heart disease and cerebrovascular disease costs in 2003 for cardiovascular diseases are the...

Heart Disease and Cerebrovascular Disease University of Colorado Hospital COMMUNITY HEALTH NEEDS ASSESSMENT

2013

University of Colorado Hospital | Heart Disease and Cerebrovascular Disease 1

TABLE OF CONTENTS

TABLE OF CONTENTS ............................................................................................................................................... 1

HEART DISEASE AND CEREBROVASCULAR DISEASE ........................................................................................ 2

OVERVIEW ................................................................................................................................................................. 2

HYPERTENSION .......................................................................................................................................................... 3

Hypertension rates ............................................................................................................................................. 3

Hypertension Demographics ............................................................................................................................4

HIGH CHOLESTEROL .................................................................................................................................................. 6

Checked cholesterol in past fve years ............................................................................................................. 6

Demographics of Those Most Likely to Check Their Cholesterol Levels ..................................................... 7

High cholesterol rates....................................................................................................................................... 9

High Cholesterol Demographics .................................................................................................................... 10

HEART DISEASE DEATH RATES .................................................................................................................................. 12

CEREBROVASCULAR DISEASE DEATH RATES .............................................................................................................. 14

RISK FACTORS FOR HEART DISEASE AND CEREBROVASCULAR DISEASE BY RACE/ETHNICITY ................................... 16

INTERVENTIONS ....................................................................................................................................................... 17

RESOURCE INVENTORY ............................................................................................................................................ 21


HEART DISEASE AND CEREBROVASCULAR DISEASE

OVERVIEW

In 2006, heart disease was the leading cause of death in Colorado, accounting for

21% of all deaths.1 Heart disease was also the leading cause of death in the United States, representing about 25% of all deaths.234 Heart disease includes a variety of diseases that affect the heart, including coronary artery disease, angina, heart attacks, cardiomyopathy (heart muscle disease), ischemic heart disease, heart failure, valvular disease, and others. Major risk factors for heart disease are aging, smoking, diets high in fat and salt, hypertension, diabetes, sedentary lifestyle, obesity and stress.5 Treatment for heart disease depends on the underlying cause, but typically involves lifestyle changes, medication, surgery and/or other procedures.

Cerebrovascular disease is a group of brain injuries, including strokes and transient ischemic attacks (TIA) which are due to disease of the blood vessels that supply the brain. Embolisms and aneurysms are some of the more common causes of strokes and TIAs. Strokes are the third leading cause of death in Colorado and the United States, and the principal cause of serious, long term disability in this country. Most strokes occur in people over 65 years old and are higher in African-Americans than in whites. The leading risk factor for strokes is hypertension; other risk factors include smoking, diabetes, and obesity.6

Treatment of heart disease and strokes is expensive. Colorado’s estimated annual treatment costs in 2003 for cardiovascular diseases are the following:

Hypertension: $.34 billion

Heart disease: $.59 billion

Stroke: $.14 billion7 Estimated Colorado Medicaid treatment costs for cardiovascular diseases in 2007

are the following:

Heart disease: $41 million

Hypertension: $132 million

Stroke: $87 million8

Congestive heart failure: $17.8 million

1 Colorado Department of Health and Environment, aahttp://www.cdphe.state.co.us/pp/cvd/statistics.html

2 Division of Vital Statistics; Arialdi M. Miniño, M.P.H., Melonie P. Heron, Ph.D., Sherry L. Murphy, B.S.,

Kenneth D. Kochanek, M.A. (2007-08-21). "Deaths: Final data for 2004" (PDF). National Vital Statistics Reports (United States: Center for Disease Control) 55 (19): 7. 3 White House News. "American Heart Month, 2007". http://georgewbush-

whitehouse.archives.gov/news/releases/2007/02/20070201-2.html. Retrieved 2007-07-16. 4 National Vital Statistics Reports Volume 58, Number 19. National Center for Health Statistics. 2010-05-01.

http://www.cdc.gov/NCHS/data/nvsr/nvsr58/nvsr58_19.pdf. Retrieved 2010-07-22. 5 http://www.mayoclinic.com/health/heart-disease/DS01120/DSECTION=risk-factors

