Is Rapid Health Improvement Possible

Five years ago, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, and partners launched a public–private initiative to prevent 1 million heart attacks and strokes by 2017.1 Although final results will not be known for several years, data suggest that the initiative made substantial progress and will achieve about half of its goal. Policies, partnerships, and programs prevented cardiovascular events and yielded important lessons. This article outlines the actions taken, progress made, and implications for health improvement in the United States. Cardiovascular disease (CVD) remains our leading cause of death, killing 800 000 Americans and costing $316 billion annually.2 CVD event and mortality rates have declined since the 1960s, but this decline decelerated around 2011.3 The Million Hearts initiative began in 2012 and faced the challenge of overcoming this trend. The purpose of the initiative was to scale effective interventions in order to prevent CVD events to resume and accelerate the decline.1 Communitywide goals were to reduce tobacco use and sodium intake and to eliminate artificial trans fat consumption. Clinical priorities were to improve management of the ABCS: aspirin use, blood pressure control, cholesterol management, and smoking cessation. More than 120 partners, including federal, state, local, and private sector organizations, are working to achieve targets. Through the first 2 years of the initiative, ≈115 000 events …