Public-private partnerships to advance cardiovascular health equity: The Million Hearts Initiative

Cardiovascular disease (CVD) and stroke are the leading causes of death in the United States. On average, someone dies of CVD every 34 seconds, and someone dies of a stroke every 3 minutes and 17 seconds in the US. Risk factors for CVD and stroke include hypertension, diabetes, high cholesterol, physical inactivity, smoking, and obesity. Beyond the human toll, CVD poses a significant economic burden: Health care spending for CVD and associated risk factors exceeded $320 billion in 2016, with $80 billion spent on ischemic heart disease and $71 billion on hypertension.
Although the majority of CVD is largely preventable, the burden of CVD and associated risk factors remains a public health challenge.  Even more concerning is the fact that CVD is the leading contributor to health disparities nationally, with Black adults dying at a disproportionately higher rate from CVD compared to White adults. The underlying cause of disparities in CVD has been identified as structural racism, not race per se, by the American Heart Association. Besides race-based disparities, place-based disparities in CVD are prominent in the US, with higher rates of CVD among persons residing in rural areas than urban areas.
Million Hearts® was established as a national initiative in 2012 by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS). The initiative is aimed at preventing one million heart attacks, strokes, and other acute cardiovascular events in five-year increments. The initiative is currently in its third five-year term (January 2022–December 2026). Below, we discuss this innovative program, with particular emphasis on the public-private partnerships that are critical to its success. (author introduction) #P4HEwebinarSeptember2024