cardiovascular health promotion by practitioners and policy makers. Topics include: hypertension, cardiovascular disease risk factors, patient centered medical homes, and sodium.
- Health Impact Assessment
This page describes how to use the Health Impact Assessment (HIA) tool to evaluate the potential health effects of a project or policy before it is built or implemented. The HIA framework is used to bring potential public health impacts and considerations to the decision-making process for plans, projects, and policies that fall outside of traditional public health arenas, such as transportation and land use.
- The Cost-Effectiveness of Interventions Designed to Reduce Sodium Intake
This comprehensive literature review summarizes evidence on selected population-wide interventions to reduce sodium as approaches to control hypertension. The findings indicate that sodium reduction interventions are low in cost and cost-effective.
- A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension
This Institute of Medicine (IOM) report recommends that federal, state, and local health agencies focus on population-based strategies that can reach large numbers of people and improve the well-being of entire communities. Behavioral and lifestyle interventions—reducing sodium intake, increasing consumption of fruits and vegetables, and increasing physical activity—are among the best examples. The report also highlights the need to improve providers’ adherence to the treatment guidelines for hypertension and to encourage patients to take medication consistently by reducing or eliminating the cost of antihypertensive medication.
- The Role of Nutrition in Maintaining Health in the Nation’s Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population
This Institute of Medicine (IOM) publication provides recommendations for nutrition services for the elderly, including sodium reduction among the Medicare population, and considers how health care coverage policies should be approached and practiced. The book also discusses the role of nutrition therapy in the management of cardiovascular disease, among other conditions.
- Barbero, C., Gilchrist, S., Chriqui, J.F., Martin, M., Wennerstrom, A., VanderVeur, J., Prewitt, K., & Brownstein, J.N. Do State Community Health Worker Laws Align with Best Available Evidence? J Community Health 2015 Oct; doi: 10.1007/s10900-015-0098-x.
- Barbero, C., Gilchrist, S., Schooley, M.W., Chriqui, J.F., Luke, D.A., & Eyler, A.A. Appraising the evidence for public health policy components using the quality and impact of component evidence assessment. Global Heart 2015 Mar; 10 (1): 3-11. doi: 10.1016/j.gheart.2014.12.013.
- Mensah GA, Goodman RA, Zaza S, et al. Law as a tool for preventing chronic diseases: expanding the spectrum of effective public health strategies. Prev. Chron. Dis. [serial online]. 2004:1(1). Available from: https://www.cdc.gov/pcd/issues/2004/jan/03_0033.htm.
- Page last reviewed: May 24, 2017
- Page last updated: May 24, 2017
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