scholarly journals Advancing Healthcare Reform: The American Heart Association’s 2020 Statement of Principles for Adequate, Accessible, and Affordable Health Care: A Presidential Advisory From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 141 (10) ◽  
Author(s):  
John J. Warner ◽  
Ivor J. Benjamin ◽  
Keith Churchwell ◽  
Grace Firestone ◽  
Timothy J. Gardner ◽  
...  

The mission of the American Heart Association is to be a relentless force for a world of longer, healthier lives. The American Heart Association has consistently prioritized the needs and perspective of the patient in taking positions on healthcare reform while recognizing the importance of biomedical research, providers, and healthcare delivery systems in advancing the care of patients and the prevention of disease. The American Heart Association’s vision for healthcare reform describes the foundational changes needed for the health system to serve the best interests of patients and to achieve health care and coverage that are adequate, accessible, and affordable for everyone living in the United States. The American Heart Association is committed to advancing the dialogue around healthcare reform and has prepared this updated statement of our principles, placed in the context of the advances in coverage and care that have occurred after the passage of the Affordable Care Act, the rapidly changing landscape of healthcare delivery systems, and our evolving recognition that efforts to prevent cardiovascular disease can have synergistic benefit in preventing other diseases and improving overall well-being. These updated principles focus on expanding access to affordable health care and coverage; enhancing the availability of evidence-based preventive services; eliminating disparities that limit the availability and equitable delivery of health care; strengthening the public health infrastructure to respond to social determinants of health; prioritizing and accelerating investments in biomedical research; and growing a diverse, culturally competent health and healthcare workforce prepared to meet the challenges of delivering high-value health care.

2003 ◽  
Vol 83 (11) ◽  
pp. 1014-1021 ◽  
Author(s):  
Pamela W Duncan

Abstract Pamela W Duncan, PT, PhD, FAPTA Dr Duncan has actively participated in and contributed to physical therapist practice, physical therapist professional education, professional preparation of other health care providers, national policy development related to rehabilitation after stroke and aging, and scientific investigation. She has served several government appointments and provides leadership within several organizations. She served as co-chair of the Consensus Panel on Establishing Guidelines for Stroke Rehabilitation for the Agency for Health Care Policy, Research, and Education. She was a panel member on the National Institutes of Health's Total Hip Replacement Consensus Conference and served on the Strategic Planning Group for Stroke Research for the National Institute of Neurological Disorders and Stroke. She recently was appointed to serve on the Steering Committee of the Department of Education's National Institute on Disability and Rehabilitation Research and is currently on the Executive Leadership Council of the American Stroke Foundation and the Advisory Committee of the Canadian Stroke Network. She has served on committees and panels for the American Heart Association and was president of APTA's Neurology section. Dr Duncan's research activities focus on geriatric rehabilitation, stroke rehabilitation, and health outcomes measurement. She developed the Functional Reach Test, used to assess balance in older adults. In the past 20 years, she has received $13 million in research awards as principal investigator or co-investigator from agencies such as the National Institutes of Health, National Institute on Aging, American Heart Association, Department of Veteran's Affairs, and National Center for Medical Rehabilitation Research and from multiple private funding sources. Dr Duncan has disseminated her research findings in more than 80 peer-reviewed articles in 20 different journals, and she has written a book and 12 book chapters. Dr Duncan's work has influenced the care and rehabilitation of patients in the United States and worldwide. Physical therapy education programs across the country incorporate her findings and professional vision into the preparation of the next generation of physical therapists. APTA has awarded Dr Duncan the Marian Williams Award for Research in Physical Therapy, the Catherine Worthingham Fellowship Award, and the Mary McMillan Scholarship Award. She has also received research awards from the APTA Neurology Section, Sports Physical Therapy Section, and Section on Geriatrics, as well as a service award from the Neurology Section. She is an elected fellow of the Stroke Council of the American Heart Association and has given 8 invited lectureships at universities across the United States.


Circulation ◽  
2020 ◽  
Vol 141 (9) ◽  
Author(s):  
Sonia Y. Angell ◽  
Michael V. McConnell ◽  
Cheryl A.M. Anderson ◽  
Kirsten Bibbins-Domingo ◽  
Douglas S. Boyle ◽  
...  

