Public Health Herald 14th Issue

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 Winter 2012                                                                                                                                  Vol. 4, No. 2

Million Hearts Initiative

Heart disease and stroke are the first and fourth leading causes of death for men and women in the United States, accounting for one of every three deaths. According to the Centers for Disease Control and Prevention (CDC), treatment for cardiovascular disease (heart disease and stroke) accounts for $1 in every $6 U.S. health care dollars spent. Leading risk factors—such as high blood pressure, high cholesterol and smoking—are, however, largely preventable. 

In September 2011, the U.S. Department of Health and Human Services launched Million Hearts™, a national public-private initiative to prevent 1 million heart attacks and strokes over the next five years. Million Hearts™ is focused on two goals:

  •  Empowering Americans to make healthy choices such as preventing or stopping tobacco use, eating healthy foods lower in sodium and trans fat, and being physically active. Community efforts to promote smoke-free air policies, increase access to healthy food options and places to be physically active may reduce cardiovascular disease risk and the number of people who need medical treatment  to control high blood pressure and high cholesterol.
  • Improving care for people who do need treatment by encouraging a targeted focus on the “ABCS” – Aspirin for people at risk, Blood pressure control, Cholesterol management and Smoking cessation – which address the major risk factors for cardiovascular disease and can help to prevent heart attacks and strokes.

Million Hearts™ is co-led by CDC and the Centers for Medicare and Medicaid Services, with increasing participation from the private sector as well as state and local governments nationwide. Early private partners of Million Hearts™ include but are not limited to the American College of Cardiology, the American Heart Association, the American Medical Association, America’s Health Insurance Plans, the American Pharmacists Association, the Association of Black Cardiologists, United Healthcare, and the YMCA. Some of Million Hearts™ wide-ranging activities include:

  • Using educational campaigns to increase awareness about heart disease prevention so that patients take control of their heart health.
  • Focusing on tracking and reporting patient data on therapeutic aspirin use, control of blood pressure and cholesterol and smoking cessation, and simplifying the process for health care providers reporting this information. 
  • Using  health information technology and quality improvement initiatives to standardize and improve  health care delivery for high blood pressure and high cholesterol.

Prior to the Million Hearts initiative, many states have been addressing cardiovascular disease risk factors by passing laws that increase opportunities to choose healthy foods and be physically active; eliminate trans fats in foods; cover smoking cessation services for Medicaid enrollees; and make public places smoke-free, among others.


Upcoming Events and NCSL Resources

The 2012 NCSL Legislative Summit in Chicago, August 6-9, will bring together some 6,000 men and women from all 50 states and around the world.  This meeting will feature 160 sessions on every major issue being debated in state legislatures today.  Legislators, legislative staff members, corporate representatives, unions, government officials, foundation members and others will discuss critical state issues, innovations, cost-saving measures and share ideas that shape the country.

NCSL will continue to update its Federal Health Reform: State Legislative Tracking Database  tracking the actions of state legislatures related to some of the major provisions in the Affordable Care Act. This database has been used by state legislators, legislative staff, the media and the public since it was launched in 2011. It includes both carry-over measures from 2011 legislative sessions and legislation introduced in 2012.

Technical Assistance
NCSL can provide testimony to legislatures on chronic disease prevention; health promotion; preventing injuries and violence; reducing health disparities; access to health care; community health centers; and other health policy topics. Contact Alise Garcia at

NCSL Heart Disease and Stroke Resources:

Heart Disease and Stroke: 2011 Update of State Policy Options
Heart Disease and Stroke: An Overview of Our Nation's Leading Killers
Postcard: Heart Disease Death Rates by County
Heart Disease and Stroke: 50-State Profile and Policy Reports
State Legislatures Magazine: "The New Healthy"

Million Hearts Resources:

Million Hearts Initiative Website
CDC Morbidity and Mortality Weekly Report Million Hearts: Strategies to Reduce the Prevalence of Leading Cardiovascular Risk Factors
The Building Blocks of Million Hearts: An Overview of Public & Private Supports

Learn More: February is American Heart Month
National Heart Lung and Blood Institute: The Heart Truth
CDC Vital Signs: Where's the Sodium?


 In the News

On January 11, 2012, Leadership for Healthy Communities hosted a webinar, Making the Connection: Linking Economic Growth to Policies to Prevent Childhood Obesity, based on a policy brief of the same title, highlighting the important links between economic growth and public health, and exploring ways to implement policies that improve both—including community design for physical activity and recreation, and increased access to affordable and healthy foods.

