Population health promotion: Stratified approach for cardiovascular health

The meeting, which focused on health and well-being and the comprehensive treatment of NCDs, was held by the United Nations NGO Committee on Mental Health, which is affiliated with the Conference of Non-Governmental Organizations (CoNGO) in Consultative Relationship with the United Nations. The event was co-sponsored by the International Council of Women, Soroptimist International, Communications Coordination Committee for the United Nations, Sigma Theta Tau International, Nightingale Initiative for Global Health, Human Rights Congress for Bangladesh Minorities, American Psychiatric Association, International Psychoanalytical Association and Nonviolence International.

According to Dr. Fuster, "We are starting to experience a significant change in the way we deliver cardiovascular medicine with a focus on promoting health over treating disease. "As a result, we should expect to see a rise in ambulatory care and shorter hospital stays. This transition will require that cardiovascular specialists and health care workers are trained in ambulatory and home-based care."

In 2010, the U.S. Institute of Medicine (IOM) formed a committee, chaired by Dr. Fuster, which produced a report, entitled "Promoting Cardiovascular Health in the Developing World." The report stressed the importance of health promotion during a person's lifetime and the significant economic burden that cardiovascular disease places on our society. The authors proposed a stratified approach at 3 different age ranges in a person's life to effectively promote cardiovascular health.

The first approach to stratified health is during the first 25 years of life, with the optimal period of time to motivate healthy behavior between 3- 5 years old. The second opportunity for stratified health is within the age range of 25 to 50 years old, when non-invasive imaging techniques can be used to detect potential future heart health issues. The third opportunity occurs at 50 years and upward, when cardiovascular disease has often begun.

"At every age range, there are scientific, psychological, and disease specific variables to consider, as well as different educational and behavioral tools to use to promote cardiovascular health globally," stated Dr. Fuster. "My years of research strongly support early education intervention and the need for a stratified approach to health promotion worldwide."

Since 2009, Dr. Fuster has worked with nearly 100,000 preschool-aged children, ages 3-5, in Madrid, Spain and Bogotá, Colombia to demonstrate that early health education can have long-lasting heart healthy effects. Under Dr. Fuster's leadership, Mount Sinai Heart of Icahn School of Medicine at Mount Sinai is launching a similar program in the United States in 8 New York City (NYC) Harlem preschools with children ages 3-5, along with their parents and caregivers, known as The FAMILIA Project.

The Project, made possible by a $3.8 million grant from the American Heart Association (AHA), is scheduled to begin this month. Mount Sinai has partnered with NYC's Administration for Children's Services (ACS), Division of Early Care and Education Head Start programs to teach young children, their parents, and caregiver's ways to reduce their risk factors of developing cardiovascular diseases, while also decreasing the growing obesity epidemic. The Project's programming will focus on child, adult, peer group, and individual health interventions.

The meeting, which was attended by members of civil society, UN staff, and government representatives, took place at the United Nations Church Center on Thursday, November 12, 2015. Welcoming remarks were delivered by Dr. Vivian B. Pender, Chair, UN NGO Committee on Mental Health. Dr. Elizabeth Carll, Founder and Convener of the Global Mental Health and NCDs Work Group of the UN NGO Committee on Mental Health, served as the moderator. The panel was comprised of Dr. Valentin Fuster; H.E. Mr. Keith Marshall, Ambassador and Permanent Representative, Mission of Barbados to the United Nations; Werner Obermeyer, Deputy Executive Director, World Health Organization in New York; Dr. Yesne Alici, Assistant Attending Psychiatrist, Memorial Sloan-Kettering Cancer Center; and Dr. Gustavo Gonzalez Canali, Senior Advisor and Focal Point for NCDs, UN Women.