Address to the Incoming US President
Dear President-Elect Trump,
Welcome to the White House and one of the most powerful seats in the world. As our next president, your focus will be on many important issues and goals, including—most importantly—how to ensure that all Americans have equal opportunity to life, liberty, and the pursuit of happiness by safeguarding against the greatest threats to our well-being. Unfortunately, too many American lives are cut short by our nation’s number 1 and number 5 killers: cardiovascular disease and stroke. As we face the mounting devastation caused by rising rates of obesity, diabetes mellitus, hypertension, and physical inactivity, I strongly urge you to put our nation’s health at the top of your list of priorities.
The burden of cardiovascular disease is growing faster than our ability to ease it.1 Distressingly, the rate of declines in death rates from heart disease and stroke has flattened and even worsened for our most vulnerable populations.2 To shift us from this destructive course, we hope you will join us in focusing on the following critical priorities.
Ensuring equitable health for ALL Americans
A one-size-fits-all approach to improving America’s health challenges won’t improve the lives of all Americans, because each community and population faces specific challenges and risk factors. Treating these communities with the same, traditional health interventions is akin to giving everyone the same prescription for eyeglasses and expecting 20/20 vision. In fact, recent research by the Centers for Disease Control shows that where you live is as equally important to your health as how you live.3 Because of this, we strongly urge the federal government to join us in standing with communities across the country to address the unique risks that confront their population, develop meaningful health solutions, and help build environments at the local level that support the health and well-being of their residents.
Patients should be at the center of scientific research
Few know better the challenges faced in our current healthcare system than those directly affected. Traditional models for scientific research must be modernized to include patients to drive advances in care and treatment tailored to their specific needs.
The American Heart Association (AHA) and the Patient Centered Outcomes Research Institute, an innovative leader in comparative effectiveness research, recently launched a breakthrough collaboration to engage with caregivers, patients, and the general public to ideate on the most important issues hindering scientific progress. The initiative is a groundbreaking example of putting patients at the center, combining the power of crowdsourcing with the lure of challenge prizes to accelerate identification of critical research needs. With the help of patients, future findings from patient-centered research will transform the landscape of cardiovascular and stroke treatment and rehabilitation.
Investing in new models for accelerating scientific research
The current models for research are inefficient at best and barriers to innovation at worst. Among the persistent problems evident in the current models are: lack of data integration across research institutions and cohort studies, lack of coordination between public, private and government research entities, and cumbersome grant application processes for investigators. Any system that requires researchers to spend close to a majority of their time writing and applying for grants, instead of performing potentially life-saving research, needs to be overhauled.
To demonstrate the possibilities created by new models for research, this past year the American Heart Association, Verily, and AstraZeneca came together and agreed to pledge $75 million over 5 years to a single research vision for ending coronary heart disease. The initiative, named One Brave Idea, was launched at the AHA’s Scientific Sessions conference in November 2015 and received 349 highly innovative vision submissions during the 30-day online application period. Six months later, a winning leader and vision had been selected. This effort proved that if you allow researchers to think “out of the box” without the time or financial constraints of a typical research grant, truly innovative ideas emerge that have the potential to transform the world.
We also established the AHA Institute for Precision Cardiovascular Medicine to help deliver on the promise of personalized medicine. The Institute is improving cardiovascular research by creating collaborative partnerships that combine genomic and phenomic patient data, registries, and other information in a comprehensive, user-friendly data registry. We hope the federal government will be an important partner in this work, bringing federally funded cohorts and publicly accessible data to feed into this new open science platform.
Easing the burden of disease by building a culture of health in our nation’s communities
We must support new research on the social determinants of health to understand the complex role that our environment plays in individual health. The federal government has a key role in implementing policies that will help make the healthy choice the easy choice in communities across the country.
To start, we must support active means of travel, including biking and walking, and the federal government should fully support and communicate the revision of the Physical Activity Guidelines for Americans. We must also set an example by implementing the improved Dietary Guidelines for Americans and supporting sound agricultural policy in a Farm Bill reauthorization that promotes access to nutritious foods across the food supply. Your administration should also champion the successful implementation of the planned revisions in the Nutrition Facts Panel, calorie labeling in restaurants, voluntary sodium targets, Child Nutrition Reauthorization, and the Every Student Succeeds Act to optimize effective physical education. Additionally, in light of the troubling rise of e-cigarettes and vaping over recent years, we hope you will support strong regulation of all tobacco products and strictly monitor the impact of new products that could reverse decades of progress in tobacco cessation.
The Association expresses its strong support for the work of the Centers for Disease Control and Prevention and its divisions, including the Division of Heart Disease and Stroke Prevention (DHDSP), which we believe should be focused on communities with the highest burden of disease. Also, in response to the many challenges we face in improving the health of all Americans, we strongly urge the federal government to increase the budget at the National Institutes of Health and other federal agencies for heart disease and stroke research and consider innovative ways to shift the current research paradigm to accelerate transformational science.
The AHA looks forward to working with your administration to reduce the burden of cardiovascular disease and stroke and ensure equitable health for all Americans, soliciting the insights of patients and caregivers, investing in new models for scientific research, and building a culture of health in our nation’s communities.
Among the many leadership qualities that the president must demonstrate, we believe your compassion will have the greatest impact during your term. Every day you will have the honor and responsibility of placing your hand on the heartbeat of the American “story.” You will hear about people’s successes and failures, you will learn about their hopes and dreams, you will empathize with their concerns and fears, and your compassion will lead you to ask that simplest and most important of questions: How can I help?
We hope this brief list is a place to start.
Circulation is available at http://circ.ahajournals.org.
- © 2016 American Heart Association, Inc.
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