Texas CVD and Stroke Digest

Texas CVD and Stroke Digest

October 2009

This Digest is provided by the Cardiovascular Health and Wellness Program at the Texas Department of State Health Services in support of the Texas CVD and Stroke Partnership. If you did not receive this Digest as a subscriber and would like to subscribe, please visit http://wwwstage.dshs.state.tx.us/wellness/partnershipdigest.shtm. Information about educational opportunities, resources, tools, and reports is compiled from national, state, and local partners. The Digest does not reflect endorsements by DSHS or the Partnership.

REPORTS and DATA

World Stroke Day was October 29, 2009. Public health practitioners and other health professionals can encourage their patients to lower the risk for stroke by preventing or controlling high blood pressure and diabetes, lowering cholesterol, avoiding tobacco use, limiting alcohol use, engaging in regular physical activity, and eating a healthy diet with more fresh fruits and vegetables and less salt and saturated fat. Public health agencies also should educate members of the public to recognize the signs and symptoms of stroke and the importance of dialing 911 immediately for prompt medical attention. CDC addresses stroke prevention by working with state-based programs, the Paul Coverdell National Acute Stroke Registry, and other organizations to develop strategies to prevent heart disease and stroke. Additional information regarding stroke is available at http://www.cdc.gov/stroke.

Study: Racial Health Disparities Cost $229 Billion From 2003–2006. The Baltimore Sun, 09/21/09
Racial health disparities cost the United States $229 billion between 2003 and 2006—money that could help cover an overhaul of the nation's health care system, according to a new report by Johns Hopkins and University of Maryland researchers. Minorities are generally sicker and more likely than whites to die of numerous diseases, and until now, medical experts and advocates fighting to close those gaps have made their pleas on moral grounds. But the new figures aim to break down the issue into dollars and cents at a time when everyone is trying to figure out how to rein in soaring health care costs. "The statistics are just stunning and shocking," said Health and Human Services Secretary Kathleen Sebelius, during an announcement of the findings Thursday. "There is no question that reducing the health disparities can save incredible amounts of money. But more importantly, it saves lives and it makes us a healthier and more prosperous nation." http://www.baltimoresun.com/health/bal-md.disparities18sep18,0,457725.story
Curtailing Second-Hand Smoke Cuts Heart-Attack Rates, Studies Show. The Wall Street Journal, 09/22/09. The growing numbers of bans on smoking in restaurants, bars and workplaces, intended to protect nonsmokers against second-hand-tobacco smoke, are turning into potent weapons in the battle to prevent heart attacks. In one of the largest analyses to date of the dangers of passive smoking, researchers found that smoke-free laws reduced the rate of heart attacks by an average of 17% after one year in communities where the bans had been adopted. The benefit increased with time: After three years, the rate had dropped about 26%. The biggest declines in heart attacks were seen among non-smokers and people between the ages of 40 and 60 years. http://online.wsj.com/article/SB10001424052970203803904574426921442513660.html#

Cutting Sodium Consumption: A Major Public Health Priority. ScienceDaily, 09/14/09.
Reducing sodium intake is a major public health priority that must be acted upon by governments and nongovernmental organizations to improve population health, states an article in CMAJ (Canadian Medical Association Journal). http://www.sciencedaily.com/releases/2009/09/090914131902.htm

Sidewalks, Parks, Farm Markets Cut Diabetes Risk. Reuters, 10/13/09. People who live in neighborhoods with safe sidewalks, ample parks, good public transportation, and ready access to fresh fruits and vegetables are 38 percent less likely to develop diabetes than others, U.S. researchers said on Monday. They said unlike a lot of other factors that influence diabetes, creating a healthy neighborhood is one thing policymakers can do to address the epidemic of diabetes, which costs the United States more than $116 billion in medical expenses each year. http://www.reuters.com/article/healthNews/idUSTRE59B57R20091012

Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. IOM Report available at http://www.iom.edu/en/Reports/2009/Secondhand-Smoke-Exposure-and-Cardiovascular-Effects-Making-Sense-of-the-Evidence.aspx

Worksite Programs Help Employees Lose Weight. Community Guide News, Accessed 10/21/09
Worksite programs help employees lose weight, according to a systematic review published in the October issue of the American Journal of Preventive Medicine. On the basis of strong evidence of their effectiveness, the U.S. Task Force on Community Preventive Services recommends worksite programs intended to improve diet and/or physical activity behaviors for reducing weight among employees. These programs include various approaches to support behavior change, such as informational and educational activities, behavioral and social strategies, and policy and environmental approaches. http://www.thecommunityguide.org/news/2009/worksiteprograms.html

Sires Introduces Urban Park Legislation to Congress with Support from NRPA. Vocus/PRWEB, 10/09/09. The cause of healthier, vibrant urban communities in America got a major boost... when Rep. Albio Sires of New Jersey's 13th District introduced the Urban Revitalization and Livable Communities Act (H.R. 3734) to Congress. The act provides federal assistance grants (which must be matched with local funds) to rehabilitate and develop urban parks and community recreational infrastructure…. The bill goes to the heart of the collective thinking that emerged when Rep. Sires presented a draft two weeks earlier at NRPA's Urban Park Summit in Washington, D.C., during which the association brought together a select group of mayors, high ranking administration officials, Congressional leaders and urban park directors. http://www.prweb.com/releases/nrpa/urban_park_summit/prweb3016934.htm

Neighborhood Resources for Physical Activity and Healthy Foods and Incidence of Type 2 Diabetes Mellitus: The Multi-Ethnic Study of Atherosclerosis. Auchincloss AH, Diez Roux AV, Mujahid MS, et al. Arch Intern Med 2009;169:1698-1704.
Are neighborhood resources associated with incidence of type 2 diabetes mellitus (DM)?

The investigators concluded that better neighborhood resources are associated with lower incidence of DM, suggesting that environmental interventions may be a critical component of prevention related to DM. This is an important finding, which highlights the need to think beyond the individual patient in regards to prevention efforts. These data suggest that health care providers should work with communities to improve the health of their patients. Finding effective interventions for such community intervention is warranted

Sugar Water Gets a Facelift: What Marketing Does for Soda. New brief chronicles the soda industry’s successful efforts to recruit new customers despite increased scrutiny from the health community. In the face of rising scientific concerns about the impact of soda consumption on the nation’s health, a report released today by Berkeley Media Studies Group and Strategic Alliance for Healthy Food and Activity Environments finds that soda companies are creating new and effective ways to market their products in response to the country’s declining consumption of full-calorie soda. The report, Sugar Water Gets a Facelift: What Marketing Does for Soda explores the targeted marketing tactics used by soda companies to reach children, adolescents, and racial and ethnic communities. Despite public health efforts to limit soda’s harmful effects, including removal of soda from school vending machines, the $72 billion carbonated soft drink industry successfully continues its efforts to keep its current customers and attract new ones. The report provides numerous examples of how they accomplish this. Read the press release. Download the full report.

RESOURCES, TOOLS, EVIDENCE BASED PROGRAMS / PRACTICES

The application for stroke facility designation is available at the following link on the DSHS website - www.dshs.state.tx.us/emstraumasystems/strokedesignation.shtm.

The Directors of Health Promotion and Education (DHPE), with CDC support, developed Public Health Solutions Through Changes in Policies, Systems, and the Built Environment: Specialized Competencies for the Public Health Workforce. This guidance document is available at http://www.dhpe.org/HPEC_Comps_Phase_Final.pdf. A related 4-hour policy training is being held November 7 from 9:00 to 2:00 p.m. in Philadelphia through the APHA Learning Institute in conjunction with the APHA Annual Meeting. This training, Health Policy and Environmental Change—Shaping Policy for Health: Understanding the Process, is now open for registration. If you are registered for the APHA conference, you may easily register for this Learning Institute for an additional $225. If you are not registered for the APHA conference, you may also select "Learning Institute only" in the APHA registration process, or contact Annette Ferebee at or 202-777-2521 if you have questions.

