Heart disease and stroke are the 1st and 5th leading causes of death in the District of Columbia (District)¿ (Vital Records Division, 2021)¿. Combined, they accounted for almost 1,400 deaths in 2021. The two main reasons individuals develop heart disease and stroke are hypertension and high cholesterol, which are common, preventable and can lead to death. Behavioral Risk Factor Surveillance Survey data show that 155,675 (27.9%) adult District residents have hypertension and 143,131 (30.6%) have high cholesterol¿ (DC Health, 2021)¿. Disparities in these prevalence rates persist by race, place of residence, and socioeconomic factors. Data show that District residents who are Black/African American, with lower educational attainment, and have lower income levels experience higher rates of hypertension and high cholesterol¿ (DC Health, 2021)¿.
DC Health’s Chronic Disease Division (CDD) implements evidence-based, data informed promising practice strategies to address the most common chronic conditions and risk factors to advance health, wellness and equity across the District. Our team of chronic disease experts work closely with health systems, community-based organizations, government agencies and other key partners to ensure that data-driven, evidence-based and sustainable approaches are utilized to improve heart disease, stroke, and other chronic disease outcomes among all District residents.¿
Under the previous funding cycle, DC Health’s Million Hearts Program successfully increased the capacity of eight (8) federally qualified health systems (FQHCs) and hospitals and the District Primary Care Association to monitor key clinical indicators for hypertension and blood cholesterol control, formed and leveraged community, clinical and public health relationships to build and sustain the Million Hearts Learning Collaborative, connected residents to community-based resources and lifestyle change programs, and increased the implementation of clinical quality improvement interventions to improve the prevention and management of hypertension and high cholesterol in federally qualified health centers (FQHCs) and hospitals. Between 2019-2021, data shows that the program reached an average of 15,135 hypertension patients per year. The program focused efforts on improving data quality of larger health systems in 2022, which accounted for an additional 46,337 hypertension patients reached in 2022.
DC Health intends to leverage successes and lessons learned under the previous funding cycle to further the prevention and management of cardiovascular disease by preventing and controlling high cholesterol and hypertension and addressing social barriers that disproportionately impact District residents at highest risk or burden. To achieve statewide reach in the prevention and management of heart disease and stroke, the District aims to implement evidence based and evidence informed risk reduction strategies by engaging multisectoral partners through the Million Hearts Learning Collaborative, strengthening the clinical team-based care workforce, expanding the use of clinical and social needs bidirectional referral technology, enhancing clinical and social needs data surveillance, reducing programmatic, provider and individual barriers to evidence-based interventions, improving organizational and individual health literacy, and implementing educational campaigns. Strategies within this proposal prioritize high burden populations including residents that are 40 years and over, Black/African American and Hispanic, with lower educational attainment, annual income below $50,000, not working (unemployed, retired and unable to work) and living in Wards 4, 5, 7 and 8.