The American Heart Association, the leading voluntary health organization devoted to a world of longer, healthier lives, is marking four decades of nonpartisan advocacy in support of public policies that improve cardiovascular health. A policy statement published today in the American Heart Association's flagship journal Circulation documents the evolution of public policy advocacy over 40 years and emphasizes the continuing importance of advocacy to achieving the Association's life-changing mission.
"For four decades and counting, the American Heart Association has shown that by passing and defending science-based public policies, we enable people to lead healthier lives free of cardiovascular disease and stroke," said Keith Churchwell M.D., FAHA, American Heart Association volunteer, the statement's lead author and president of Yale New Haven Hospital. "To ensure all communities experience the benefits of policy change, our advocacy efforts are squarely focused on remedying health disparities to equitably improve health for everyone, everywhere."
After years of engaging with U.S. presidents and federal agencies, the Association in 1981 established an advocacy office in Washington, D.C. with full-time staff focused on enacting tobacco-control policies and increasing federal research funding at the National Institutes of Health (NIH). Over time, the Association's advocacy priorities expanded to include improving access to quality, affordable health care; increasing access to healthy foods; creating opportunities for physical activity; improving air quality; strengthening the public health infrastructure and systems of care; and ensuring state and local governments address the health concerns of their residents. More recently, the Association's 2020 presidential advisory on structural racism, which established a scientific link between institutional racism and poor health, elevated the importance of addressing racism and other social determinants of health through public policy.
Leveraging its research, volunteers, community reach and scientific expertise, the Association has built an extensive record of bipartisan success informing and influencing public policy at the federal, state and community levels. The Association also has established itself as a partner and collaborator, working with others to improve public health.
"Policy change is essential to achieving our mission, and our advocacy efforts are designed to have maximum impact," said American Heart Association Chief Executive Officer Nancy Brown. "Our advocacy successes have improved people's lives in ways that include increasing access to health care, making more public spaces tobacco-free, reducing food insecurity, promoting physical activity and boosting investments in heart and brain research."
With a staff and volunteer presence in every state capital and in communities across the country, the Association helped to pass or defend more than 100 priority policies at the state and community levels this past year alone. The Association remains an advocacy force in Washington, D.C., having supported the following federal policies:
- NIH funding increases – The NIH budget has increased more than 400 percent since 1990.
- Affordable Care Act (2010) – Landmark legislation that includes numerous protections for patients in the insurance market.
- Healthy, Hunger-Free Kids Act (2010) – Empowers the U.S. Department of Agriculture to update nutrition standards for all food sold in schools.
- Every Student Succeeds Act (2015) – The biggest-ever federal commitment to physical education, including the Fitness Integrated into Teaching (FIT) Kids Act, a bill led by the association to improve physical education in schools.
- Furthering Access to Stroke Telemedicine (FAST) Act (2018) – Significantly expands access to telestroke care nationwide.
- Tobacco 21 (2019) – Increases the federal sales age for all tobacco products to 21.
- Surprise medical billing (2020) – A bipartisan agreement to shield patients from bills for medical services and remove patients from payment disputes between providers and insurers.
Several other milestones beyond the opening of its D.C. advocacy office 40 years ago have contributed to the Association's advocacy success and positioned it for the political challenges and public policy opportunities of the future. Major milestones include:
- Expanding advocacy across all levels of government – Beginning in the late 1990s, the Association broadened its focus beyond the federal policy landscape to include policy work in all 50 states.
- Elevating grassroots voices – In 2003, the Association launched You're the Cure, a nationwide network of grassroots advocates who ensure the voices of patients and their families are heard in policy debates.
- Researching and translating science – Beginning in the mid-2000s, the Association began publishing peer-reviewed policy statements that set the course for its advocacy agenda.
- Engaging in global advocacy – Since moving into global advocacy following the 2011 United Nations high-level meeting on noncommunicable diseases, the Association has worked with the World Health Organization and other international partners to reduce premature deaths from NCDs.
- Catalyzing community advocates – With the creation of Voices for Healthy Kids in 2013, the Association and the Robert Wood Johnson Foundation developed a critical resource for community groups in need of advocacy capacity building, technical assistance and tools.
"Advocacy has been core to the American Heart Association's mission over the past 40 years and remains an essential component of our work as we strive to improve cardiovascular health for everyone," said Mark Schoeberl, an author of the statement and the association's executive vice president of advocacy. "Our country needs fact-based, nonpartisan policy solutions and volunteer advocates motivated by the simple yet extraordinary desire to improve public health."
