INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH AND ANALYSIS ISSN(print): 2643-9840, ISSN(online): 2643-9875 Volume 04 Issue 06 June 2021 DOI: 10.47191/ijmra/v4-i6-13, Impact Factor: 6.072 Page No.- 765-773 IJMRA, Volume 4 Issue 6 June 2021 www.ijmra.in Page 765 An Analysis of the Million Hearts Initiative utilizing the Centers for Disease Control and Prevention Policy Framework Christine Ku, MPH 1 , Shivaughn Hem-Lee-Forsyth, PhD, MPH 2 , Leselle Pierre, MSc 3 1 naviHealth, Brentwood, Tennessee 2-3 Department of Public Health and Preventive Medicine, School of Medicine, St. George’s University, Grenada. ABSTRACT: This policy analysis of the Million Hearts Initiative (MHI) intended to examine the extent to which the initiative met the policy process guidelines set forth by the Centers for Disease Control and Prevention (CDC). The three objectives were to identify which CDC policy process domains were met; to identify any gaps in implementing the CDC Policy domains; and finally, to determine if the MHI was successful in preventing 1 million heart attacks and strokes within 5 years. The CDC policy process includes five domains: problem identification, policy analysis, policy and strategy development, policy enactment, and policy implementation (1). Data was collected through the use of key words that subject matter experts utilize when describing cardiovascular disease (CVD) risks and peer-reviewed journal articles. Results showed that not all CDC domains were met and there were also gaps when implementing the MHI. KEYWORDS: Million Hearts Initiative, Centers for Disease Control and Prevention, heart attacks, strokes, policy analysis, public policy INTRODUCTION The National Heart, Lung, and Blood Institute defines cardiovascular disease (CVD) as a “disease that affect[s] the heart or blood vessels”, and includes heart attacks and strokes (2). Worldwide, there are approximately 17 million people who die of these diseases each year (3), and more than 2 million Americans who experience a heart attack or a stroke annually (4). Each year in the United States (U.S.), 800,000 individuals die of a heart attack or a stroke and 2,200 people die daily from a CVD (5). The Million Hearts Initiative is a crucial step in making a significant national impact in translating science into daily deliverables, preventing over 100,000 related cardiovascular events, and saving approximately 5.6 billion dollars in direct medical costs (31). In the U.S., the first and fourth leading causes of death are heart attacks and strokes, respectively (5). In 2011, heart attacks and strokes cost the nation approximately $316.6 billion in healthcare costs and decreased productivity (5). For those who suffer a stroke, it is the leading cause of long-term disability in adults, as approximately 30% of stroke survivors become permanently disabled (6). Although CVD affects millions of people each year, they are preventable and the MHI attempts to reduce both heart attacks and strokes among Americans. The MHI is the United States’ first nation-wide initiative, taking a comprehensive approach to health and the reduction of CVDs. Before 2011, there have been many attempts to help reduce CVDs. During the 20 th century, there were a number of hearthealth related declarations. The Victoria Declaration in 1992 asked “governments and the private sector to educate and coordinate public efforts” to slow the rate of heart disease and stroke (7). In 1996, the Catalonia Declaration focused on resources needed to invest in heart-health programs, and in 2001, the Osaka Declaration emphasized the importance of examining factors associated to CVD outside of the health sector (7). The public health sector of the 21 st century needed to broaden their partnerships into government, private and public sector education, culture, recreation, and agricultural domain (7), which is what the MHI strived to accomplish. Although these attempts were successful in their own ways, the comprehensive approach that the Million Hearts Initiative utilized was a key factor in making the initiative successful. With how the U.S. healthcare system is structured, it was imperative to include the collaborative efforts of both the private and public sector to outreach to all communities. The expertise of multiple stakeholders helped closed the gap that was experienced by the 20 th century heart-health related policies in order to implement a successful framework. The MHI was selected for analysis because it is a national, public- private partnership with the Center for Medicare and Medicaid Services (CMS), the largest contributor to health care, providing