Heart Disease and EducationAnthony Noces, Mohammed Qasim, Nayab Rifat, Aries Socrates

Coronary heart disease and stroke are the leading causes of deaths and illnesses in US adults. More than 80 million American adults live with cardiovascular disease.

In California, heart disease is the leading cause of death, accounting for more than 73,000 deaths in (about one-third of the total) in 2004.

When linked to education, data reflects how those with less education attainment suffer from greater rates of heart disease.

•Heart Disease TodayAs related to education attainment

51%

36%

14%

National Data Coronary Heart Disease Mortality By Education Level 2006

<High School High School Grad Some College

Data: National Vital Statistics System—Mortality (Retrieved from DATA2010 at http://wonder.cdc.gov/data2010).

• Levels of education are correlated to incidences of the most expensive yet preventable disease; CHD. By providing educational services to individuals of lower education levels through governmental public policies the ever increasing cost of healthcare insurance caused can be dampened, allowing the public to enjoy affordable healthcare.

•Heart Disease TodayThe Problem

•National DataAge-adjusted Mortality Rates

2000 2001 2002 2003 2004 2005 20060

20

40

60

80

100

120

National Coronary Heart Disease Mortality by Education Level (2000-2006)

<High School High School Grad Some College

Mor

talit

y Ra

tes (

Age-

adju

sted

per

100

,000

pop

ulati

on)

Data: National Vital Statistics System—Mortality (Retrieved from DATA2010 at http://wonder.cdc.gov/data2010).

•State DataCalifornia vs. Nevada

Data: National Vital Statistics System—Mortality (Retrieved from DATA2010 at http://wonder.cdc.gov/data2010).

2000 2002 20030

20

40

60

80

100

120

140

160 149141

131

7792 98

58

7668

California Diabetes Prevalence Rates by Educa-tion Level (2000, 2002, 2003)

<High School

High School Grad

Some College

Year

Prev

alen

ce R

ates

(Age

-adj

uste

d pe

r 1,0

00

popu

latio

n)

2000 2002 20030

20406080

100120140160180200

175

11696102

6582

39

65 61

Nevada Diabetes Prevalence Rates by Educa-tion Level (2000, 2002, 2003)

<High School

High School Grad

Some College

Year

Prev

alen

ce R

ates

(Age

-adj

uste

d pe

r 1,0

00

popu

latio

n)

•County DataMerced vs.

Levels of educational attainment have been shown through the Framingham Offspring Cohort study to show that unhealthy lifestyles are risk factors of CHD which are correlated to the amount of education present.

•ContributorsFrom the Framingham Offspring Cohort Study

Data: …

•SolutionsIndividual

• Policy• African American Barbershops, Promotoras from the Hispanic

community and Community Health Workers in Haiti are model programs

• We need public health messages to be understood by a diverse community… enlist members of different cultures to shape the message in a culturally appropriate way for maximum impact. Fund these workers so that they can make it a day job checking up on their constituents to ensure our strategies are reaching the right people and these people are getting access to preventative and curative treatment.

• The above models have been shown to be effective in public health: see reference slide for references.

•SolutionsCommunity

• To test whether communitywide health education can reduce stroke and coronary heart disease, we compared two treatment cities (N =122 800) and two control cities (N =197 500) for changes in knowledge of risk factors, blood pressure, plasma cholesterol level, smoking rate, body weight, and resting pulse rate.

• Treatment cities received a 5-year, low-cost, comprehensive program using social learning theory.

• Risk factor changes resulted in important decreases in composite total mortality risk scores (15%) and coronary heart disease risk scores (16%). Thus, such low-cost programs can have an impact on risk factors in broad population groups.

•SolutionsOrganizational

• Regulate/manage the availability of foods in poor neighborhoods; education level primarily affects other social and economic factors, we can’t give everyone a PhD but we can account for some of those income related issues!

• Less fast food in low income neighborhoods• More regular grocery stores in low income neighborhoods• Regular farmer’s market in low income neighborhoods

• In middle and upper income bracket target with health benefits at work, like an office gym and allotted time off daily work to use the gym, etc.

• Also be forgiving about taking time off work for regular health checkups, be sure to hand out reminders to get checked up systematically on some sort of time table (every two months, or whatever).

•References

•Alton, H. (2008). Recruiting african-american barbershops for prostate cancer education . Journal of the National Medical Association, 100(9), 1012-1020.•Stephen P. Fortmann , and Ann N. Varady Effects of a Community-wide Health Education Program on Cardiovascular Disease Morbidity and Mortality The Stanfort Five-City Project Am. J. Epidemiol. 152: 316-323.•http://ijahsp.nova.edu/articles/Vol7Num3/Lujan.htm. Article on Promotoras•Pathologies of Power•http://www.youtube.com/watch?v=m4a6cpI0pjg&feature=related