Heart disease and stroke have been the number one killers of men and women in the United States for 100 years, particularly among those with lower socioeconomic status. But new study findings from a University of Florida expert and colleagues in Maine show how one rural, low-income community in Maine has been able to fight the statistics.
Over a 40-year period, Maine’s Franklin County, a rural area near the New Hampshire border, has reduced death rates and risk factors related to heart disease and stroke through a variety of continuous communitywide efforts dating back to 1970. Findings about the outcomes of these efforts were published last month in the Journal of the American Medical Association.
Efforts to address the problem of heart disease and stroke began in the community in the 1960s when a community group, a nonprofit medical group and local hospital began working together. Using small grants, the community members, health care workers and volunteers worked to improve access to health care and prevention efforts, targeting areas such as smoking cessation, hypertension, physical activity, diet and cholesterol. In 1974, the communitywide Franklin Cardiovascular Health Program was established.
In the JAMA article, lead author Dr. N. Burgess Record of Franklin Memorial Hospital, Farmington, Maine, and colleagues, including senior author Dr. Thomas Pearson, UF Health executive vice president of research and education and a professor of epidemiology and medicine at the College of Public Health and Health Professions and the College of Medicine, reported the health outcomes associated with the comprehensive cardiovascular risk reduction program in Franklin County.
The researchers found that, when compared to Maine as a whole, Franklin County has had higher smoking cessation rates and higher rates of cholesterol control as well as lower hospitalization rates and death rates related to heart disease and stroke during the decades since the program began. In the 1960s prior to the inception of the program, Franklin County’s mortality rate related to heart disease and stroke was above the state average. But after the program began, the mortality rate declined and remained below the state average for almost the entirety of the time between 1970 and 2010 — the years the researchers specifically discussed in the JAMA article. According to the findings, Franklin County was the only county in Maine to consistently have lower-than-expected mortality rates related to heart disease and stroke.
“Wonderful changes can start with one person, or in this case, one small group,” said Dr. Pearson, a leading authority on heart disease prevention. Pearson has been working with the team in Maine as a consultant for 20 years.