Cardiovascular disease is the leading cause of death in the United States, especially among vulnerable populations. February is American Heart Month, an important time for health care organizations to raise awareness about risk factors for heart disease, encourage healthy eating and exercise habits, and develop programs that educate and empower at-risk individuals.
According to the Centers for Disease Control, 610,000 people die of heart disease in the United States each year, accounting for 1 in 4 deaths. Additionally, about 795,000 Americans have a stroke every year. Social determinants of health, such as food insecurity, housing instability, health behaviors, and health literacy play a large role in health outcomes, including risk factors for heart disease and stroke.
About half (49 percent) of Americans have a combination of risk factors that put them at a higher risk for heart disease, including high blood pressure, elevated low-density lipoprotein (LDL) cholesterol, smoking, obesity, diabetes, poor diet, physical inactivity, and excessive alcohol use. Research suggests that cardiovascular disease in the U.S. is expected to rise 10 percent between 2010 and 2030, due to a dramatic rise over the past 25 years in obesity, hypertension, diabetes, and physical inactivity.
Every aspect of our lives affects health; an individual’s ability to afford nutritious food or access safe spaces to exercise affects their capacity to minimize risk factors for heart disease. Additionally, the benefits of advances in prevention and treatment are not always shared equally across economic, racial, and ethnic groups.
To promote health equity, it is important for health care organizations to target the social determinants that affect an individual’s health and their ability to reduce their risk factors for cardiovascular disease. Here are just some of the ways that essential hospitals around the nation have committed to improving cardiovascular health.
Essential Hospitals Lead A Path To Cardiovascular Health
Navicent Health, in Macon, Ga., created a population health/palliative care case manager role to intervene pre- and post-discharge with African-American patients with heart failure. The Heart Failure Readmission Disparity Resolution Initiative has seen a statistically significant reduction in readmissions in the target population. This initiative has helped Navicent resolve readmission health disparities among African-American patients with chronic obstructive pulmonary disease, heart failure, and diabetes, as well as health disparities between male and female patients with diabetes. By treating the health conditions that make people more susceptible to heart-related incidents, these improvements help reduce individuals’ risk for heart disease.
Arrowhead Regional Medical Center, in Colton, Calif., launched the Heart Success Program, which uses case managers to educate and empower heart failure patients after their initial admission and diagnosis. Arrowhead also uses health information technology infrastructure to identify patients at risk of heart failure. Identifying at-risk patients is an important step in helping to prevent heart disease, and the reminder system alerts providers to conduct tests and educate patients about healthy lifestyle changes and behaviors.
Promoting cardiovascular health is not limited to heart failure, but also includes stroke treatment and prevention, especially because the risk factors are the same for both. Only half of the U.S. population has timely access to a primary stroke center. In particular, Hispanic and African-American populations often have reduced access to preventive care because they have lower median household incomes and are frequently uninsured.
Providers at University of Arkansas for Medical Sciences (UAMS), in Little Rock, Ark., expanded access to quality stroke treatment to rural patients through the Arkansas Stroke Assistance through Virtual Emergency Support (AR SAVES) program, an initiative to improve statewide stroke outcomes. AR SAVES links emergency department doctors at participating hospitals to specially trained vascular neurologists via live, two-way video, available 24 hours a day.
The real-time video communication enables stroke neurologists to evaluate a distant stroke patient and assess whether emergency department physicians should administer a potent clot dissolving drug to attack brain clots. Neurologists from the three “hub” hospitals are available 24 hours a day to the 40 outlying “spoke” hospitals within the network. In fiscal year 2017, AR SAVES had 744 consults, which resulted in 247 patients treated.
Although there is much more work to be done, essential hospitals are leaders in prioritizing cardiovascular wellbeing, especially in vulnerable communities. They proactively target patients at risk for heart disease, educate and empower heart failure patients, and expand access to quality care for heart disease and stroke, all with a focus on social determinants of health.