Dr. Jim Peacock
Appearances
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
So yes, Stan, it's an interesting trajectory for these conditions, sort of the deaths in Minnesota. For cardiovascular disease, especially, and for stroke to some degree, All across the country, we saw rapid declines, really big improvements for decades in the death rates due to these conditions.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
And that's due to a number of things, reduction in the amount of people smoking, the introduction of new therapies like high blood pressure medications or statins as a way to manage and control the risk factors that lead to those conditions. But that has really flattened out since about 2010 in every state in the country.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Minnesota historically has had the lowest death rate in the country due to cardiovascular disease. I believe that's still the case. But the data that you quoted are from 2021. Although not released yet, provisional data from 2022 show a pretty large increase in heart disease deaths in Minnesota last year. Every state in the country has seen this happen in different ways and at different times.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
I will say COVID has had a very large impact on chronic disease deaths and cardiovascular disease, diabetes, and stroke are part of that equation. Those have gone up fairly strongly in all parts of the country since 2020.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
So it's really, it's not that we're at an inflection point, but we really are at a point where those trends that had existed for decades where we could sort of rely on improvements in health They just aren't happening anymore.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
And COVID has, I think, laid bare not only it really is laid bare a chronic disease epidemic in the United States where many people have poor risk factor profiles, inability to access healthy foods or find a place to exercise. lack of awareness about whether or not they have high blood pressure and or not able to control that if they are on medication.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
It's a larger problem in the United States than many other Western industrialized countries. And that's evidence in the fact that our death rate or our length of life has been slowing in this country compared to other places. We're falling behind a lot of other places with similar economies and similar levels of development.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Yeah, I can start on that, Clarence. So the point of this plan, and I think we list this how we describe it as a call to action. for communities and healthcare systems, community and organizational leaders, but we specifically put communities first in that list.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
As Courtney just described, communities are much closer to understanding what's going right, but also what's not going right in their community. And we want to make sure that this plan is designed in such a way that it's not just the state health department, or it's this esteemed group of committee members that helped finalize this plan, making decisions.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
It's creating the conditions for communities to come to us and say, we have a solution for this problem. We've identified a way to make our community members feel better, or we've identified a way to connect people with the right type of resource so that they're not experiencing 15 medications and living in this cloud as Courtney just described. So again,
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
The goal of this plan is really to grow and change over time, and it's an invitation for more community input. It's not just something we want to sit on a website and not be changed for the next 15 years or however many years until it's over.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
But we want it to grow and change, and it's community input to tell us what's working and what's not working that is going to be so important for making this an impactful plan.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Not only improving outcomes for people, but in solidifying and increasing the types of partnerships that government, community organizations, healthcare systems, public health agencies can have with one another to affect positive change.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Yeah, Clarence, I want to react to that comment for a second and I want to verify this with Courtney, but Courtney, if I recall correctly, investing in partnerships, this very first outcome here in the plan, that's what our committee members were most excited about and felt intense passion for. around this is the place we need to start.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
And it makes sense because as you've said, Clarence, we need to build trust and that trust is multiple directions. And there's a real opportunity and interest in doing that from all perspectives of the folks that contributed to putting this plan together. So we're excited about that. We feel like we're starting from a really good place where everyone has sort of a common understanding and interest.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
And people, because this is a podcast, you couldn't see me shaking my head vigorously during what Courtney just said there. Actually, we all are. Okay, there we go. So what I would add to it as well is these 10 outcomes, if you dive deeper into some strategies underneath them, there's so much overlap. And that was intentional.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
We wanted people to be able to see work that maybe they found in one part of this plan intersecting with other parts. So it could open up the way that it could deepen the impact that their work could have. It could expand their ideas around how they can improve health and well-being in the community.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
It can potentially unlock and open doors for new partnerships that can strengthen that impact that a community or health system or public health is having.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
I can jump in first, but I'd like Courtney to follow up on that is When people are talking about how they feel well or don't feel well, and they go to the doctor, they come in like, oh, my blood pressure is high. Oh, they said I might have something called prediabetes too. These conditions operate together. And many people who have cardiovascular disease also experience diabetes or prediabetes.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Folks that aren't able to manage their blood pressure often have another one of these. These conditions are so intersecting. We wanted to make sure that, you know, we were able to talk again about this whole person as much as we could with these conditions that are often happening, you know, at the same time in a person or in a family or in a community.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Courtney, how would you add on to that from a clinical perspective?
