Burden of Cardiovascular Disease in California August 25, 2020 Right Care Initiative Meeting Catrina Taylor, PhD, MSPH Epidemiologist/Evaluation Lead California Department of Public Health
Burden of Cardiovascular Disease in California • 12 million Californians are affected by cardiovascular disease (CVD). • The most common forms of CVD are: – Heart Disease (HD), – Heart Failure (HF), – Hypertension (HTN), and – Stroke. Data Source: AskCHIS 2018. Last Accessed on May 21, 2020. California Department of Public Health
Prevalence of the Common Forms of CVD by Race/Ethnicity African American American Indian/Alaska Native Asian Latino Native Hawaiian/Pacific Islander Two or More Races White 45% 41% 33% 30% 23% 20% 10% 8% 6% 4% 4% 4% 2% 3% Heart Disease (2018) Heart Failure (2017) Stroke (2012) Hypertension (2018) Data Source: AskCHIS 2012, 2017 and 2018 data. Last accessed on May 21, 2020. California Department of Public Health
Prevalence of Hypertension by Race/Ethnicity, 2015-2018 African American American Indian/Alaska Native Asian Latino Native Hawaiian/Pacific Islander Two or More Races White 45% 43% 43% 41% 41% 4… 38% 33% 34% 31% 33% 32% 31% 31% 30% 30% 29% 2015 2016 2017 2018 Data Source: AskCHIS 2015-2018 data. Last accessed on May 21, 2020. California Department of Public Health
CA Leading Causes of Death, 2018 Disease or Condition Number of Deaths 1. Heart Disease 37,088 25,070 2. Alzheimer's Disease and other Dementias 3. Stroke 16,331 13,042 4. Chronic Obstructive Pulmonary Disease 5. Hypertension 11,801 11,072 6. Trachea, Bronchus and Lung Cancers 10,747 7. Other or Unspecified Cardiovascular Diseases 7,546 8. Kidney Diseases 9. Heart Failure 7,589 7,207 10. Other Malignant Neoplasms California Community Burden of Disease and Cost Engine. Last accessed on 7/29/20. California Department of Public Health
Leading Causes of Death • In 2017, the age-adjusted coronary heart disease death rate for California decreased from 97.4 to 87.4 per 100,000 people, a reduction of 10.3%. • California met the HP 2020 HDS-2 objective to reduce heart disease deaths. • In 2017, the age-adjusted stroke death rate increased 4.6%, from 34.7 to 36.3 per 100,000 people. • California did not meet the HP 2020 HDS-3 objective to reduce stroke related deaths. County Health Statistics, 2019. California Department of Public Health
CVD Associated Risk Factors by Race/Ethnicity African American 69%72% 69% American Indian or Alaska Native Asian Latino 45% Native Hawaiian and Other Pacific Ispander Two or More Races Whites 17% 20% 17% 14% 13% 12% 12% 7% 5% 5% Obese/Overweight Smoking Physical Inactivity No Access to Fresh Fruits/Veggies in Neighborhood Data Source: AskCHIS 2018 data. Last accessed on May 21, 2020. California Department of Public Health
Cost of CVD • In 2018, it was reported that CVD costs California an estimated $51.9 Billion – These costs are specific to the four most common forms of CVD – Are related to direct (health care costs)and indirect (lost productivity and life years) costs Economic Burden of Chronic Disease in California, 2018 California Department of Public Health
CVD Health Equity Lens • Burden of Self-Reporting CVD is highest among American Indian/Alaska Natives, African Americans, Native Hawaiian/Pacific Islanders, and Whites. • Burden of CVD Associated Risk Factors is highest among African Americans, Native Hawaiian/Pacific Islanders, and Multiple Races. • Burden of Mortality from CVD is highest among African Americans and Latinos. California Department of Public Health
Equity Lens on CA COVID-19 Statistics including data for select chronic conditions COVID-19 Cases COVID-19 Deaths CA Population Hypertension 50% Heart Disease Diabetes Prediabetes Obese 40% 30% 20% 10% 0% Latino White Asian African American Multi-Race American Indian Native Hawaiian or Alaska Native and other Pacific Islander Data Source: AskCHIS 2018 data. Last accessed on May 21, 2020. Official California State Government Website Last accessed May 21, 2020 California Department of Public Health
A Closer Look Through the Equity Lens African American Latino Native Hawaiian/Other Pacific Islander 58% 46% 45% 40% 32% 20% 17% 17% 9% 8% 7% 6% 6% COVID-19 COVID-19 CA Heart Diabetes Prediabetes Obese HTN Cases Deaths Population Disease Data Source: AskCHIS 2018 data. Last accessed on May 21, 2020. Official California State Government Website Last accessed May 21, 2020 California Department of Public Health
