Fighting Heart Disease, State by State — How the AHA Can Help

Cover of guide: State Cardiovascular Health Programs: A Guide to Core Infrastructure, Activities and ResourcesFighting heart disease and stroke means expanding the reach of CVD programs at the state level — and helping officials identify ways to help fund it. The American Heart Association convened experts to develop a guide for state health departments and CVD prevention and control programs to improve cardiovascular health.

We asked Miriam Patanian, MPH, a member of our expert advisory group, how stakeholders can use the guide. Patanian is Lead Consultant for Cardiovascular Health and Health Systems at the National Association of Chronic Disease Directors.

You represent state and territorial health department chronic disease directors and their staff who are at the front lines of designing and implementing programs to address cardiovascular health.

How should your members use the report?

The guide outlines components that state health departments should consider as they assess their infrastructure for addressing heart disease and stroke and their associated risk factors.

The advisory group did not assume that a successful cardiovascular health program will have sufficient capacity in all areas we listed. Instead we hope the report will be valuable in assessing where partnerships will be required.

For example, chronic disease and health promotion directors and their staff can use the report to distinguish areas where their cardiovascular health program(s) have sufficient capacity from areas where relationships with other partners are needed to achieve desired outcomes. Partners could include other programs within the health department or external groups.

Chronic disease and health promotion directors could use the report to compare the knowledge, skills and abilities included in the position descriptions of their staff to the infrastructure needs for a cardiovascular health program, making adjustments as needed.

What are the report’s most important points?

Partnerships are absolutely critical. Public health ‘does’ partnerships very well—state health departments have demonstrated great success in convening partners. It is important to always seek partnerships in which both organizations can benefit.

For example, policy advancement is key for state health departments. We know that applying evidence-based policies can improve health, and partners outside the state health department can shape and promote a policy agenda. Working closely with those partners can help ensure the policy agenda aligns with the goals of the state health department.

What challenges could members face using the guide?

I see two major areas that will be particularly challenging for state and territorial health departments.

First, many health departments have limited experience securing funding outside of state or federal government sources. I encourage them to talk with their finance office staff to learn about any restrictions for receiving outside funding. It may be helpful to reach out to other chronic disease unit staff to find people or programs that have been successful in obtaining such funds.

Second, state health departments need to prioritize their focus areas. The advisory group stressed the importance of working in primary and secondary prevention, as well as maintaining a strong surveillance and monitoring infrastructure. Limited resources are the current reality, so states must focus on having the greatest population impact while capitalizing on partnerships that can focus on other areas.

What can the AHA and other partners do?

The AHA affiliates have a number of partnerships in the states. I encourage the AHA to understand each state and territorial health department’s focus areas and to work collaboratively to bring partners to the table, ensure implementation of identified actions and provide ongoing support.

Many of the organizations represented on the advisory group already support state and territorial health departments by providing technical assistance such as building sufficient infrastructure within health departments, implementing evidence-based strategies and exploring alternative funding mechanisms. Additional efforts can be made to support peer sharing, networking and making connections to needed partners and resources.