March 2017
The Quarterly Newsletter of the HHQI Underserved Populations (UP) Network


Quarterly UP Network Webinar | April 20, 2017 | 2-4pm ET
Patient Safety: All in a Day's Work!

During this webinar from the Home Health Quality Improvement National Campaign 
(HHQI), you will learn how to begin preparing a Quality Assurance & Performance  Improvement (QAPI) plan related to patient safety that will be required by all home health agencies under CMS' new Home Health Conditions of Participation (CoP).

Click here for more information or to register.

Guest Speaker: 
Tina Hilmas, RN, BSN, CCPS
Assistant Vice President, Center for Patient Safety
Now Available: January 2017 UP Network Webinar Recording

 Check out the Value of Home & Community-Based Services UP webinar recording. The free nursing continuing education credits are still available with the recording in HHQI University.
Save the Dates: 2017 UP Network Webinars

All webinars will be held from 2-3pm ET.  As soon as more details are available, they will be accessible via the UP page on the HHQI website and emailed directly to those who are subscribed to our  UPDate and Educational & Networking Opportunities mailing lists .

July 20:
Topic TBD
October 19:
Topic TBD


Heart disease remains the leading cause of death in the U.S. and stroke (cerebrovascular disease) is the fourth leading cause of death ( CDC, 2015). Over the last 14 years, there has been a decline but the rates have plateaued over the last several years.

Unfortunately, racial/ethnic population disparities continue especially for African American populations ( Sidney, et. al., 2016).

Dr. Janet Wright's (Executive Director of Million Hearts®) recent Million Hearts® 2022 presentation highlights the variances with disparities. One disparate cardiovascular health area is the prevalence of hypertension. Non-Hispanic black population's hypertension rate is 7% higher than the rates for Non-Hispanic white populations (NHANES 2013-2014). Hypertension control is only at 54% overall with great variances with racial/ethnic populations (NHANES 2013-2014).
  • Non-Hispanic white population (57.4%)
  • Hispanic population (47.7%)
  • Non-Hispanic black population (46.3%)
  • Non-Hispanic Asian population (41.5%)
Physical inactivity effects not only cardiovascular health (CVH) risk but many other chronic diseases such as diabetes. CVH disparities persist with both Non-Hispanic black and Hispanic populations (NHANES 2013-2014).

Million Hearts® 2022 will focus on reaching more people within the community settings including home health. There will also be a focus on improving outcomes for priority populations including:
  • Black/African Americans
  • 35-64 year olds
  • People who have had a heart attack or stroke
  • People with mental illness or substance use disorders
Gender CVH differences are also evident. Women have lower rates of CVD through menopause, but the rates then approach being the same for men and women. A study by McSweeney, et al. (2010) concludes that significant racial differences exist in prodromal (early symptoms) and acute myocardial infarction (AMI) symptoms reported by women. Ninety-six percent (96%) of all women reports prodromal symptoms prior to an AMI. The authors also conclude that the women's descriptions of coronary heart disease and AMI symptoms should assist providers in interpreting women's symptoms (McSweeney, 2010).



  • Cardiovascular Health for At-Risk Populations Focused BPIP
    • Information and resources related to racial/ethnic populations, gender, regional differences, and effects of low health literacy and cardiovascular health (pp. 5-17)
    • Discipline Actions including home health aides (pp. 22-27)
    • Leadership Actions (pp. 27-28)
    • Resources for at-risk populations (pp. 28-32)
    • Visit the BPIP webpage for additional resources
  • HHQI Cardiovascular Health (CVH) Patient and Clinician videos
    • Short videos to assist with education on a variety of CVH topics
    • Available on YouTube or available on HHQI website in the Complete Resource Library (filter by Topic: Cardiovascular Health (any/all topics) and Material Type: Video)
    • Race and Ethnicity Cardiovascular Factors (Clinician video)
Additional Resources
For more information or to suggest future UP topics or speakers,  please contact us at Visit our website t learn more about  HHQI .

This material was prepared by Quality Insights, the Medicare Quality Innovation Network-Quality 

Improvement Organization supporting the Home Health Quality Improvement National Campaign, 

under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. 

Department of Health and Human Services. The views presented do not necessarily reflect CMS policy. 

Publication number 11SOW-WV-HH-ADL-031717