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Complete Health Indicator Report of Blood Cholesterol: Doctor-diagnosed High Cholesterol

Definition

The proportion of adults who have ever been told by a doctor, nurse, or other health professional that they have high blood cholesterol.

Numerator

The number of adults who have ever been told by a doctor, nurse, or other health professional that they have high blood cholesterol.

Denominator

The total number of survey respondents (BRFSS survey) excluding those with missing or refused values in the numerator.

Data Interpretation Issues

Doctor-diagnosed hypercholesterolemia is based on the answer to the question: "Have you ever been told by a doctor, nurse, or other health professional that you have high blood cholesterol?" This question is asked on the Behavioral Risk Factor Surveillance System (BRFSS) in odd-numbered years. Due to small numbers, data by Utah Small Area are based on combined years. Some of these estimates may be statistically unreliable and should be interpreted with caution. Beginning in 2011, BRFSS data include both landline and cell phone respondent data along with a new weighting methodology called iterative proportional fitting, or raking. This methodology utilizes additional demographic information (such as education, race, and marital status) in the weighting procedure. Both of these methodology changes were implemented to account for an increased number of U.S. households without landline phones and an under-representation of certain demographic groups that were not well-represented in the sample. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Why Is This Important?

High blood cholesterol is a major risk factor for heart disease and stroke. It is preventable. If identified early, it can be controlled with medication and lifestyle changes, such as eating a diet low in saturated fat and cholesterol, increasing physical activity, and reducing excess weight. Because high blood cholesterol does not produce obvious symptoms, experts recommend that all adults aged 20 years and older have their cholesterol levels checked at least once every five years to help them take action to prevent or lower their risk of cardiovascular disease.

Healthy People Objective HDS-7:

Reduce the proportion of adults with high total blood cholesterol levels
U.S. Target: 13.5 percent

How Are We Doing?

In 2021, the age-adjusted percentage of Utah adults who reported being told they had high cholesterol was 25.4% (approximately 1 in 4 adults). In 2019 doctor-diagnosed high cholesterol was different by gender (23.7% for females and 27.0% for males). High cholesterol prevalence increased with age. Among Utahns aged 65 and over, 49.1% were diagnosed with high cholesterol, compared to 7.3% of adults aged 18 to 34.

How Do We Compare With the U.S.?

In 2019, the age-adjusted U.S. estimate for high cholesterol was 29.2% of adults (compared to 24.4% for adults in Utah).

What Is Being Done?

HEAL aims to reduce the incidence of diabetes, heart disease, and stroke by targeting risk factors including reducing obesity, increasing physical activity and nutritious food consumption, and improving diabetes and hypertension control. The HEAL Program is working on the following things to address issues related to high blood cholesterol: *Increasing healthy nutrition and physical activity environments in K-12 schools *Increasing healthy nutrition and physical activity environments in early care and education (childcare/preschool) *Increasing healthy nutrition and physical activity environments and programs in worksites *Improving awareness of prediabetes, hypertension, and high blood cholesterol for Utahns *Improving the quality of medical care for people with diabetes, hypertension, and high blood cholesterol *Improving the linkages between health care providers and supporting community programs for Utahns with prediabetes, diabetes, hypertension, and high blood cholesterol *Improving access and availability to community health programs for Utahns with prediabetes, diabetes, hypertension, and high blood cholesterol *Improving care and management of students with chronic conditions in Utah schools

Evidence-based Practices

High cholesterol is one of the most commonly treated medical conditions. Aggressive treatment focuses on lowering LDL ("bad" cholesterol levels). Lowering LDL cholesterol reduces the risk of coronary heart disease and ischemic stroke. A low-cholesterol diet, increased exercise, and statin medications are the first line of treatment.

Available Services

The Utah Department of Health and Human Services Healthy Environments Active Living (HEAL) Program works with health care organizations and other partners to improve blood cholesterol measurement and to improve medication adherence for people with high blood cholesterol. See the HEAL website for more details: https://heal.health.utah.gov/heart%20health/.