Each decade, the American Heart Association (AHA) develops an Impact Goal to guide its overall strategic direction and investments in its research, quality improvement, advocacy, and public health programs. Guided by the AHA’s new Mission Statement, to be a relentless force for a world of longer, healthier lives, the 2030 Impact Goal is anchored in an understanding that to achieve cardiovascular health for all, the AHA must include a broader vision of health and well-being and emphasize health equity. In the next decade, by 2030, the AHA will strive to equitably increase healthy life expectancy beyond current projections, with global and local collaborators, from 66 years of age to at least 68 years of age across the United States and from 64 years of age to at least 67 years of age worldwide. The AHA commits to developing additional targets for equity and well-being to accompany this overarching Impact Goal. To attain the 2030 Impact Goal, we recommend a thoughtful evaluation of interventions available to the public, patients, providers, healthcare delivery systems, communities, policy makers, and legislators. This presidential advisory summarizes the task force’s main considerations in determining the 2030 Impact Goal and the metrics to monitor progress. It describes the aspiration that these goals will be achieved by working with a diverse community of volunteers, patients, scientists, healthcare professionals, and partner organizations needed to ensure success.


Circulation ◽  
2021 ◽  
Author(s):  
Sheryl L. Chow ◽  
Comilla Sasson ◽  
Ivor J. Benjamin ◽  
Robert M. Califf ◽  
Wilson M. Compton ◽  
...  

The misuse of opioids continues to be epidemic, resulting in dependency and a recent upsurge in drug overdoses that have contributed to a significant decrease in life expectancy in the United States. Moreover, recent data suggest that commonly used opioids for the management of pain may produce undesirable pharmacological actions and interfere with critical medications commonly used in cardiovascular disease and stroke; however, the impact on outcomes remains controversial. The American Heart Association developed an advisory statement for health care professionals and researchers in the setting of cardiovascular and brain health to synthesize the current literature, to provide approaches for identifying patients with opioid use disorder, and to address pain management and overdose. A literature and internet search spanning from January 1, 2012, to February 15, 2021, and limited to epidemiology studies, reviews, consensus statements, and guidelines in human subjects was conducted. Suggestions and considerations listed in this document are based primarily on published evidence from this review whenever possible, as well as expert opinion. Several federal and institutional consensus documents and clinical resources are currently available to both patients and clinicians; however, none have specifically addressed cardiovascular disease and brain health. Although strategic tools and therapeutic approaches for recognition of opioid use disorder and safe opioid use are available for health care professionals who manage patients with cardiovascular disease and stroke, high-quality evidence does not currently exist. Therefore, there is an urgent need for more research to identify the most effective approaches to improve care for these patients.


1990 ◽  
Vol 12 (5) ◽  
pp. 136-141
Author(s):  
Robert A. Sinkin ◽  
Jonathan M. Davis

Approximately 3.5 million babies are born each year in approximately 5000 hospitals in the United States. Only 15% of these hospitals have neonatal intensive care facilities. Six percent of all newborns require life support in the delivery room or nursery, and this need for resuscitation rises to 80% in neonates weighing less than 1500 g at birth. Personnel who are skilled in neonatal resuscitation and capable of functioning as a team and an appropriately equipped delivery room must always be readily available. At least one person skilled in neonatal resuscitation should be in attendance at every delivery. Currently, a joint effort by the American Academy of Pediatrics and the American Heart Association has resulted in the development of a comprehensive course to train appropriate personnel in neonatal resuscitation throughout the United States. Neonatal resuscitation is also taught as part of a Pediatric Advanced Life Support course offered by the American Heart Association. In concert with the goals of the American Academy of Pediatrics and the American Heart Association, we strongly urge all personnel responsible for care of the newborn in the delivery room to become certified in neonatal resuscitation. The practical approach to neonatal resuscitation is the focus of this article.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Adnan Younus ◽  
Ehimen Aneni ◽  
Oluseye Ogunmoroti ◽  
Omar Jamal ◽  
Shozab Ali ◽  
...  