6 http://www.strokecenter.org/patients/about-stroke/stroke-statistics/

7 Milken Institute, An Unhealthy America: The Economic Impact of Chronic Disease, October 2007. 8 Centers for Disease Control and Prevention and RTI International Chronic Disease Cost Calculator

http://www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_19.pdf

http://en.wikipedia.org/wiki/PDF

http://georgewbush-whitehouse.archives.gov/news/releases/2007/02/20070201-2.html



http://www.cdc.gov/NCHS/data/nvsr/nvsr58/nvsr58_19.pdf

http://www.cdc.gov/NCHS/data/nvsr/nvsr58/nvsr58_19.pdf


HYPERTENSION

HYPERTENSION RATES

BRFSS Survey Question: Have you ever been told by a doctor, nurse, or other health

professional that you have high blood pressure? Adams, Arapahoe, and

Denver Counties have hypertension rates that are close to the state average. Douglas County has a hypertension rate that is lower than the state rate. All the counties have rates that are better than the HP 2020 target of 26.9%.

Figure 1 Hypertension Rates9

9 Chart Source: Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and

Environment, Average 2003/2004, 2005/2006, 2007/2008, 2009/2010.


HYPERTENSION DEMOGRAPHICS

Hypertension rates are generally higher

among males, and also increase with age.

Figure 2 Hypertension by Gender10

Figure 3 Hypertension by Age11

Hypertension rates are highest

among those of Black race, followed by those of White race and then Hispanics.

Figure 4 Hypertension by Race/Ethnicity12

10

Chart Source: Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment. 11 Ibid.

12 Ibid.


High hypertension rates were most significant among those making less than $25,000 a year. Those with high income levels generally had the lowest hypertension rates. Differences among education levels were not statistically significant.

Figure 5 Hypertension by Income13

Divorced/separated/widowed persons also have significantly higher rates, while those who have never married had the lowest rates.

Figure 6 Hypertension by Marital Status14

13

Chart Source: Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment. 14

Ibid.


HIGH CHOLESTEROL

CHECKED CHOLESTEROL IN PAST FVE YEARS

BRFSS Survey Question: Have you had your blood cholesterol checked in the past 5

years?

People in Douglas County check their cholesterol levels at a similar rate as the HP2020 goal of 82.1%. Arapahoe County is close to meeting that target.

People in Denver and Adams Counties check their cholesterol levels slightly less than the state average.

Figure 7 Cholesterol Checked in Past 5 Years15

15

Chart Source: Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment, Average 2003, 2005, 2007, 2009.

HP 2020 Goal 82.1%


DEMOGRAPHICS OF THOSE MOST LIKELY TO CHECK THEIR CHOLESTEROL LEVELS

Those who are most likely to check their

cholesterol levels are female, and the likelihood of checking cholesterol increases significantly with age.

Figure 8 Checked Cholesterol by Gender16

Figure 9 Checked Cholesterol by Age17

Coloradans of White and

Black race were significantly more likely than Hispanics to check their cholesterol levels.

Figure 10 Checked Cholesterol by Race/Ethnicity18

16


Ibid. 18

Ibid.


People are significantly more likely to check their cholesterol levels the higher their education and income levels.

Figure 11 Checked Cholesterol by Income19

Figure 12 Checked Cholesterol by Education20

People who have never

married were the least likely to check their cholesterol.

Figure 13 Checked Cholesterol by Marital Status21

19


Ibid. 21

Ibid.


HIGH CHOLESTEROL RATES

BRFSS Survey Question: Have you ever been told by a doctor, nurse, or other health

professional that your blood cholesterol is high? (Among those who have ever had it checked.)

When examining high cholesterol levels among those tested, Arapahoe and Adams

Counties have rates that exceed the state average. Denver and Douglas Counties have cholesterol rates that are lower than the state average.

Figure 14 High Cholesterol Among Those Tested22

22

Chart Source: Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment, Average 2003, 2005, 2007, 2009. HP 2020 Goals measured among total population and therefore are not comparable.


HIGH CHOLESTEROL DEMOGRAPHICS

Males are significantly more likely than

females to have high cholesterol levels. Cholesterol increases significantly with age, starting at 35 years old.

Figure 15 High Cholesterol by Gender23

Figure 16 High Cholesterol by Age24

Cholesterol levels are significantly more likely to be high for those with incomes less than $25,000, while the levels are significantly lower for those making $50,000 and above. Differences among education levels were not significant.

Figure 17 High Cholesterol by Income25

23


Ibid. 25

Ibid.


Cholesterol levels were significantly higher for those who are

divorced/separated/widowed, than people who are married or part of a couple, and even less for those who have never married.

Figure 18 High Cholesterol by Marital Status26

26

Chart Source: Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment.