Health Program Information

The Utah Department of Health and Human Services, Healthy Environments Active Living program plays a key role in improving the health of residents in the state of Utah. The program was formed in July 2013 (as EPICC), through a new funding opportunity from the Centers of Disease Control and Prevention (CDC) that allowed for the merging of three previously existing programs: the Heart Disease and Stroke Prevention Program, the Diabetes Prevention and Control Program, and the Physical Activity, Nutrition and Obesity Program, as well as the addition of a school health program. The Healthy Environments Active Living Program (HEAL) was recently restructured as part of this strategic planning process and the new program model focuses on working together with staff and partners to address the social determinants of health while advancing health equity and increasing policy, systems and environment changes. HEAL champions public health initiatives and addresses the challenges of making health awareness and access truly universal and equitable in eight key areas: nutrition, heart health, diabetes, physical activity, schools, child care, community health workers, and worksites. Visit HEAL?s website for more information.


Related Indicators

Relevant Population Characteristics

Prevalence of high cholesterol was highest among the 65 and over age category compared to younger age categories.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

High cholesterol must be diagnosed by a physician therefore screening for high cholesterol should be integrated into routine care.

Related Health Care System Factors Indicators:


Risk Factors

The risk factors for high cholesterol include lack of exercise, overweight and obesity, cigarette smoking, and high cholesterol diet. Some risk factors can be reduced through lifestyle changes. Others, such as family history and liver functioning, are more difficult to control. Certain medications can contribute to high cholesterol as well. Individuals are encouraged to discuss their risk factors with a physician and request blood cholesterol screening at least every five years.

Related Risk Factors Indicators:


Health Status Outcomes

High blood cholesterol is a major risk factor for heart disease and stroke. Early identification and treatment of high cholesterol can decrease this risk.

Related Health Status Outcomes Indicators:




Graphical Data Views

Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Year, Utah and U.S., 1991-2021

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confidence limits

In 2019, the prevalence of high blood cholesterol continued to be lower among Utah adults than among the general U.S. adult population. In 2019, 29.2% of U.S. adults who have had their cholesterol checked had doctor-diagnosed high cholesterol, compared to 24.4% of adults in Utah.
BRFSS Utah vs. U.S.YearAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 34
UT Old Methodology199116.4%14.6%18.4%
UT Old Methodology199319.3%17.3%21.5%
UT Old Methodology199516.5%14.9%18.4%
UT Old Methodology199719.8%18.0%21.8%
UT Old Methodology199920.7%18.9%22.6%
UT Old Methodology200122.1%20.5%23.8%
UT Old Methodology200321.5%19.9%23.1%
UT Old Methodology200524.9%23.6%26.2%
UT Old Methodology200725.6%24.4%27.0%
UT Old Methodology200925.9%24.9%26.8%
US Old Methodology199117.7%17.3%18.1%
US Old Methodology199320.2%19.8%20.5%
US Old Methodology199519.6%19.2%20.0%
US Old Methodology199720.0%19.6%20.3%
US Old Methodology199921.1%20.8%21.4%
US Old Methodology200122.6%22.3%22.9%
US Old Methodology200325.1%24.8%25.4%
US Old Methodology200526.5%26.6%26.8%
US Old Methodology200733.2%32.8%33.6%
US Old Methodology200928.9%28.6%29.1%
UT New Methodology200925.6%24.7%26.6%
UT New Methodology201126.4%25.5%27.3%
UT New Methodology201223.6%22.3%24.9%
UT New Methodology201325.9%25.1%26.8%
UT New Methodology201524.5%23.7%25.4%
UT New Methodology201723.7%22.7%24.6%
UT New Methodology201924.4%23.5%25.3%
UT New Methodology202125.4%24.4%26.3%
US New Methodology201128.7%28.5%29.0%
US New Methodology201328.9%28.6%29.1%
US New Methodology201527.2%27.0%27.4%
US New Methodology201727.3%27.0%27.5%
US New Methodology201929.2%28.9%29.5%
US New Methodology202127.4%27.1%27.7%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change, Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   [[br]][[br]]Age-adjusted to 2000 U.S. standard population. To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. In 2011, it began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method.

Data Sources

  • The Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS)
  • Behavioral Risk Factor Surveillance System Survey Data, US Department of Health and Human Services Centers for Disease Control and Prevention (CDC).


