Why Sodium? Why Kansas?

Transcription

1 Why Sodium? Why Kansas? Jason Eberhart-Phillips, MD, MPH Director of Health State Health Officer Paula F. Clayton, MS, RD Director, Bureau of Health Promotion

2 High Blood Pressure Trend in Kansas Percentage of adults 18 years and older diagnosed with high blood pressure in Kansas and the United States, % Prevalence of High Blood Pressure (%) 30% 25% 20% 15% 10% 5% 25.6% 24.8% 25.5% 23.9% 25.3% 23.3% 24.2% 27.8% 26.8% Kansas United States (Median) 28.7% 30.3% 28.7% 0% Year Source: Kansas Behavioral Risk Factor Surveillance System, Bureau of Health Promotion, Kansas Department of Health and Environment. Questions regarding high blood pressure were asked on one branch of the BRFSS survey to approximately half of all respondents with high blood pressure for 2004 and Questions related to high blood pressure were not included in the survey for 2002 and Estimates for the United States, available in odd years only, are medians for all 50 states and the District of Columbia.

3 High Blood Pressure Disparities Age-adjusted percentage of adults 18 years and older diagnosed with high blood pressure by race and ethnicity, Kansas % Age-Adjusted Prevalence (%) 40% 30% 20% 10% 0% White, Non-Hispanic African American, Non- Hispanic Other/Multi-Race, Non- Hispanic Hispanic Prevalence: 27.1% 42.7% 28.8% 27.0% Race, Ethnicity Source: 2009 Kansas Behavioral Risk Factor Surveillance System, Bureau of Health Promotion, Kansas Department of Health and Environment. The Other/Multi race group includes Asians, Native Hawaiian or other Pacific Islanders, American Indians, Alaska Natives, other race groups and multiple race. Prevalence estimates were age-adjusted to the U.S standard population. See Technical Appendix for details on how prevalence estimates were calculated. Error bars indicate 95% confidence intervals.

4 Factors That Affect Health Our Vision Healthy Kansans living in safe and sustainable environments

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6 Excerpts from the Op-Ed The shocking fact about dietary sodium is that about 80 percent of it is completely hidden. It has been added to the processed foods you eat and the meals you enjoy when eating out in restaurants. It s this concealed sodium that lies at the heart of the crisis in high blood pressure. The epidemic of high blood pressure will begin to pass in coming years, as government and industry work together to solve the problem of excess salt in our food supply. But if you want to beat the odds on developing high blood pressure now, aim for a healthy weight, increase your physical activity, avoid excess alcohol and get savvy about sodium. A low-sodium lifestyle. Now that s an idea worth its salt.

7 Readiness for Implementing a Sodium Reduction in Communities Project Cardiovascular Health Exam Survey ( ) BRFSS optional module on actions to control high blood pressure (2005, 2007 and 2009) Well-developed local health coalition

8 Cardiovascular Health Exam Survey (CVHES) Oversampled three racial and ethnic groups (White/other races, African-American, Hispanic) Stratified sample from 20 counties, including Shawnee County Three components Telephone survey Physical exam with lab tests Self-administered mail survey N = 1,869 adult Kansans participated

9 Survey findings Adequate sample to provide reliable prevalence estimates at a sub-population level for: The two most prominent minority racial/ethnic groups Measure of doctor s advice to cut down on salt to control blood pressure Validation of self-reported blood pressure.

10 BRFSS Data Health Risk Behavior Shawnee County Kansas Prevalence of hypertension 30.5% 29% Not told by a doctor to cut down on salt 32% 33.8% Not told by a doctor to change their eating habits to lower blood pressure Do not consume fruits and vegetables > 5 times per day 37.3% 42.6% 82.5% 81.4% 2009 BRFSS Data

11 Local Coalition Heartland Healthy Neighborhoods Topeka named a Pioneering Healthier Community by the National YMCA and CDC Instrumental in advocating for a passage of a resolution requiring consideration for Complete Streets framework application on every planning and engineering project Lead the effort to pass a clean indoor air ordinance in the city of Topeka prior to state law Raised money from corporate and private sponsors to conduct a bike routes study Recipient of the 2010 Public Policy Award given by the National Association of Chronic Disease Directors

12 Coalition Activities

13 Shawnee County Kansas Cheyenne Rawlins Decatur Norton Phil lips Smi th Jewel l RepublicWashington Marshall Nemaha Brown Doniphan Sherman Wallace Greeley HamiltonKearney Stanton Grant Morton Thomas Sheridan Graham Rook s Logan Gove Tr e go Ellis Wichita Scott Lane N e ss Finney Haskell Stevens Seward Gray Meade Pawnee Hodgeman Fo r d Cl ar k Rush Edwards Kiowa Comanche Osborne Russell Barton Stafford Pr a t t Barber Mi tchell Lincol n Cloud Ottawa Saline Ellsworth Rice Ren o Kingman Harper Cl ay McPherson Marion Harvey Pottawatomie Jeff erson Leavenworth Riley Shawnee Wyandotte Dickinson Geary Wabunsee Douglas Morris Osage Johnson Lyo n FranklinMiami Sedgwick Sumner Butler Cowl ey Chase Gr eenwood Woodson Allen Elk Atch ison Jack son Co ff ey Anderson Lin n Bourbon Wilson Neosho Crawford M on tgom er ylabette Cherokee Chautauqua

14 Shawnee County Demographics Location of the capital city of Kansas Topeka Home to over 70% of the county s population 3 smaller communities surround Topeka Population: 174,709 10% African American 10% Hispanic 11.9% categorized as low income

15 Selected Sodium Strategies Policy, system and environmental change strategies Reduce sodium intake through procurement policies Promote venue-based policies that support healthy nutrition and sodium reduction Promote policies to change relative prices of healthy vs. unhealthy sodium items Media strategy Counter-advertising of high sodium foods to promote heart healthy low sodium foods

16 Community Assessments Survey of 800 Shawnee County adults Three components Telephone survey Height, weight and blood pressure measurement 24 hour dietary recall to gather data on estimated levels of sodium intake Baseline assessment of procurement policies Message testing/focus groups

17 Influential Partners Shawnee County Medical Society Kansas Cardiovascular Advisory Council (Professional Education Committee) Heartland Healthy Neighborhoods Capital City Wellness Coalition

18 Short-term Outcomes Expected Outcomes Increased awareness or desire to purchase and/or consume low sodium foods Increased access to low-sodium foods Increased consumption of low-sodium foods

19 Contact Information Jason Eberhart-Phillips, MD, MPH (785) Paula F. Clayton, MS, RD (785)

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