42.4

34.4

27.3

0% 10% 20% 30% 40% 50%

Divorced/Separated/Widowed

Married/Couple

Never Married

2009

High Cholesterol by Marital Status Colorado


HEART DISEASE DEATH RATES

Heart disease generally includes heart attacks, heart failure, myocarditis and all

other forms of heart disease. Death rates due to heart disease are highest in Denver and Adams Counties, and below average in Arapahoe and Douglas Counties.

Figure 19 Heart Disease Death Rates27

27

Chart Source: Colorado Department of Health and Environment. Age adjusted rates per 100,000 population. 5 year average 2006-2010. National rates for 2009. HP2020 goal covers “coronary heart disease.”


The death rates due to heart disease are decreasing in Colorado for all race and ethnic groups. However, among those groups, people of Black race experience the highest mortality rates from heart disease. Asians have the lowest rates followed by American Indians.

Trends in Heart Disease by Race/Ethnicity, Colorado, 1990-2003

Figure 20 Trends in Heart Disease by Race/Ethnicity, Colorado, 1990-200328

28

Colorado Department of Health and Environment, http://www.cdphe.state.co.us/pp/cvd/HealthDisparities2005.pdf


CEREBROVASCULAR DISEASE DEATH RATES

Deaths due to cerebrovascular disease are usually caused by strokes. Most of the

counties have death rates that are less than the state average. The rate in Adams County is the highest in the market.

Figure 21 Cerebrovascular Disease Death Rates29

29

Chart Source: Colorado Department of Health and Environment. Age adjusted rates per 100,000 population. 5 year average 2006-2010. National rates for 2009.


People of Black race experience higher death rates due to stroke than other ethnic groups. Part of the reason is the higher hypertension rates among this demographic group, which if reduced, would greatly reduce their death rates due to stroke. American Indians have the lowest death rates while people of White race have the steadiest rate.

Trends in Stroke by Race/Ethnicity, Colorado, 1990-2003

Figure 22 Trends in Stroke by Race/Ethnicity, Colorado 1990-200330

30



RISK FACTORS FOR HEART DISEASE AND CEREBROVASCULAR DISEASE BY RACE/ETHNICITY

Many risk factors for heart disease and stroke are non-modifiable, such as aging,

family history, and gender. The risk factors that are modifiable are listed in the chart below. The chart also shows disparities by race and ethnicity.

Risk Factors for Heart Disease and Cerebrovascular Disease by

Race/Ethnicity31

One of the most significant risk factors is inadequate nutrition. People’s risk for

ischemic strokes would be reduced by 30% if they ate five servings of fruits and vegetables a day. Other risk factors are as follows:

“High blood pressure is a major risk for heart attack and the most important risk factor for stroke.

High blood cholesterol, high total cholesterol, high LDL cholesterol, high triglyceride levels, and low levels of HDL cholesterol increase risk of heart disease and stroke.

Tobacco smoking increases risk of cardiovascular disease. Breathing second-hand smoke is an additional risk.

Adults with diabetes are two to four times more likely to have a heart attack or suffer a stroke than adults who do not have diabetes.

Adults who are obese are twice as likely to have high blood pressure. Obesity is also associated with elevated triglycerides and decreased HDL cholesterol.

Physical inactivity increases the risk of heart disease and stroke by 50 percent.”32

31



INTERVENTIONS

Colorado Program to Reduce Risk of Cardiovascular Disease and Strokes

“The Cardiovascular Disease and Stroke Prevention Program, administered

through the Chronic Disease Section of the Colorado Department of Public Health and Environment, is designed to reduce premature morbidity and mortality from cardiovascular disease and stroke and to promote healthy lifestyles for all Coloradans.

The Cardiovascular Health Coalition developed a 10-year strategic plan that helps to guide the efforts of the program. Current efforts focus on prevention, detection and management of high blood pressure and high cholesterol. In addition, the coalition educates health care professionals on the management of these risk factors while informing the public about the signs and symptoms of heart attack and stroke. Future efforts by the Coalition and its task forces will direct special efforts toward:

Collaborating with healthcare agencies, businesses, community organizations to promote cardiovascular health

Promoting policy changes which enhance cardiovascular health

Reducing heart attack and stroke in women

Training healthcare providers on current guidelines for heart attack and stroke treatment

Morbidity, mortality, and cardiovascular disease risk factor data are reviewed on an ongoing basis.”33

National Programs That Reduce the Risk of Heart Disease, Stroke & Diabetes

“Interventions that reduce obesity, blood pressure, and cholesterol and increase

physical activity and healthy eating have been proven effective in reducing risks for cardiovascular disease as well as diabetes and stroke.