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Age and Sex, Utah, 2021

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confidence limits

Older adults have a higher rate of high blood cholesterol. Men also tend to have higher rates of high blood cholesterol. For reference, the overall crude rate of high cholesterol in 2017 was 24.3% of adults who have had their cholesterol checked.
Males vs. FemalesAge GroupPercentage of AdultsLower LimitUpper Limit
Record Count: 14
Male18-347.8%6.2%9.7%
Male35-4923.9%21.2%26.7%
Male50-6441.4%38.1%44.8%
Male65+49.6%46.2%53.0%
Female18-346.9%5.4%8.8%
Female35-4916.6%14.4%19.2%
Female50-6437.7%34.4%41.1%
Female65+48.6%45.5%51.7%
Total18-347.3%6.2%8.7%
Total35-4920.3%18.5%22.2%
Total50-6439.5%37.2%41.9%
Total65+49.1%46.8%51.4%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change, Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.

Data Source

The Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS)


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Education Level, Utah, 2021

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confidence limits

In 2021, there was no statistically significant difference in the rate of cholesterol by education level.
Education LevelAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 5
Less Than High School24.8%20.8%29.2%
H.S. Grad or G.E.D.23.9%21.9%25.9%
Some Post High School25.4%23.7%27.1%
College Graduate27.1%25.6%28.6%
Total25.4%24.4%26.3%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change, Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   [[br]][[br]]For adults aged 25 years old and above. Age-adjusted to 2000 U.S. standard population.

Data Source

The Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS)


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Income Level, Utah, 2021

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confidence limits

In, 2021, here was no statistically significant difference in the rates of high cholesterol by income.
Income CategoryAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 5
<$25,00025.4%22.2%28.9%
$25,000-$49,99926.1%23.8%28.7%
$50,000-$74,99925.8%23.3%28.4%
$75,000+25.3%23.9%26.8%
Total25.4%24.4%26.3%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change, Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   [[br]][[br]]Age-adjusted to 2000 U.S. standard population.

Data Source

The Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS)


Doctor-diagnosed hypercholesterolemia (High Blood Cholesterol) by Ethnicity, Utah, 2021

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confidence limits

In 2021, there were no statistically significant differences between ethnicity categories and the state rate.
Hispanic EthnicityAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 3
Hispanic/Latino25.5%22.3%28.9%
Non-Hispanic/Latino25.3%24.3%26.3%
All Ethnicities25.4%24.4%26.3%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change, Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   [[br]][[br]]Age-adjusted to the U.S. 2000 standard population.

Data Source

The Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS)


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Race, Utah, 2021

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confidence limits

In 2021, there was no statistically significant difference in the rate of cholesterol by Race.
Race/Ethnicity group dataAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 7
American Indian/Alaskan Native19.2%12.5%28.2%
Asian26.1%18.5%35.5%
Black/African American28.1%19.4%38.7%
Native Hawaiian/Pacific Islander28.3%16.7%43.6%
White25.1%24.1%26.1%
Other23.7%20.0%27.8%
All Races/Ethnicities25.1%24.1%26.0%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change, Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   [[br]][[br]]The federal government (United States Census Bureau) considers Hispanic to be an ethnicity rather than a race, a separate data table and chart compares high cholesterol among non-Hispanic and Hispanic Utahns. Age-adjusted to the 2000 U.S. standard population using 3 age groups for standardization.

Data Source

The Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS)


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Disability, Utah, 2021

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confidence limits

Rates of doctor-diagnosed high cholesterol are higher among those with cognitive or mobility-related disabilities.
Disability TypeAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 7
Cognitive disability32.2%29.1%35.4%
Mobility disability30.8%26.9%35.0%
Self-care disability27.6%20.8%35.5%
Independent living disability26.2%22.1%30.6%
Difficulty seeing or blind27.5%21.7%34.1%
Difficulty hearing or deaf28.6%24.0%33.8%
No disability23.9%24.4%26.3%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change, Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.