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
And so, yeah, yeah, I agree with that completely, Stan. I mean, I think it allowed us a lot more freedom to be responsive to the community and flexibility instead of being responsive to the desires of the CDC who is funding things Cardiovascular disease funding is completely separate and distinct from their diabetes funding to support states and local governments.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
If I have a chance, I just want to jump in something that Clarence mentioned a few minutes ago. You talked about a lot of conversations about dementia in the community. Something that we aren't talking about here, but it's is how what's good for your heart and what's good for your blood sugar is really good for your brain health as well.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
And so communicating about how all of these conditions, high blood pressure, high blood sugar, high cholesterol, impact so many parts of our bodies and our ability to live well. There's great benefit to be talking about these as a group instead of individual distinct diseases. There's a lot of benefit in coming together. It's improving everyone's health.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Well, Stan, you're right. We have a lot of data systems to sort of measure disease impact through things like number of deaths, number of hospitalizations, number of people that are meeting a vascular disease target for their blood pressure medication and their statin and so on. What we don't have a great time or great ability to measure is how people feel.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
And that's another reason going up to community and having community really lead on this plan. And we don't want to be in a position as folks that have put this plan out of deciding how to measure some of these outcomes that you described a few minutes ago, we really want the community to help tell us what is the right way to measure this.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Community, tell us what is real impact for the populations that you work with or in the neighborhood where you operate. We believe this investing in partnerships outcome, which I mentioned a couple of minutes ago, is really key to developing that trust and communication so that we can together measure that impact. And the impact may just be who's engaged in the plan and what are they doing?
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
And we're working on those systems in order to put that together to communicate out the successes. Yeah, yeah. Courtney, what do you think?
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Yeah. One thing I would add to that, Courtney, I think spoken, that's exactly how I would answer that question. You said it more eloquently. What I would add is that embedded in these 10 outcomes, we also made an effort over the last 18 months to reach out to
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
diverse communities in multiple parts of Minnesota to show work that they were doing, demonstrate their successes that often were not funded by the health department. They may have not been funded by a health system, but they were community-driven initiatives that really speak to the spirit of this plan.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
The idea there was to show Minnesotans, other organizations, folks from all across the country, the type of impact that a community-based initiative can have in improving the health and wellbeing of members of that community. So we're reviewing that as sort of, it's inspiration from many different types of players and organizations with whom we may have not worked directly in the past.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
They may have not even been at the table with the development of the plan that we had in 2010 or the plan from 2000, but they were at the table this time and we're trying to elevate that voice.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Sure. The plan is available for anyone to view right now. I'll give you the website, but also give you a special trick as well. You can go to health.state.mn.us slash 2035plan. You can also just go to a Google browser and type in MN2035 plan. And I'm happy to say it's already the top link on that search history. Oh, good. Love it. Super. That's a way you can connect.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
And as I mentioned, there's success stories. There's voices from community members, both Courtney and myself, talk a little bit in a short video about why this plan is needed in Minnesota at this time.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
I mean, I could jump in first, Dan, and thanks for that really warm introduction there. From a state health department perspective, when I came to MDH in 2007, we were in the middle of implementing a state plan. And I think that they largely were born, at least here in Minnesota, out of a necessity as a deliverable for the funding we receive from the Centers for Disease Control and Prevention.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
CDC tends to fund programs in silos within a disease. So there's a CVH program, a diabetes program, cancer programs, and so on. And an important part of receiving that funding was to create a coordinated comprehensive plan for how you'll address those conditions in your state, bringing in community, clinical, public health support and information to design that.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
CDC has moved away from that in recent years and requiring states to do that. But I think what was exciting here is that, you know, what is it, four years ago, pre-COVID, we asked that question of folks in cardiovascular health if they felt it was important.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
And we heard a resounding yes, even though it's not required by the funder for MDH's work, that it was an important way to bring together many partners across Minnesota.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Yeah, I can take an attempt at that answer first, Clarence. When Courtney and I joined back in 2007, and Courtney, I'd forgotten about that. So thank you for bringing that back to mind for me that we have a history going back 16 years.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
The plan that was developed that was in place from 2010 through 2020 had a lot of engagement from many members of the professional clinical community, from academic settings, from public health, and not a lot of input from folks in the community that are working with populations that are experiencing disparities or populations that lack access to services.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
And this change that we made with this new plan being developed as we centered the community voice in not only how we collected information, the people we brought together to discuss what was really going on, what do people need to be healthy in the community?
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
Many times people aren't thinking about, oh, I've got heart disease, but they're thinking about, oh, my blood pressure might be a little bit higher. I'm not able to eat the healthy foods or I don't have access to those. We wanted to bring those voices in to identify community based solutions to these problems that are happening way before someone would intersect with the health care system.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
How can we help someone feel good and have access to those things to be healthy? So those voices were brought initially, and that's how we centered the plan outcomes, which there are 10 of them. I think we'll maybe talk a little bit about those later.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
But they're really centered in a way that makes it so many different people could look at the plan and say, hey, there's something I can do in this space. I'm not a clinician.
Health Chatter
2035 Minnesota Cardiovascular and Diabetes Health State Plan
I don't actually work in health, but I work in a small community and I can make things better for the people that live here by offering healthy fruits and vegetables in my store or by providing a place for people to be physically active and where they feel safe to do that and supported to do that. Those are just some small examples.