The Mystery of the Stroke Belt Buckle

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The Mystery of the Stroke Belt Buckle

• Described by Dr. George Howard, then of WFUBMC,
  now at UAB
• Easternmost counties of NC, SC and GA have some
  of the highest stroke death rates in the nation
• This has existed for about 50 years and the
  causes remain either uninvestigated or
  unexplained

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The Birth of a Network

• The NC Heart Disease and Stroke Prevention Task
  Force sponsored a Tri-State Stroke Summit in 1999
  with Health Directors from GA, NC and SC
• Proceedings published in 2000
• Included A Call to Action
• Proposal to CDC for Tri-State Stroke
  Network - funded October 2000

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• 100,000 supplemental funding was added to the NC
  Heart Disease and Stroke Prevention Program
• A steering committee nominated members from each
  State and they were approved by the appropriate
  leadership

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• Comprised of 27 appointed members- 9 each from
  GA, NC and SC
• Includes public health and medical professionals,
  policy makers and advocates
• Additionally supported by liaisons, consultants
  and resource persons. 3 State Health Directors
  are Ex-Officio members.

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• Leadership includes
• Chair
• Vice-Chair, Chairman-Elect
• Past Chair
• Executive Director
• Executive Committee
• Nominating Committee

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• 5 established subcommittees
• Awareness and Advocacy
• Epidemiology and Data
• Prevention and Control
• Nominating Committee
• Racial Disparites (new)
• Meet via quarterly conference calls and in person
  one time a year in conjunction with other
  national or regional meetings

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• Awareness and Advocacy
• Facilitates coordination of and communication
  among, state and local agencies, organizations
  and partners to publicize the stroke burden and
  its preventability, proposes new laws and
  regulations, and creates awareness of needs
  related to stroke prevention and care.

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• Epidemiology and Data
• Assesses current knowledge of stroke burden and
  potential reasons for excess stroke deaths in the
  Tri-State area identifies critical questions for
  population-based studies designed to explain
  excess stroke deaths, and advocates for funding
  and completion of such studies.

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• Prevention and Control
• Identifies and examines priority strategies
  including laws, regulations, programs, services
  and interventions aimed at enhancing stroke
  prevention,managing the early signs and symptoms
  of stroke and assuring appropriate care.

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• Network members will advocate for
• Increased funding for stroke research, prevention
  and control
• The development and implementation of stroke
  prevention and control programs in the Stroke
  Buckle states and
• Will continue to support the development of
  research initiatives that focus on the reasons
  for the geographic disparity in stroke deaths
  that affects the Stroke Buckle states

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Accomplishments to Date

• Georgia and North Carolina received CDC funding
  to develop and test a prototype for the Paul
  Coverdell Stroke Registry and subsequently funded
  for a State Registry
• Network representatives participated in the
  development of the national action plan to
  prevent heart disease and stroke.

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Accomplishments (contd.)

• Compiled a matrix of stroke clinical guidelines
  and programs in the Tri-State area
• Executed 2 Data Summits in 1999, 2002 and in 2003
  Poster Sessions and Roundtables
• Launched www.tristatestrokenetwork.org in August
  2003.
• The CDC has also funded DSSC and the GLRSN

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Accomplishments (contd.)

• Completed an assessment of Basic and Enhanced
  9-1-1 services in the Tri-State area
• Provided technical assistance to US-DHHS and CDC
  for SBEI RFA and TA to applicants
• Supplemental funding received from CDC July 2004
  at 180,000/year for next 3 years to continue the
  Network

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Lessons Learned

• A shared problem, limited resources and an
  agreement to collaborate, provide stronger
  opportunities to address a critical health
  problem.
• Continuing to add partners to assist in achieving
  shared goals helps contend with issues of
  sustainability.
• No one program or source can provide all the
  resources needed to adequately address the third
  leading cause of death.

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Next on the Horizon

• Stronger focus on hypertension control and
  patient self management and disparity issues
• Connecting with Cardiovascular Health
  Collaboratives
• Strengthening of legislative stroke task force in
  GA
• Working with the SC Heart Disease and Stroke
  Alliance

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Next on the Horizon

• Continue monitoring the Kennedy-Frist STOP Stroke
  Act
• Continue support of ASH CME rural Experts in HTN
  Series
• GIS Mapping Project with UNC
• Assist CDC with pilot communications plan for
  stroke

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Next on the Horizon

• Implement Evaluation component
• April 2005 Data Summit in NC
• 5th Face to Face meeting in NC
• Development of cost of stroke document
• Enhancements to website

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