Data Source

The Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS)


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Local Health District, Utah, 2021

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confidence limits

In 2021, the Southeast Utah Local Health Department had the highest rate of high blood cholesterol among adults in the state of Utah (31.1%). TriCounty Local Health Department had the lowest rate of high blood cholesterol in the state (19.2%).
Local Health DistrictAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 15
Bear River25.9%22.5%29.6%
Central22.4%18.8%26.4%
Davis County27.3%24.4%30.5%
Salt Lake County25.2%23.6%26.8%
San Juan17.7%11.7%25.7%
Southeast31.1%25.5%37.3%
Southwest25.9%22.3%29.8%
Summit22.6%18.4%27.4%
Tooele22.1%18.2%26.4%
TriCounty19.2%16.2%22.6%
Utah County25.6%23.6%27.8%
Wasatch26.1%18.7%35.2%
Weber-Morgan25.5%22.3%29.1%
State of Utah25.4%24.4%26.3%
U.S.29.2%28.9%29.5%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change, Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   [[br]][[br]]Age-adjusted to the U.S. 2000 standard population.

Data Source

The Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS)


Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Utah Small Area, 2019 and 2021

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confidence limits

During 2019 and 2021 combined, rates of high cholesterol were higher than the state rate for North Logan, Clearfield Area/Hooper, Centerville, North Salt Lake, Bountiful, West Valley (West), Eagle Mountain/Cedar Valley, and Richfield/Monroe/Salina Small Areas. Rates were significantly lower than the state for Layton/South Weber, Salt Lake City (Glendale), West Jordan (Northeast), Delta/Fillmore, Central (other), and San Juan (Other) Small Areas. Two years of data were combined to increase the reliability of the estimates for small areas. Rates for Salt Lake city (Glendale) and San Juan (Other) should be interpreted with caution. These estimates have a coefficient of variation >30% and are therefore deemed unreliable by Utah Department of Health and Human Services standards.
Utah Small AreasAge-adjusted Percentage of AdultsLower LimitUpper LimitNote
Record Count: 100
Brigham City23.2%17.5%30.2%
Box Elder Co (Other) V227.2%17.7%39.3%
Tremonton31.5%23.1%41.4%
Logan V222.7%18.4%27.8%
North Logan33.2%25.8%41.4%
Cache (Other)/Rich (All) V222.4%17.3%28.6%
Hyrum33.0%21.9%46.5%
Smithfield28.2%19.1%39.4%
Ben Lomond27.2%22.7%32.3%
Weber County (East)22.8%17.7%28.9%
Morgan County34.5%23.3%47.7%
Ogden (Downtown)28.5%22.8%35.0%
South Ogden23.8%18.9%29.5%
Roy/Hooper19.8%15.3%25.4%
Riverdale27.5%20.5%35.9%
Clearfield Area/Hooper29.8%25.2%34.9%
Layton/South Weber19.7%16.3%23.8%
Kaysville/Fruit Heights25.0%19.6%31.3%
Syracuse27.7%21.5%34.9%
Centerville36.4%26.0%48.2%
Farmington24.0%17.3%32.4%
North Salt Lake37.3%28.1%47.6%
Woods Cross/West Bountiful26.2%17.2%37.7%
Bountiful35.2%29.0%41.8%
SLC (Rose Park)29.4%21.6%38.7%
SLC (Avenues)18.9%12.8%26.9%
SLC (Foothill/East Bench)23.0%16.5%31.0%
Magna25.1%19.1%32.4%
SLC (Glendale) V213.4%7.3%23.2%*Estimate may not be reliable.
West Valley (Center)28.7%22.3%36.1%
West Valley (West) V234.6%26.3%43.9%
West Valley (East) V223.2%17.8%29.6%
SLC (Downtown) V225.0%18.9%32.3%
SLC (Southeast Liberty)24.9%17.2%34.5%
South Salt Lake30.8%22.9%40.2%
SLC (Sugar House)25.6%20.1%32.0%
Millcreek (South)23.0%16.2%31.5%
Millcreek (East)23.3%17.0%31.1%
Holladay V229.1%22.0%37.5%
Cottonwood22.1%17.2%27.9%
Kearns V225.2%19.6%31.6%
Taylorsville (E)/Murray (W)26.8%21.7%32.6%
Taylorsville (West)24.4%18.9%30.8%
Murray22.6%16.7%29.7%
Midvale24.4%18.3%31.9%
West Jordan (Northeast) V218.4%13.7%24.2%
West Jordan (Southeast)26.0%20.4%32.6%
West Jordan (W)/Copperton25.9%20.1%32.7%
South Jordan V222.3%17.4%28.1%
Daybreak25.7%18.9%33.9%
Sandy (West)26.7%20.1%34.6%
Sandy (Center) V230.8%23.4%39.3%
Sandy (Northeast)32.7%23.9%43.0%
Sandy (Southeast)27.3%20.7%35.0%
Draper24.3%19.0%30.5%
Riverton/Bluffdale22.6%17.7%28.6%
Herriman24.9%19.4%31.3%
Tooele County (Other)23.6%18.2%29.9%
Tooele Valley23.7%20.3%27.6%
Eagle Mountain/Cedar Valley33.3%26.3%41.2%
Lehi26.0%21.4%31.3%
Saratoga Springs21.7%15.5%29.4%
American Fork21.8%17.6%26.8%
Alpine18.2%11.7%27.2%
Pleasant Grove/Lindon24.7%20.3%29.6%
Orem (North)29.9%24.0%36.5%
Orem (West)26.3%20.5%33.1%
Orem (East)23.7%18.0%30.6%
Provo/BYU20.6%15.8%26.3%
Provo (West City Center)22.3%16.5%29.4%
Provo (East City Center)27.1%19.4%36.6%
Salem City24.6%16.1%35.6%
Spanish Fork23.3%18.6%28.9%
Springville31.0%24.5%38.5%
Mapleton16.9%10.8%25.5%
Utah County (South) V219.7%12.2%30.4%
Payson23.8%18.3%30.4%
Park City24.6%19.1%31.3%
Summit County (East)23.0%18.0%28.8%
Wasatch County25.3%19.9%31.5%
Daggett and Uintah County21.8%18.5%25.4%
Duchesne County21.8%16.7%27.9%
Nephi/Mona26.9%18.1%38.0%
Delta/Fillmore15.5%10.8%21.8%
Sanpete Valley20.5%15.1%27.2%
Central (Other)20.4%16.7%24.8%
Richfield/Monroe/Salina31.7%26.1%38.0%
Carbon County30.1%24.3%36.7%
Emery County31.0%22.7%40.7%
Grand County23.8%16.3%33.3%
Blanding/Monticello21.7%14.8%30.7%
San Juan County (Other)13.2%8.0%21.1%*Estimate may not be reliable.
St. George26.4%22.5%30.9%
Washington Co (Other) V217.1%11.1%25.6%
Washington City24.3%17.9%32.0%
Hurricane/La Verkin24.9%19.3%31.5%
Ivins/Santa Clara26.7%17.8%38.2%
Cedar City23.4%18.0%29.9%
Southwest LHD (Other)22.2%16.6%29.0%
State of Utah24.9%24.3%25.6%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change, Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   [[br]][[br]] ^ ^*Use caution in interpreting; the estimate has a coefficient of variation > 30% and is therefore deemed unreliable by Utah Department of Health standards. Age-adjusted to U.S. 2000 standard population. A description of the Utah Small Areas may be found on the Methodology and Guidelines page: [https://ibis.health.utah.gov/resource/Guidelines.html].

