The state of Colorado is submitting this response to CDC’s funding opportunity, CFDA-CDC-1815, to advance the prevention and management of cardiovascular disease and diabetes. These two conditions are among the leading causes of death and hospitalizations in Colorado. Heart disease and stroke kill one in four Coloradans and diabetes is the state’s eighth leading cause of death. Overall, 25.7 percent of adults have been diagnosed with high blood pressure and 6.6 percent of adults have been diagnosed with diabetes. The prevalence is significantly higher among seniors, Blacks, Hispanics, low-income adults and Medicaid beneficiaries. There is a clear need in Colorado for a continued focus in areas of the state with populations affected disproportionately by these diseases due to socioeconomic and other characteristics. Colorado will focus on these populations in this opportunity.
The Preventing and Managing Diabetes, Heart Disease and Stroke in Colorado Program combines strategic community-based and health system interventions to ensure a broadly reaching, sustained impact on diabetes and key modifiable risk factors for heart disease and stroke. To accomplish this, the Colorado Department of Public Health and Environment (Colorado) will work with health systems and community-based organizations to start prevention and disease self-management programs where access is low and burden is high. In areas where programs already exist, Colorado will support health systems to improve their identification of individuals with prediabetes, diabetes, high blood pressure and high blood cholesterol and connect them to care. Additionally, Colorado will assure the sustainability of these programs by working with health payers to secure coverage for these services.
Colorado is well-positioned to advance this work over the next five years. Its cardiovascular and diabetes programs will build upon the strong statewide infrastructure developed through its work under CDC DP13-1305 funding over the last five years. This infrastructure includes a committed group of staff with expertise in program development and sustainability. It includes a dedicated clinic quality improvement staff who have forged strong relationships with health systems and developed the capacity to help clinics use their own data to improve their management of diabetes and hypertension. Colorado’s established infrastructure also includes partnerships with innovative programs that are training community pharmacists to deliver disease management services and an emerging statewide pipeline to train and place qualified health navigators in clinics to support clients with chronic disease.
Colorado’s efforts to increase access to and utilization of prevention and management programs in health systems and community-based organizations is aimed at addressing existing health inequities and achieving state-level impact for all the proposed strategies and activities. Over the next five years, Colorado will decrease the proportion of Coloradans with uncontrolled diabetes. It will increase the number of people with prediabetes who have met the goals of a diabetes prevention program. It will increase the proportion of adults with known high blood pressure who have achieved blood pressure control, and it will increase the proportion of patients who have brought their total cholesterol below their targeted goal.