In Pawtucket, Rhode Island, the Pawtucket Heart Health Program conducted an intervention to educate 71,000 people about heart disease through a mass media campaign and community programs. Five years into the intervention, the risks for cardiovascular disease and coronary heart disease had decreased by 16 percent among members of the randomly selected intervention population.34

The Stanford Five-City Project used a mass media campaign and community programs to target a population of 122,800 people. At five years, risk for coronary heart

32

Colorado Department of Health and Environment, http://www.cdphe.state.co.us/pp/cvd/HealthDisparities2005.pdf 33

Colorado Department of Health and Environment, http://www.cdphe.state.co.us/pp/cvd/cvdhom.html 34

Carleton RA, Lasater TM, Assaf AR, Feldman HA, McKinlay S. 1995. The Pawtucket Heart Health Program: community changes in cardiovascular risk factors and projected disease risk. Am J Public Health 85(6):777-85.


disease had decreased by 16 percent, cardiovascular disease mortality risk had decreased by 15 percent, prevalence of smoking was down 13 percent, blood pressure was down 4 percent, resting pulse rates were down 3 percent, and cholesterol was down 2 percent among members of the randomly selected intervention population.35

Researchers at Ohio State University recruited 60 women in their forties for a 12-week walking program that took place on the college’s campus. At 3 months, the intervention group saw a 1 percent decrease in body mass index (BMI), a 3.4 percent decrease in hypertension, a 3 percent decrease in cholesterol, and a 5.5 percent decrease in glucose.36

Shape Up Somerville, a comprehensive effort to prevent obesity in high-risk first through third grade students in Somerville, Massachusetts, included improved nutrition in schools, a school health curriculum, an after-school curriculum, parent and community outreach, collaboration with community restaurants, school nurse education, and a safe routes to school program. After one year, on average the program reduced one pound of weight gain over 8 months for an 8 year old child. On a population level, this reduction in weight gain would translate into large numbers of children moving out of the overweight category and reducing their risk for chronic disease later in life.37

A physical activity intervention targeting low-income adults in Oslo, Norway, provided individual counseling, walking groups, increased accessible areas for safe recreation, and information through leaflets and mass media. After 3 years, compared to the control group, the intervention group had an 8-9 percent increase in physical activity, 14 percent fewer individuals gained weight, 3 percent more quit smoking, and significant decrease in blood pressure rates were reported.38

WISEWOMAN, a CDC-funded lifestyle intervention program, provides low-income uninsured women aged 40 to 64 with chronic disease risk factor screenings, lifestyle interventions, and referral services in an effort to prevent coronary heart disease and improve health. Over the course of a year, WISEWOMAN participants improved their 10-year risk of coronary heart disease by 8.7%, and there were significant reductions in the percent of participants who smoked (11.7%), had high blood pressure (15.8%), or had high cholesterol (13.1%).39

35

Farquhar JW, Fortmann SP, Flora JA, Taylor CB, Haskell WL, Williams PT, Maccoby N, Wood PD.

1990. Effects of communitywide education on cardiovascular disease risk factors. The Stanford Five-City Project. JAMA 264(3):359-65. 36

Haines DJ, Davis L, Rancour P, Robinson M, Neel-Wilson T, Wagner S. 2007. A pilot intervention to promote walking and wellness and to improve the health of college faculty and staff. J Am Coll Health 55(4):219-25. 37

Economos CD, Hyatt RR, Goldberg JP, Must A, Naumova EN, Collins JJ, Nelson ME. 2007. A Community Intervention Reduces BMI z-Score in Children: Shape Up Somerville First Year Results. Obesity 15(5):1325-1336. 38

Jenum AK, Anderssen SA, Birkeland KI, Holme I, Graff-Iversen S, Lorentzen C, Ommundsen Y, Raastad T, Odegaard AK, Bahr R. 2006. Promoting physical activity in a low-income multiethnic district: effects of a community intervention study to reduce risk factors for type 2 diabetes and cardiovascular disease: a community intervention reducing inactivity. Diabetes Care 29(7):1605-12. 39

Finkelstein EA, Khavjou O, Will JC. 2006. Cost-effectiveness of WISEWOMAN, a program aimed at reducing heart disease risk among low-income women. J Womens Health (Larchmt) 15(4):379-89.


