Wednesday, January 15, 2025
1/15/2025
The Massachusetts Department of Public Health (MDPH) proposes to build on the extensive infrastructure, experience, and programming established through previous CDC chronic disease funding to focus on approaches that have the highest potential for maximal impact on cardiovascular health. The purpose of the proposal is to implement and evaluate evidence-based and evidence-informed strategies to prevent and manage cardiovascular disease (CVD), in particular high blood pressure and cholesterol, with a focus on Massachusetts (MA) communities with the highest burden of disease. MDPH proposes to serve the residents of MA and priority populations that have high prevalence of CVD or CVD risk factors and have faced significant inequities in accessing the social conditions that support good health. Cardiovascular disease is a significant public health problem in MA. In 2019, heart disease and stroke were the leading underlying cause of all deaths in MA, accounting for every 1 in 4 deaths. Black, non-Hispanic and Hispanic residents were nearly 3 times as likely to die from heart disease prematurely (before the age of 65) compared to White, non-Hispanic residents. A long history of economic, housing, and zoning policies rooted in discrimination has resulted in a highly segregated state with 70% of residents of color living in just 30 of the 351 municipalities. The residents of these municipalities have some of the highest CVD-related hospitalization and emergency department-visit rates in the state. MDPH will work with a newly created Massachusetts Heart Disease and Stroke Learning Community (LC) to implement the three strategies in this initiative. In the first three months, MDPH and the LC will identify the priority populations and communities using a data map created using Geographic Information System (GIS) mapping technology. Overlaying services on the map to uncover gaps in services, the LC will develop a plan for improving services for these priority populations. To improve cardiovascular health for priority populations in the state, MDPH and its partners will advance the community health worker workforce and support their integration into team-based care teams; and partner with community health centers and other health systems on detecting and managing CVD, hypertension, cholesterol, and health-related social needs using health information technology and team-based care. MDPH will also focus on increasing community-clinical linkages to support self-management and lifestyle change and to address the health-related social needs of patients. Anticipated outcomes from this initiative include improving the clinical care of patients at highest risk of CVD, increasing the multidisciplinary partnerships that address identified barriers to social services and support needs within populations at highest risk of CVD, and enhancing community services and community clinical linkages to identify and respond to social services and support needs of populations at highest risk of CVD. The long-term goals are to improve cardiovascular health and reduce CVD disparities in MA. MDPH has the capability to serve all residents and priority populations within MA. As a recipient of CDC chronic disease cooperative agreements 1305, 1422, 1815, and 1817, MDPH has built extensive programmatic and epidemiological expertise on improving and tracking public health chronic disease interventions and approaches. Our clinical and community partnerships with community health centers, lifestyle change organizations, American Heart Association, MA Association of Community Health Workers, and culturally competent providers enable us to effectively implement the proposed strategies. MDPH’s proposal builds on the state’s significant investment in the CHW workforce, and the recent advances made to the MA Medicaid Program (MassHealth) under a 1115 Medicaid Waiver that offers the potential for sustainable funding.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).