Cardiovascular Disease in TEXAS

Cardiovascular Disease in TEXAS

A STATE PLAN

WITH

DISEASE INDICATORS

AND

STRATEGIES FOR ACTION

APLAN PREPARED BY: BUREAU OF DISEASE, INJURY AND TOBACCO PREVENTION

TEXAS DEPARTMENT OF HEALTH

Cardiovascular Disease in TEXAS

A STATE PLAN

WITH

DISEASE INDICATORS

AND

STRATEGIES FOR ACTION

CVD In Texas

ACKNOWLEDGMENT

This report was a collaborative effort of programs within the Bureau of Disease, Injury, and Tobacco Prevention.

We would like to recognize the following staff for their dedication to compiling the data, organizing the sections, developing the graphs, reviewing the document and ensuring the publication of this surveillance report:

Philip P. Huang, MD, MPH, Chief, Bureau of Disease, Injury and Tobacco Prevention Celan J. Alo, MD, MPH, Epidemiologist, Bureau of Disease, Injury and Tobacco Prevention Jennifer Smith, Director, Chronic Disease Community and Worksite Wellness Program Ken Condon, Director, Behavioral Risk Factor Surveillance System Richard Kropp, Program Specialist, Bureau of Disease, Injury and Tobacco Prevention Sandy Guyn, Staff Service Officer, Bureau of Disease, Injury and Tobacco Prevention Texas Coalition on CVD and Stroke

CVD In Texas

Page 3

TABLE OF CONTENTS

PAGE

Introduction

5

Strategies to address CVD

6

Texas Coalition on CVD and Stroke

8

Cardiovascular Disease and Stroke in Texas12

Background

13

Risk Factors

1. Smoking

14

2. Cholesterol

14

3. HBP

15

4. Diet

15

5. Physical Activity

15

6. Obesity

16

Prevention Initiatives

Primary Prevention

17

Community

17

Corporate

18

Managed Care

18

School Based

19

Church Based

19

Cardiovascular Diseases Major Cardiovascular Disease Ischemic Heart Disease Sex and Race 10 year Mortality Trend Geographic Location Public Health Regions Stroke Sex and Race 10 year Mortality Trend Geographic Location Public Health Regions

PAGE

52

53 54 55 56

57 58 59 60

Medical and Behavior Risk Factors with Prevalence

Trends

Obesity (Overweight)

62

Current Smoking

63

High Blood Pressure

64

High Cholesterol

65

Sedentary Lifestyle

66

Secondary Prevention

20

Technical Notes

67

How Texas is Addressing CVD:

Texas Department of Health

A Limited Inventory

Resources

69

Public Sector

22

Voluntary Sector

23

Private Sector

25

Education/Research

27

Business

27

Community

28

Conclusion

29

Recommendations

30

Demographics

Whites

36

African Americans

37

Hispanics

38

Socio-economic Indicators

Per capita income

40

Food stamps participants

41

Medicaid Eligibles - Families/Children

42

Medicaid Eligibles - Aged/Disabled

43

Mortality

Leading Causes of Death

46

Mortality Due to Chronic Diseases

47

Chronic Diseases - Age at Death

48

Overall Mortality Rates

49

Trends in Leading Causes of Death

50

CVD In Texas

Page 4

INTRODUCTION

This report was prepared by the Texas Department of Health, Bureau of Disease, Injury and Tobacco Prevention to monitor outcomes for cardiovascular disease and stroke and associated medical and behavioral risk factors. It is a subset of a larger report on chronic disease conditions in Texas.

Chronic disease conditions are the major cause of illness, disability, and death in Texas as well as in the United States today. Despite broad public awareness of specific life-threatening diseases such as cancer and heart disease, most people are still not aware that, collectively, chronic disease conditions account for three out of every four deaths in Texas and the United States.

Chronic diseases are defined by the federal Centers for Disease Control and Prevention as those diseases that are prolonged, do not resolve spontaneously, and for which a complete cure is rarely achieved. The Texas Department of Health's Bureau of Disease and Injury Prevention monitors diseases that : a) fit this broad definition of chronic diseases; b) that are preventable; and c) pose a significant burden in mortality, morbidity, and cost. For this report, we chose to include the following chronic diseases: ischemic heart disease, stroke, lung cancer, breast cancer, cervical cancer, colo-rectal cancer and diabetes mellitus.

Demographics According to the U.S. Census estimates for

1996, Texas has the third largest African American population and the second largest Hispanic population among all states. Compared to the state's white population, a large proportion of the Texas African American and Hispanic populations have social, economic, or other factors that place them at increased risk for developing illness and experiencing premature death.

Leading Causes of Death Because of the changing nature of illness and

death, Americans are no longer dying from the same diseases as they did in previous generations. Given the limits of medical and public health knowledge of this century, Americans frequently died at young ages from infectious and parasitic diseases. In 1900, pneumonia and influenza, tuberculosis and gastritis, enteritis and colitis were the three leading causes of death, accounting for nearly one-third of all deaths. As sanitation, nutrition, and living conditions improved and medical technology advanced, deaths from infectious diseases declined steadily and children and young adults survived longer. While deaths from infectious diseases have decreased, deaths from chronic conditions have increased. Today, heart disease, cancer, and stroke are the three leading causes of death, accounting for almost two-thirds of all deaths.

Preventable Causes of Death The figure in the opposite page shows that to-

bacco use is the most preventable cause of premature death in Texas, accounting for more than 26,000 lost lives in 1995 ----- more than alcohol, auto accidents, AIDS, drugs, suicides, homicides and fires combined. Tobacco use contributes substantially to deaths from cancer (especially cancers of the lung, esophagus, oral cavity, pancreas, kidney and bladder), cardiovascular disease (ischemic heart disease, stroke and high blood pressure) and lung disease (chronic obstructive pulmonary disease).

The content of this report provides information on cardiovascular diseases and stroke, its risk factors and trends over time. Data from this report contribute to the planning and implementation of strategies that will improve the health of all Texans.

CVD In Texas

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