Check out the Association of State and Territorial Health Officials' Smart Growth Toolkit at http://www.astho.org/Programs/Environmental-Health/Built-and-Synthetic-Environment/Smart-Growth-Tool-Kit/.

Active Living Research published a research brief in summer 2009 entitled Active Transportation: Making the Link from Transportation to Physical Activity and Obesity. This publication is available at http://www.activelivingresearch.org/files/ALR_Brief_ActiveTransportation.pdf.
The Rand Corporation offers a research brief, How Neighborhoods Can Reduce the Risk of Obesity, at http://www.rand.org/pubs/research_briefs/RB9267/index1.html.

Minnesota Town Gets Healthy Together. USA Today, 10/15/09. (NOTE: Albert Lea was recently selected as a 2010 PHC Community.) Hardware store owner and heart attack survivor Leo Aeikens spent most of his life hankering for meat, cheese and ice cream. But an ambitious effort aimed at making his entire southern Minnesota town healthier has Aeikens calling himself a vegan and weighing 25 pounds less than just 10 months ago. The 69-year-old's radical lifestyle change came as part of the "Vitality Project," an endeavor spearheaded by the retirement group AARP and the United Health Foundation that organizers say has added an average 3.1 years to the lives of Albert Lea residents through improved diet and exercise. http://www.usatoday.com/news/health/2009-10-14-minnesota-health_N.htm

Piano Staircase TheFunTheory.com, 10/07/09. "Take the stairs instead of the escalator or elevator and feel better" is something we often hear or read in the Sunday papers. Few people actually follow that advice. Can we get more people to take the stairs over the escalator by making it fun to do? See the results here. http://www.youtube.com/watch?v=2lXh2n0aPyw&feature=player_embedded

Check out the monthly newsletter issued by the National Complete Streets Coalition. It provides a roundup of news related to complete streets policies -- policies to ensure that the entire right of way is routinely designed and operated to enable safe access for all users. www.completestreets.org

World Health Day 2010 will focus on urbanization and health. With the campaign "1000 cities - 1000 lives", events will be organized worldwide calling on cities to open up streets for health activities. April 7 – 11, 2010. http://www.who.int/world-health-day/2010/en/index.html

COUNTY-BY-COUNTY COMPARISON ON THOSE WITH NO HEALTH INSURANCE.
It's no secret that a quarter of all Texans have no health insurance. But a new county-by-county comparison of census data, compiled by the state demographer and distributed by Rep. Garnet Coleman, D-Houston, highlights the state's worst offenders. http://rs6.net/tn.jsp?et=1102746020770&s=626&e=001HypaX4Q5qDR8S2u1c2SDMza3E_9nR-ATz_7lX0ny179Gh4EuXROPVFjOkCwCGvfHclFcjCG5XU9Kz9neW9LTTX_zNswHqDHYNyrQpU10nyTdXgUiHmJ3x_IkhSFuZmDvIu_y96wkPPWJPOEC9Lyb7Q==> )

(Maps are available here. <http://rs6.net/tn.jsp?et=1102746020770&s=626&e=001HypaX4Q5qDRSCdZo67XHCrQUyq4DvQv88vB2Pqr8jQ95B8pwNdcmmB1cgcjWNtwILiRiAIXkWhawxJWkBugs4Cd1Ol9xzOi1WAqypsjpoodVrzARBqA1dTRYTAg0ajemyNieO0hImR20qYND4ykELQ==> )

Are you using the latest tools to keep in-touch with current information and events? Check out this new blog created by Marci Wilson. Marci started a Blog and Twitter pages related to CVD/stroke education. She will be updating them frequently with quickreads.She plans to publish the blog in Spanish as well. www.StrokeEd.blogspot.com. www.twitter.com/strokeEd.

