People who live in rural communities live an average of three years fewer than urban counterparts and have higher death rates from cardiovascular disease and stroke. To break down health care barriers for these residents, the American Heart Association/American Stroke Association announced a statewide commitment of $7.5 million for its Mission: Lifeline Stroke initiative to strengthen the full spectrum of stroke care across Iowa. The foundation of this new initiative is a $6.3 million grant from The Leona M. and Harry B. Helmsley Charitable Trust.
Mission: Lifeline Stroke focuses on connecting all components of acute stroke care into a smoothly integrated system that reinforces the use of evidence-based guidelines to timely and effectively treat stroke patients. It brings together hospitals, emergency medical services and first responders, rehabilitation facilities, communications and regulatory agencies, state and local government, and payers to forge a proactive system of stroke care that saves and improves lives.
"The work of the Iowa Stroke Task Force ensures that Iowans swiftly receive excellent care from highly skilled providers, so that stroke patients have the greatest odds of survival and full recovery," said Kelly Garcia, Director of the Iowa Department of Health and Human Services. "This significant investment by the American Heart Association and the Helmsley Charitable Trust builds on the work of the Stroke Task Force to enhance and expand those lifesaving efforts and to improve stroke recovery and rehab in large and small communities across Iowa."
Cardiovascular disease, including heart and stroke conditions, is the leading cause of death in the United States. The acute nature of heart attacks and strokes is particularly deadly and requires time-sensitive treatment to save lives and reduce lasting disability. Stroke is a leading cause of death in Iowa, accounting for more than 1,400 deaths in 2020. Many more Iowans are living with stroke-related disabilities.
This is the latest in a series of Helmsley investments in Mission: Lifeline's system of care model for acute cardiac and stroke care. "We believe that a comprehensive approach is the best way to make the most substantial impact, especially for rural populations that face longer transit times and limited access to specialists," said Walter Panzirer, a Trustee for the Helmsley Charitable Trust.
The stroke program in Iowa builds upon prior success with this approach. In 2015, the Helmsley Charitable Trust provided a $4.6 million grant to support the launch of Mission: Lifeline STEMI in Iowa to reduce treatment times for acute cardiac care in the cases of ST Segment Elevation Myocardial Infarction (STEMI). STEMI is the most serious type of heart attack and occurs when blood flow is completely blocked to a portion of the heart.
Every minute saved in heart attack and stroke treatment can directly improve survival and recovery rates. Strengthening care requires a system-wide, data-driven quality improvement approach to address many similar triaging, transfer, and treatment challenges in time-sensitive stroke care.
"This ongoing commitment from the Helmsley Charitable Trust will directly touch the lives of all Iowans and for this I am very grateful," said Dr. Enrique Leira, Professor of Neurology and Head of the Comprehensive Stroke Center at the University of Iowa and co-Chair of the Iowa Stroke Task Force. "The Mission: Lifeline Stroke initiative will help us better coordinate stroke care, from the time of onset to treatment. Stroke treatment is time-sensitive, so getting patients the proper treatment faster, is crucial. This investment is going to be particularly impactful in decreasing the unacceptable disparity in stroke care we are currently experiencing in rural states like Iowa."
Mission: Lifeline Stroke will build upon the gains achieved by the existing Iowa Stroke Task Force by further strengthening the collaboration with stakeholders across the state representing hospitals, individual ambulance services, the Iowa Department of Human Services and others. The project will enhance many critical elements of an optimal stroke system of care, including:
- Improved public awareness on the symptoms of a stroke and the need to call 9-1-1;
- A coordinated EMS network, well-trained to identify suspected stroke patients quicky and transport them to the most appropriate facility;
- Well-trained hospital staff who are prepared to properly treat stroke patients and transfer, when appropriate, to higher levels of care and high-quality rehabilitation services;
- Coordination and collaboration among all statewide stroke centers;
- Seamless discharge to high-quality, post-acute stroke rehabilitation and recovery care;
- Guideline-directed care in post-acute care facilities to improve recovery and quality of life;
- A sustainable statewide quality improvement data system to monitor patient care, identify successes and areas in need of further improvement and investment; and
- Robust, collaborative infrastructure for long-term attention to stroke outcomes across the state.
HeartCorps to Launch in Iowa and across the country
The Helmsley Charitable Trust is also granting $3 million to the American Heart Association to launch HeartCorps in Iowa, Minnesota, and Wyoming. HeartCorps is the Association's new initiative serving rural communities across the U.S. As an inaugural grantee of the Public Health AmeriCorps Program, the AHA will launch HeartCorps this fall to address health inequities and develop a new generation of public health leaders in rural America.
The goal of the initial three-year HeartCorps program is to grow a sustainable pipeline of public health workers, reduce cardiovascular risks among rural residents and accelerate the adoption and implementation of systems changes to improve cardiovascular health. The Public Health AmeriCorps Program is a joint partnership between AmeriCorps and the Centers for Disease Control and Prevention (CDC).
"HeartCorps is an excellent opportunity to bolster the public health workforce in communities across the country," Panzirer said. "Developing local expertise and resources to improve health outcomes will provide long-term benefits to these communities."
With funding from the Helmsley Charitable Trust, the AHA will place HeartCorps members in counties that rank among the least healthy in Iowa according to County Health Rankings. These members will focus on improving cardiovascular health, including blood pressure awareness and control. Funding will also support HeartCorps members in several counties throughout Minnesota and Wyoming.
HeartCorps will support 100 Public Health AmeriCorps members each year in rural areas across the country. AmeriCorps will provide $8.6 million, or 63% of the project with the remaining $5.1 million, or 37% of the project funded by the Helmsley Charitable Trust, the American Heart Association, and other funders.
Since 2010, the Helmsley Charitable Trust has committed over $64 million to the American Heart Association's mission. Helmsley's support has been foundational to improving statewide systems of care in the Upper Midwest, including Mission: Lifeline STEMI projects in seven states from 2010 to 2016 and the launch of Mission: Lifeline Stroke in North Dakota, Nebraska, Montana and Iowa.