Other Nontraditional Risk Factors Affecting CVD among African Americans and Latinos 67% African Americans 61% Latino 55% 43% 42% 41% 32% 24% 23% 22% HTN HD HF HTN HD HF HTN HD HF Cost, lack of insurance, or other Healthcare system/provider issues Experienced unfair treatment during insurance-related reasons for and barriers as reason for delayed your lifetime when getting medical delayed medical care medical care care Data Source: AskCHIS 2018 data. Last accessed on August 4, 2020. California Department of Public Health
Other Nontraditional Risk Factors Affecting CVD among African Americans and Latinos 58% African Americans 53% Latino 36% 18% 18% 14% 8% 8% 7% HTN HD HF HTN HD HF HTN HD HF Experienced difficulty finding a Was often unable to get a doctors Visited emergency room in the past primary care provider appointment within 2 days in past 12 12 months months Data Source: AskCHIS 2018 data. Last accessed on August 4, 2020. California Department of Public Health
CVD Health Equity Lens During COVID-19 • Why are racial/ethnic groups or economically disadvantaged people of any background more susceptible of becoming infected or developing severe disease and dying? • What are possible underlying causes of differential outcomes of COVID-19 in populations burdened by CVD? California Department of Public Health
Addressing CVD Disparities Through Programs Prevention Forward (PF) is the five-year Centers for Disease Control and Prevention grant the California Department of Public Health Chronic Disease Control Branch received to increase prevention and management of diabetes, prediabetes, hypertension, stroke, and high blood cholesterol. California Department of Public Health
PF Objectives to Address the Burden of CVD Objective 1 : Assess and increase use of health care reporting systems to identify, report standard clinical quality measures, and/or refer patients with chronic conditions to nationally recognized lifestyle change programs; Objective 2 : Identify policies and procedures within the organization to identify, manage, and prevent chronic conditions; and Objective 3 : Assess use of team-based models to manage, monitor, and refer patients with chronic conditions to nationally recognized lifestyle change programs. California Department of Public Health
Objective 1: Assess and increase use of health care reporting systems to identify, report standard clinical quality measures, and/or refer patients with chronic conditions to nationally recognized lifestyle change programs. • PF is linking partner clinics, hospitals, and pharmacies to electronic health systems technical assistance to ensure patients with chronic conditions are: – Diagnosed (identified) – Referred to lifestyle change programs within their community, and – Receive standard clinical quality care. • PF is promoting telehealth capacity to link patients to health care services to reduce delayed care. California Department of Public Health
Objective 2: Identify policies and procedures within the organization to identify, manage, and prevent chronic conditions. • PF is promoting the patient care process, which includes Comprehensive Medication Management/Medication Therapy Management to manage CVD. • PF is promoting and hosting health education and self-management of CVD webinars. • PF is promoting adoption and implementation of team-based care approaches with the inclusion of non-physician team members. California Department of Public Health
Objective 3: Assess use of team-based models to manage, monitor, and refer patients with chronic conditions to nationally recognized lifestyle change programs. • PF is promoting and sharing information about Collaborative Practice Agreements and adoption. • PF staff is working to increase equity capacity with Community Health Workers and providers to promote improved awareness and treatment of patients with CVD. • PF staff is hosting webinars on lifestyle modification/referral topic area regarding self- measured blood pressure monitoring training. California Department of Public Health
Prevention Forward Surveillance • PF, on a quarterly, annual and biennial basis, monitors treatment, management, referrals, and engagement of non-physician team members to reduce CVD burden and/or negative health outcomes from being diagnosed with CVD. • Next steps are to implement evidence-based interventions in PF partner clinics, hospitals, and pharmacies then monitor change in screening, treating, referring patients with CVD to lifestyle change programs, and medication management. PF will also monitor change in communication between team members and use of Collaborative Practice Agreements. California Department of Public Health
Recommend
More recommend
