Cardiovascular disease (CVD) is one of the leading causes of death in Michigan, which has accounted for more than a quarter of deaths in 2021 (28%). CVD disproportionately affects people of color, lower socioeconomic status, and adults aged 65 and older. These disparities can be attributed to the social determinants of health (SDOH) such as the built environment, food insecurity, and access to care. (Centers for Disease Control and Prevention [CDC], 2022).
The purpose of this application is to demonstrate how the Michigan Department of Health and Human Services’ (MDHHS) Heart Disease and Stroke Prevention Unit (HDSP) housed within the Cardiovascular Health Nutrition and Physical Activity Section (CVHNPA) will invest and engage in activities to improve cardiovascular health in the state. HDSP will address health disparities by targeting local communities with the most significant burden of cardiovascular disease and improve their access to care, reduce food insecurity, and overcome barriers caused by the built environment.
Under Strategy 1, HDSP will make further enhancements to develop its chronic disease registry, Chronic Disease Registry Linking Electronic Health Record Data (CHRONICLE), with statewide and clinical partners to build our capacity to understand emergent, chronic disease trends. In addition to developing a chronic disease registry, HDSP will work with clinical partners to implement quality improvement initiatives that ensure the use of electronic health records to identify and address social needs for their patients. Initial clinical partners include Corktown Health Center, Authority Health, Hurley Medical Center, McLaren, Ascension Genesys Hospital, and Federally Qualified Health Centers (FQHC).
Under Strategy 2, HDSP will build the knowledge, skills, and abilities of clinical partners from Strategy 1 to coordinate patient-centered multidisciplinary care teams that meet the needs of disparate communities they serve for improved cardiovascular health outcomes by improving medication adherence and overall access to quality care.
Under Strategy 3, HDSP will improve food security for people with hypertension and high cholesterol by exploring opportunities with Michigan Farmers Market Association to expand statewide produce prescription programs through policy changes. At the local level, HDSP will expand self-measured blood pressure monitoring (SMBP) programs such as the Healthy Heart Ambassador Program (HHAP) and YMCA’s Blood Pressure Self-Monitoring Program. With the help of our clinical partners, these programs will have a strong bi-directional referral system in place for housing, food, and transportation resources. HHAP will also be incorporated into MSU’s Maternal Infant Health home visiting program to address hypertensive disorders associated with pregnancy.
All strategies will contribute to improving blood pressure control in health care and community settings, reduce disparities in blood pressure and blood cholesterol control in health care and community settings, increase utilization and social services and support among populations at highest risk of CVD with a focus on hypertension and high cholesterol. By achieving these outcomes, Michigan hopes to see improved cardiovascular health and reduced disparities in cardiovascular health.