Introduction: With the development of new health metrics to define ideal cardiovascular health (CVH), several studies have examined the distribution of the American Heart Association (AHA) 2020 ideal CVH metrics both within and outside the United States (US). In this meta-analysis of proportions, we synthesized available data on ideal CVH metrics distribution in US cohorts and compared them with non-US populations. Methods: A MEDLINE database search was conducted using relevant free text terms such as “life’s simple 7”, “AHA 2020”, “American Heart Association 2020” and “ideal cardiovascular health” between January 2000 and October 2014. Studies were included in the meta-analysis if the proportions achieving ideal for 0, 1, 2, 3, 4, 5 or ≥6 ideal CVH metrics were known or could be estimated. A meta-analysis of proportions was conducted for US and non-US studies using a random effect model (REM). REM models were chosen because of the significant heterogeneity among studies. Results: Overall the pooled data consisted of 10 US cohorts with a total population of 94,761 participants and 6 non-US cohorts with a total of 130,242 participants. The table shows the pooled prevalence of ideal CVH factors in this population. Overall the pooled estimates of US cohorts showed 15% had 0-1 ideal CVH metrics (inter-study range: 7-22%), while 3% (inter-study range: 1-10%) had 6-7 ideal CVH metrics. This is comparable to 12% (inter-study range 1-17%) and 2% (inter-study range: 1-12%) for 0-1 and 6-7 ideal CVH metrics in the non-US studies. Conclusion: The proportion of persons achieving 6 or more ideal CVH metrics in both US and non-US cohorts is very low and the distribution of CVH metrics is similar in both US and non-US populations. Considering the strong association with worse outcomes, a coordinated global effort at improving CVH should be considered a priority.


Circulation ◽  
2020 ◽  
Vol 141 (7) ◽  
pp. 592-599 ◽  
Author(s):  
Anandita Agarwala ◽  
Erin D. Michos ◽  
Zainab Samad ◽  
Christie M. Ballantyne ◽  
Salim S. Virani

Cardiovascular disease (CVD) is the leading cause of death among women in the United States. As compared with men, women are less likely to be diagnosed appropriately, receive preventive care, or be treated aggressively for CVD. Sex differences between men and women have allowed for the identification of CVD risk factors and risk markers that are unique to women. The 2018 American Heart Association/American College of Cardiology Multi-Society cholesterol guideline and 2019 American College of Cardiology/American Heart Association guideline on the primary prevention of CVD introduced the concept of risk-enhancing factors that are specific to women and are associated with an increased risk of incident atherosclerotic CVD in women. These factors, if present, would favor more intensified lifestyle interventions and consideration of initiation or intensification of statin therapy for primary prevention to mitigate the increased risk. In this primer, we highlight sex-specific CVD risk factors in women, stress the importance of eliciting a thorough obstetrical and gynecological history during cardiovascular risk assessment, and provide a framework for how to initiate appropriate preventive measures when sex-specific risk factors are present.


Stroke ◽  
2020 ◽  
Vol 51 (4) ◽  
pp. 1339-1343 ◽  
Author(s):  
Krishna Nalleballe ◽  
Sen Sheng ◽  
Chenghui Li ◽  
Ruchira Mahashabde ◽  
Amarnath R. Annapureddy ◽  
...  

Background and Purpose— Industry payments to physicians raise concerns regarding conflicts of interest that could impact patient care. We explored nonresearch and nonownership payments from industry to vascular neurologists to identify trends in compensation. Methods— Using Centers for Medicare and Medicaid Services and American Board of Psychiatry and Neurology data, we explored financial relationships between industry and US vascular neurologists from 2013 to 2018. We analyzed payment characteristics, including payment categories, payment distribution among physicians, regional trends, and biomedical manufacturers. Furthermore, we analyzed the top 1% (by compensation) of vascular neurologists with detailed payment categories, their position, and their contribution to stroke guidelines. Results— The number of board certified vascular neurologist increased from 1169 in 2013 to 1746 in 2018. The total payments to vascular neurologist increased from $99 749 in 2013 to $1 032 302 in 2018. During the study period, 16% to 17% of vascular neurologists received industry payments. Total payments from industry and mean physician payments increased yearly over this period, with consulting fee (31.1%) and compensation for services other than consulting (30.7%) being the highest paid categories. The top 10 manufacturers made the majority of the payments, and the top 10 products changed from drug or biological products to devices. Physicians from south region of the United States received the highest total payment (38.72%), which steadily increased. Payments to top 1% vascular neurologists increased from 64% to 79% over the period as payments became less evenly distributed. Among the top 1%, 42% specialized in neuro intervention, 11% contributed to American Heart Association/American Stroke Association guidelines, and around 75% were key leaders in the field. Conclusions— A small proportion of US vascular neurologists consistently received the majority of industry payments, the value of which grew over the study period. Only 11% of the top 1% receiving industry payments have authored American Heart Association/American Stroke Association guidelines, but ≈75% seem to be key leaders in the field. Whether this influences clinical practice and behavior requires further investigation.


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