Hartslag Limburg is an integrative, community-based cardiovascular disease prevention program that promotes a healthy lifestyle. The 5-year follow-up for a cohort of over 2,400 participants who were compared with a control group found that Hartslag Limburg succeeded in reducing – and in some cases, preventing – age- and time-related increase in BMI, waist circumference, blood pressure, and, in women, non-fasting glucose concentration.40

The Rockford Coronary Health Improvement Project (CHIP) was a community-based lifestyle intervention program aimed at reducing coronary risk, especially in a high risk group. The intervention included a 40-hour educational curriculum delivered over a 30-day period with clinical and nutritional assessments before and after the educational component, in which participants were instructed to optimize their diet, quit smoking, and exercise daily (walking 30 minutes per day). At the end of the 30-day intervention period, stratified analyses of total cholesterol, LDL, triglycerides, blood glucose, blood pressure and weight showed highly significant reductions with the greatest improvements among those at highest risk.41

A community-oriented, coronary heart disease prevention program conducted in six regions of former West Germany included activities that emphasized healthy nutrition and increased physical activity, in addition to the reduction of smoking, hypertension, and hypercholesterolemia. Over a seven year period, the intervention saw a net reduction in the mean values of systolic (-2.0%) and diastolic (-2.0%) blood pressure, total serum cholesterol (-1.8%), as well as the percentage of smokers (-6.7%), compared with the nationwide trend.42

A study that followed Diabetes Prevention Program participants randomized to an intensive lifestyle intervention found that weight loss was the dominant predictor of reduced diabetes incidence. Participants experienced a 16 percent reduction in their diabetes risk for every kilogram of weight that they lost after a 3.2 year mean follow-up period.43

EPODE, a multisectoral, 5-year plan to improve nutrition among 5 to 12 year old youths in 10 French towns, involved parents and families, medical providers, school nurses, teachers, towns, businesses, and media campaigns in the intervention. In the targeted towns, obesity rates have remained consistent while they have doubled in control areas, making youths who experienced the intervention less likely to develop

40

Schuit AJ, Wendel-Vos GC, Verschuren WM, Ronckers ET, Ament A, Van Assema P, Van Ree J, Ruland EC. 2006. Effect of 5-year community intervention Hartslag Limburg on cardiovascular risk factors. Am J Prev Med 30(3):237-42. 41

Englert HS, Diehl HA, Greenlaw RL, Willich SN, Aldana S. 2007. The effect of a community-based coronary risk reduction: the Rockford CHIP. Prev Med 44(6):513-9. 42

Hoffmeister H, Mensink GB, Stolzenberg H, Hoeltz J, Kreuter H, Laaser U, Nussel E, Hullemann KD, Troschke JV. 1996. Reduction of coronary heart disease risk factors in the German cardiovascular prevention study. Prev Med 25(2):135-45. 43

Hamman RF, Wing RR, Edelstein SL, Lachin JM, Bray GA, Delahanty L, Hoskin M, Kriska AM, Mayer-Davis EJ, Pi-Sunyer X and others. 2006. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care 29(9):2102-7.


obesity-related health conditions in the future. Mothers in the intervention towns have reported weight loss as well.”44 45

44

Ensemble Prevenons L’Obesite Des Enfants (EPODE). Together, we can Prevent Obesity in Children. 2004.Paris, France: French Ministry of Health,

http://ec.europa.eu/health/ph_determinants/life_style/nutrition/documents/ev_20041029_co07_e 45

The New York Academy of Medicine, http://www.cahpf.org/GoDocUserFiles/611.NYAM_Compendium.pdf


RESOURCE INVENTORY

County City Provider Contact Person

Email Website Address Phone

Number Programs

Adams Brighton

Platte Valley Medical Center Cardiology and Pulmonary Rehabilitation

Jade Alvarez

* http://www.pvmc.org/services/cardiac-pulmonary-rehab.asp

1600 Prairie Center Parkway Brighton, CO 80601

(303)498-1850

Cardiology services and cardiac rehab services including heart health

Adams

Saint Anthony's North Cardiology Services

* * http://www.stanthonynorth.org/heart

2551 W. 84th Ave. Westminster, CO 80031

(303)-426-2005

Centura Healthcare Cardiology Services for Adams County

Arapahoe Littleton

Littleton Adventist Hospital Cardiac Services

* * http://www.mylittletonhospital.org/cardiacservices

7700 S. Broadway Littleton, CO 80122

303-730-8900

Centura Healthcare Cardiology Services for Arapahoe County

Arapahoe Aurora

The Medical Cetner or Aurora Cardiac Rehabilitation

Sheryl Bussard

*

http://www.auroramed.com/conditions_we_treat/heart_care/cardiac_rehabilitation.htm