The Centers for Disease Control and Prevention (CDC) recently added more than 200 new policies to its Heart Disease and Stroke Prevention (HDSP) Policy Database Web site—your one-stop shop for state-level policies on heart disease and stroke. Go to www.cdc.gov/DHDSP/DHDSPLeg to see the updated site, which now features nearly 500 HDSP policies passed through December 2008. You can use this resource to:

o  Search for policies for all 50 states and the District of Columbia.

o  Create policy maps by topic area or CDC priority area.

o  Learn about the policy-making process.

o  Get information on policy assessments.

New IOM Report Affirms Local Governments’ Role in Creating Healthy Environments

On September 1st, The Institute of Medicine (IOM) released their newest report, Local Government Actions to Prevent Childhood Obesity. This report identifies specific actions that local governments can take to improve healthy eating and increase physical activity in communities.

Statement by American Heart Association President Clyde Yancy, M.D. on the Institute of Medicine Report “School Meals: Building Blocks for Healthy Children” WASHINGTON, October 20, 2009 - As childhood obesity rates in the United States steadily increase, it’s critical that the current standards for school meals better reflect children’s nutrition and health needs. With an estimated 20 percent of our nation’s youth expected to be obese by 2010, we are facing an epidemic that’s showing no signs of slowing down. That’s why we must insist that schools provide improved nutrition to help our kids reduce their chances of developing obesity-related illnesses such as high blood pressure and diabetes -- risk factors for heart disease and stroke. For more information, visit www.americanheart.org/obesitypolicy. To access the IOM Report http://www.iom.edu/Reports/2009/School-Meals-Building-Blocks-for-Healthy-Children.aspx

EDUCATION AND TRAINING

Nontraditional Risk Factors May Not Help Assess Coronary Heart Disease Risk CME/CE

News Author: Laurie Barclay, MD. CME Author: Charles Vega, MD, FAAFP

CME/CE Released: 10/19/2009; Valid for credit through 10/19/2010. This article is intended for primary care clinicians, cardiologists, and other specialists who care for patients at risk for coronary heart disease. http://cme.medscape.com/viewarticle/710814?src=cmemp&uac=122388MJ

Global Climate Change: Implications for Public Health. Free Webcast Thursday, November 5, 20092:00 - 4:00 pm ET. 2:00-2:45 Webcast. 2:45-4:00 Online discussion forum with the experts. The webcast is free, but we encourage you to register. Register NowGet more program information

Guidelines Issued for Cardiovascular Risk Management in Patients With Inflammatory Arthritis CME. News Author: Laurie Barclay, MD. CME Author: Charles P. Vega, MD.

CME Released: 10/07/2009; Valid for credit through 10/07/2010. This article is intended for primary care clinicians, rheumatologists, cardiologists, and other specialists who care for patients with rheumatic disease. http://cme.medscape.com/viewarticle/710100?src=cmemp&uac=122388MJ

2010 Texas Obesity Research Center Conference. November 18-19, 2010. Save the Date! The TORC's second research conference will be held in the Rockwell Pavilion, MD Anderson Library on the University of Houston Main Campus, with the theme, Advancing Obesity Research in a New Decade. http://hhp.uh.edu/obesity

http://cme.medscape.com/viewarticle/710100?src=cmemp&uac=122388MJ

Identifying and Removing Barriers to Treatment Adherence in Patients With Subclinical Atherosclerosis: A Multicultural Perspective CME. Keith C. Ferdinand, MD, FACC, FAHA ;Olakunle Akinboboye, MD, MPH, MBA; Carlos S. Ince, Jr., MD, ScM. CME Released: 09/30/2009. Valid for credit through 09/30/2010. This activity is intended for Cardiologists. It may also be of interest to other healthcare professionals involved in the management of cardiovascular disease in multicultural populations.