Data Source

The Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS)

References and Community Resources

'''Impact of Heart Disease and Stroke in Utah'''[[br]] In 2012, the Utah Heart Disease and Stroke Prevention Program published a statistical report titled the Impact of Heart Disease and Stroke in Utah. This report describes overall patterns in cardiovascular disease and risk factors at the state and national levels and among Utah subpopulations (age group, sex, race, ethnicity, and Utah Small Area). '''Million Hearts Initiative'''[[br]] Heart disease and stroke are the first and fifth leading causes of death in the United States ([https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm CDC 2022]). Heart disease is responsible for 1 of every 3 deaths in the country. [https://millionhearts.hhs.gov/ Million Hearts] is a national initiative that has set an ambitious goal to prevent 1 million heart attacks and strokes within 5 years (by 2027). Million Hearts aims to prevent heart disease and stroke by: *Improving access to effective care *Improving the quality of care for the ABCS (appropriate aspirin prescription, blood pressure control, cholesterol control, and smoking cessation) *Focusing clinical attention on the prevention of heart attack and stroke *Activating the public to lead a heart-healthy lifestyle Improving the prescription and adherence to appropriate medications for the ABCS

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

Page Content Updated On 11/25/2022, Published on 11/30/2022
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 27 January 2023 8:33:18 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Wed, 30 Nov 2022 11:23:36 MST