In one of the largest-ever analyses of lifetime risks for cardiovascular disease, the National Institutes of Health analyzed data from 18 population-based studies, involving over 250,000 people and found that middle-ages adults who have one or more risk factors for CVD, such as high blood pressure, have a greater chance of having a heart attack or stroke during their lifetime than people with a low level of risk, according to the study published in the New England Journal of Medicine. -January 2012

The American Cancer Society released guidelines on Nutrition and Physical Activity for Cancer Prevention. The guidelines recognize the association between overweight and obesity and an increased risk of developing cancers, including colon and rectal cancers. The guidelines suggest limiting consumption of processed and red meat and eating at least 2.5 cups of vegetables and fruits each day.  -January 2012

To improve nutrition standards for National School Lunch and School Breakfast Programs, the U.S. Department of Agriculture released new school meal guidelines that help ensure that school meals offer more fruits and vegetables, whole-grain breads and pastas, and low- and non-fat milk options.  -January 2012

An article published in the Archives of Internal Medicine, “Primary health care providers’ attitudes and counseling behaviors related to dietary sodium reduction,” shows that the majority of primary health care providers agreed their patients should reduce sodium intake. However, most providers also indicated they advise patients to remove the salt shaker from the table or add less salt during cooking, even though current knowledge indicates that for most people these behaviors are unlikely to result in major salt reduction. -January 2012

The U.S. Conference of Mayors launched a food policy task force as a key step in getting healthy, affordable food to their constituents . The goal is to share information on projects that work, and also make sure that federal food policy doesn't impede local efforts.  -January 2012

Health Beat: Diabetes is a full-time job and has to be managed constantly. It’s not easy, and can be frustrating.  The director of the National Institute of Diabetes and Digestive and Kidney Diseases, Dr. Griffin Rodgers, says you can start by setting one goal to work on like physical activity because it is important for managing diabetes. -January 2012

Obese children who grow up into normal-weight adults have the same cardiovascular risk as people without a history of obesity, according to research published in the New England Journal of Medicine. Obese children are at high risk for type 2 diabetes and cardiovascular disease, however losing childhood weight can lower heart disease risk later in life. -November 2011    

Mayo Clinic research shows that after a smoke-free ordinance took effect in Olmsted County, Minn., heart attacks and sudden cardiac deaths were reduced among residents. -November 2011

A Robert Wood Johnson Foundation policy brief, "Return on Investments in Public Health and Prevention: A Summary of Groundbreaking Research Studies,"  highlights recent evidence indicating that strategic investments in proven, community-based prevention programs can help prevent chronic diseases, reduce escalating health costs and improve the economy overall. -October 2011

The Urban Institute report, "The Role of Prevention in Bending the Cost Curve,"  shows the importance of primary care and community-based prevention efforts in decreasing the incidence of chronic diseases and lowering health care costs, especially for Medicare and Medicaid programs. -October 2011

On January 25, 2012, the Robert Wood Johnson Foundation's Public Health Law Research program announced more than $2 million in funding for 15 new studies looking at the public health effects of laws on issues such as food safety, the health impacts of local power plants, youth concussions, and monitoring prescription drug use and access.  

On September 13, 2011, the CDC awarded $40 million in funding to the 50 states, D.C., and seven territories to support essential public health functions to address chronic disease and improve coordination both within states and at CDC.  The initiative targets the nation’s five leading chronic disease-related causes of death and disability: heart disease, cancer, stroke, diabetes, and arthritis. 

Public Health Project Partner News

NCSL collaborates with the Centers for Disease Control and Prevention and other national organizations—including the National Governors Association, the Association of State and Territorial Health Officials and the Society for Public Health Education—on public health projects. Recent resources available from partner organizations on public health topics include the following.

CDC Releases New Report on Healthy Food Policies
CDC’s Division of Nutrition, Physical Activity, and Obesity at the Centers for Disease Control and Prevention recently released the report State Initiatives Supporting Healthier Food Retail: An Overview of the National Landscape,” that provides information about healthy food retail legislation enacted in the past decade. -January 2012

CDC Releases Two National Vital Statistics Reports
CDC's National Center for Health Statistics released the report, Deaths: Final Data for 2008, presenting data on U.S. deaths, death rates, life expectancy, infant mortality, and trends showing that the 15 leading causes of death in 2008 remained the same as in 2007, but chronic lower respiratory diseases and suicide increased in the ranking while stroke and blood stream infections decreased.  The top five leading causes of death in order are: heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries.  -December 2011

The CDC’s National Center for Health Statistics released a new set of data from its National Health and Nutrition Examination Survey on obesity prevalence in the United States. The data shows that between 2007-2008 and 2009-2010, there has been no change in the prevalence of obesity among children and adults.  -January 2012

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