The Texas Department of State Health Services (DSHS) is applying for CDC-RFA-DP-23-0005: The Innovative Cardiovascular Health Program.
Cardiovascular disease (CVD) is the leading cause of death in Texas. Heart disease claimed the largest number of Texan lives in 2021 at a rate of 180.7 deaths per 100,000 individuals and was followed by stroke as the fifth leading cause of death in Texas at 43.8 deaths per 100,000. Based on 2021 mortality data, on average, someone in Texas dies of CVD every 8 minutes. High blood pressure (HBP) and high blood cholesterol (HBC) levels are major risk factors for CVD. An estimated 31.4 percent and 33.2 percent of adult Texans reported having HBP and HBC levels in 2021, after adjusting for age, respectively. High CVD mortality and morbidity estimates can be found within disadvantaged communities. This is likely due to several socioeconomic and physical factors.
Using Geographic Information Systems, DSHS identified 12 census tracts with crude HBP prevalence estimates of 53 percent or higher among adults, ages 18 years or older; one in Dallas County, four in Harris County, and seven in Jefferson County. All 12 census tracts have a majority non-Hispanic Black population (55.4 percent – 95.6 percent). The majority of these 12 census tracts also have high vulnerability (social vulnerability index score > 0.50) in terms of socioeconomic status (91.6 percent of the identified tracts) and housing type/transportation (50.0 percent of the identified tracts). Thus, it is vital to focus intervention efforts on addressing factors that influence and help prevent and manage CVD risk factors as a means of improving CVD-related outcomes and minimize or eliminate health disparities in our communities.
DSHS will focus its efforts in these 12 census tracts to identify and address risk factors, lack of supporting social services, and health care disparities in CVD and improve related outcomes. The DSHS Heart Disease and Stroke Program’s (HDSP) expertise with previous CDC cooperative agreements will be used in preventing, detecting, controlling, and managing HBP and HBC for the populations of focus. DSHS staff have extensive experience planning, implementing, and evaluating evidence-based, data-driven strategies across the public health spectrum. DSHS uses a collaborative approach that minimizes duplication of effort.
As part of a cross-sector approach, the HDSP will strategically partner with local health departments that serve the populations of focus, two University of Texas system academic partners, and the American Heart Association (AHA). Grant activities will concentrate on reducing health and health care disparities in CVD for those disproportionately impacted by socioeconomic conditions and opportunity structures. HDSP will work with AHA to create regional Learning Collaboratives (LC). The LCs will support grant activities and concentrate on reducing health disparities for the populations of focus.
The HDSP will achieve the following outcomes across the five-year grant term:
•increase the use of electronic health records/health information technology, geo-mapping tools, and evidence-based guidelines to optimize cardiovascular care and reduce healthcare disparities for the populations of focus;
•expand the use of community health workers and multidisciplinary care teams in cardiovascular care and in addressing patients’ health-related social needs (HRSN);
•increase referrals to and the use of supports for patients in CVD self-management;
•expand access to, referral to, and use of social services and supports that address the HRSNs of populations of focus;
•increase multidisciplinary partnerships at local levels that address identified barriers to social services and support needs for populations of focus; and
•improve blood pressure (BP) control and reduce disparities in BP control among populations within partner health care and community settings.
