In 2010, the healthcare spending and lost productivity (direct and indirect costs) due to cardiovascular disease (CVD) exceeded $400 billion, making it the most costly disease in the Untied States. Although the past few decades have seen steady decreases in cardiovascular disease risk overall, there are important racial, geographic and socioeconomic health disparities that persist among certain subgroups of people. These health disparities are preventable differences in the indicators of health of different population groups. Given New York City’s large uninsured, under-insured, and underserved population—one of the largest among urban areas in the United States—innovative methods are necessary to tackle the growing burden of CVD.
The Heart-to-Heart Community Outreach Program was conceived of by Jonathan D. Moreno and Suchit H. Patel, two MD/PhD students at Weill Cornell Medical College. While leading the Weill Cornell Community Clinic, a student-run free clinic for the uninsured, they realized that the majority of patients seen at the clinic carried a primary diagnosis of CVD. The program was developed with the idea of mobilizing a primary care infrastructure and “bringing the clinic to the community” to actively find new cases of undiagnosed and undertreated CVD, and then transition those participants to more permanent health care solutions. By using innovative tools and strategies to reach those most in need, the program empowers participants to make beneficial lifestyle changes based on personal CVD risk.
Comprehensive screenings are held in spaces provided by community centers and faith-based organizations where participant familiarity and trust is already firmly established, thereby decreasing the barriers (real and perceived) to engaging with the traditional medical establishment. Each participant is assessed for the traditional anthropomorphic measures (height, weight, body-mass-index (BMI), blood pressure, and waist circumference), as well as biochemical measures (blood glucose, hemoglobin A1C and a complete lipid panel – HDL, LDL, total cholesterol, and triglycerides). After the screening is performed, participants meet with a physician who explains their results and provides individualized follow-up information.
Through socioeconomic and demographic history, this program also seeks to understand the factors that contribute to an increased disease burden in these at-risk populations. By engaging communities at the local level, the Heart-to-Heart campaign has the potential to further our current understanding of how behavior, lifestyle choices, and knowledge of CVD impact differences in risk and future health care decision-making.