Aurora, CO 80012 Centennial Medical Plaza 14200 E Arapahoe Road Centennial, CO 80112

(303)-338-7446


Colorado/Statewide

Colorado

Colorado Foundation for Physical Fitness-Shape Up Colorado

Jeff Taylor [email protected]

http://www.coloradofitness.org/?page_id=3

* *

Community outreach program to encourage individuals to incorporate physical activity into everyday living to increase healthful lifestyles and habits

Colorado /Statewide

Colorado 9 Health Fair Becky Aragon

* http://www.9healthfair.org/default.aspx

1139 Delaware Street Denver, CO 80204

(303) 698-4455

Statewide Health Fairs that encourage the public to partake in weight loss programs and develop healthy eating habits

mailto:[email protected]






Number Programs

Colorado /Statewide

Colorado Elevate Your Health Colorado

* * http://www.elevateyourhealthco.com/node/534

*

Kaiser Permanente Program that offers the public advice via the web on weight loss and maintaining and developing a healthy lifestyle

Colorado/Statewide

Colorado

Cardiovascular and Stroke Prevention Program

* [email protected]

http://www.cdphe.state.co.us/pp/cvd/cvdhom.html

PSD-CD-A5 4300 Cherry Creek Drive South Denver, CO 80246-1530

(303) 692-2562

Prevention program based on community projects, awareness, education and referral

Colorado/Statewide

Colorado Colorado Prevention Center

Marilyn Greenwalt

[email protected]

http://www.cpcmed.org

13199 E. Montview Blvd. Suite 200 Aurora, CO 80045

(303) 860-9900

Interactive cardiovascular risk assessment kiosks, community programs, awareness, education

Colorado/Statewide Colorado

CDC National Heart Disease and Stroke Prevention Program Colorado Capacity Building *

[email protected]

http://www.cdc.gov/dhdsp/programs/nhdsp_program/co.htm

CDC/NCCDPHP/DHDSP 4770 Buford Hwy, NE Mail Stop F-72 Atlanta, GA 30341-3717

800-CDC-INFO

CDC National Initiative regarding heart health and and stroke prevention focusing on education and reduction in case numbers

Colorado/Statewide

Colorado

Colorado Connections for Healthy Kids

Carol Muller

[email protected]

http://take.actionforhealthykids.org/site/Clubs?club_id=1104&pg=main

* *

Statewide initiative in support of Coordinated School Health Programs. Through this coordination of programs, resources, messages and training school staff, students, families and community resources we will work together for healthy students, healthy living, and better learners














Number Programs

Colorado/Statewide

Colorado Action For Healthy Kids Colorado

Carol Muller

[email protected]

http://take.actionforhealthykids.org/site/Clubs?club_id=1104&pg=main

* (1-800) 416-5136

Build awareness and encourage positive role modeling among administrators, teachers, food service workers, develop and implement policies that are consistent with dietary guidelines, provide age appropriate education to children and offer opportunities for youth to explore nutrition and physical activity topics

Colorado/Statewide

Colorado Live Well Colorado

Maren C. Stewart

* www.livewellcolorado.org

1490 Lafyette Street #404 Denver, CO 80218

(720) 353-4120

LiveWell Colorado is a nonprofit organization committed to reducing obesity in Colorado by promoting healthy eating and active living. In addition to educating and inspiring people to make healthy choices.

Denver, Broomfield, Jefferson, Adams, Arapahoe,

*

Denver Chapter of American Heart Association

Rob Bluestein

[email protected]

http://www.heart.org/HEARTORG/Affiliate/Denver/Colorado/Home_UCM_SCA030_AffiliatePage.jsp

1280 South Parker Road Denver, CO 80231

(303)369-5433

Advocacy, research, education, fund raising

Douglas Parker

Parker Adventist Hospital Cardiology Services

* * http://www.parkerhospital.org/cardiology

9395 Crown Crest Blvd. Parker, CO 80138

303-269-4500.

Centura Healthcare Cardiology Services for Douglas County

Douglas Lone Tree

Sky Ridge Medical Center Heart Program

* *

http://www.skyridgemedcenter.com/home/search_results.htm?keyword=cardiac

10101 Ridgegate Parkway Lone Tree, CO 80124

(720) 225-1318


See Resource Inventory for Obesity, Nutrition and Physical Activity for other relevant resources.





http://www.livewellcolorado.org/

http://www.livewellcolorado.org/

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