Heart Disease and Stroke Prevention in the Pacific Territories heart disease, stroke prevention, american heart month, cardiovascular health, chronic disease, pacific territories, environmental infrastructure, disease epidemic, tobacco use, mental health, united states, physical activity, health problems, leading cause of death, health conditions, american heart, cardiovascular disease, chest pain, type of heart disease, coronary heart disease, heart health, flow to the heart, risk of heart disease, heart disease and stroke, prevent heart disease, astho, association of state and territorial health officials Marcus Plescia Heart disease and stroke prevention in the pacific territories. Each February, American Heart Month raises awareness for heart disease and cardiovascular health—a matter that warrants attention year-round. In ASTHO’s 2023 Environmental Scan, territorial health officials highlighted chronic disease prevention and treatment as top current public health program and service priorities, emphasizing heart disease and stroke as key focus areas. As such, I want to highlight heart disease as a public health issue in the U.S. territories, which have played an important role in ASTHO’s chronic disease prevention efforts. Several years ago, ASTHO CEO Mike Fraser pointed out Mark Durand’s work in the Pacific territories. Durand developed a list of prioritized chronic disease-related health policies and a matrix to map progress across six jurisdictions. This ultimately provided the basis for ASTHO’s Essential Policies for Chronic Disease Prevention and Control—which served as a foundation for ASTHO’s Heart Disease and Stroke Prevention (HDSP) Learning Collaborative—and led to the launch of ASTHO’s technical packages in all program areas. Heart Disease and Stroke Prevalence in the Pacific In the United States, heart disease is the first leading cause of death and stroke is the fifth. Disparities exist across several demographic lines, including race, ethnicity, and nationality. U.S.-Affiliated Pacific Islands (USAPIs) adults have the second-highest death rate from cardiovascular disease in the country. Additionally, in all USAPIs involved in ASTHO’s HDSP Learning Collaborative—Commonwealth of Northern Mariana Islands (CNMI), Federated States of Micronesia (FSM), Republic of the Marshall Islands (RMI), Guam, and Republic of Palau—heart disease and stroke are in the top three leading causes of death, with cases soaring in recent years. The U.S. territories are home to small and diverse populations with rich history, cultural practices, and languages. Unfortunately, the long-lasting impacts of colonialism have weakened the social, cultural, and environmental infrastructure that has historically protected the health of USAPIs communities. In recent decades, health threats have shifted from infectious diseases to preventable chronic diseases; the Pacific Island Health Officers Association even declared a Regional State of Emergency in 2010 because of their non-communicable disease epidemic. Since this declaration, there has been increased interest in and efforts toward policy and health system interventions in USAPIs, which ASTHO has been proud to support through our learning collaborative. Heart Disease and Stroke Prevention Learning Collaborative: Key Accomplishments Since 2013, ASTHO has partnered with CDC to develop and sustain the HDSP Learning Collaborative, focused on improving rates of hypertension. In all, 36 participating states, territories, and freely associated states have implemented innovative strategies through systems, policy, and quality improvement processes. Historically, this learning collaborative—open to both states and islands—has focused on the design and implementation of hypertension control programs. In USAPIs, program efforts evolved to address and improve cardiovascular health more broadly. Although USAPIs workplans differ from each other, they all have advanced health equity by understanding community needs and adapting to health system capacity. Table-CMO Heart Disease Stroke Prevention in the Pacific Tools for Change/Spotlight-CMO Heart Disease Stroke Prevention in the Pacific website yes