Nearly half of U.S. adults live with high blood pressure and only 1 in 4 adults have it under control due to ineffective treatments, lack of awareness and education and limited access to and inconsistent use of medication. Among the states with the highest death rates from heart disease are Illinois and Ohio, with Ohio ranking 10th and Illinois ranking 21st in the United States.
In response to the cardiovascular health crisis, the National Association of County and City Health Officials partnered with the Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention to implement the CDC Best Practices for Heart Disease and Stroke (the Guide) for controlling high blood pressure. The partnership provided $140,000 in grant funding to support a cohort of six local health agencies to advance health equity by leveraging the strategies from the Guide and implementing the cardiovascular disease prevention activities.
Among the grantees selected were local health departments (LHDs) and community-based organization partners such as UI Health Mile Square Health Center (Chicago, IL), Franklin County Public Health & the American Heart Association (Columbus, OH), Ross County Health District (Chillicothe, OH), Unlimited Potential (Phoenix, AZ), Tacoma-Pierce County Health (Tacoma, WA), and Central District Health (Boise, ID), which implemented strategies to increase the number of adults with controlled hypertension.
Through the grant partnership, the cohort of LHDs and partner organizations worked on improving health inequities through a social determinants of health (SDOH) screening to provide insight on patient needs, strengthening the use of community health workers as well as establishing and sustaining multi-sector partnerships.
In Franklin County, Ohio one out of three residents are at risk of high blood pressure — contributing to a growing number of heart attacks and strokes in the community. Franklin County Public Health’s existing programs and services aim to improve the community’s health through disease prevention and the promotion of healthy lifestyle interventions. Franklin County Public Health also advocates for policy change and offers community education through partnerships with community-based organizations.
Using the Guide, Franklin County Public Health partnered with the American Heart Association - Central Ohio, Heart of Ohio Family Health, and Health Impact Ohio to provide services and support to people in cardiovascular disease self-management, including self-measured blood pressure monitoring with clinical support and lifestyle modification programs. The initiative helped to establish relationships with community members and develop meaningful health goals. In addition, the local health department and partner organizations improved the response time to admit patients to the hospital by educating families on identifying stroke symptoms. As a result, over 90% of patients participating in the Franklin County program achieved blood pressure control and reduced the long-term effects of strokes.
In the South side of Chicago, risk factors for cardiovascular disease are disproportionately high with 36% of adults in South Chicago reporting they have been told they have hypertension. UI Health Mile Square Health Center (Mile Square), a community-based, primary-care clinic, provides access to an academic health care system and a vast array of advanced and specialty services to reduce health disparities in the community. As an equitable provider of primary care to individuals regardless of their ability to pay, Mile Square’s providers prioritize measures to help patients prevent, detect, and treat cardiovascular disease.
To enhance their programs’ impact, Mile Square implemented the Guide including the implementation of telehealth technology to optimize cardiovascular care, while also leveraging the expertise of the public health workforce. To ensure patients had access to care, Mile Square utilized a SDOH screening — gathering data from all patients — that provided insight into how many patients required support with a specific social need such as transportation, help navigating insurance, language barriers, access to nutritious foods, and/or safe housing. By utilizing evidence-based practices, Mile Square was able to provide 109 home blood pressure cuffs and improve blood pressure control in patients and communities. As a result, 45 participants completed the program and were given educational materials on proper blood pressure measurement and nutrition, while also receiving support from Quality Navigators, local community and public health workers that helped meet the patients’ holistic needs to achieve blood pressure control.
