A Nickel For Prevention?
John M. Clymer, Executive Director
The nearly simultaneous release this month of the 2013 County Health Rankings and the American Heart Association Guide for Improving Cardiovascular Health at the Community Level, 2013 Update draw attention to an important fact: Many of the highest impact and most cost-effective ways to prevent heart disease and stroke are policies and environmental changes. They can be grouped together under the heading, “Making healthy choices easier choices”.
In a nation where 95 cents of every dollar spent on health goes to diagnose and treat disease – leaving only a nickel or less for prevention – it is counterintuitive that the most powerful heart disease-preventing interventions largely happen outside of clinical settings. However, it has become increasingly well-known that we can significantly reduce the risk of heart disease and stroke by making it easier for people to walk to school, work, and stores; eat healthier foods; and to quit smoking; as well as by making it difficult for young people to get hooked on tobacco. Places where it is easier for people to make healthy choices tend to rank higher in the County Health Rankings.
The AHA Community Guide, co-authored by National Forum members Tom Pearson, James Galloway, David Goff, and Darwin Labarthe, points out, “According to the World Health Organization, policy and other environmental changes may bring about major reductions in CVD burden in all countries for less than $1 per person per year, whereas costs of individual counseling, drug, or surgical approaches are at least several-fold higher.”
Members of the National Forum understand this fundamental fact and, through the National Forum, work in concert to inform opinion leaders, policy makers, and the public. If you are already involved with one of the National Forum’s priority teams, thank you. If you are not yet involved, the door is open. I urge you to contact Julie Harvill,Benn Grover or myself to find out how you can play a role in our efforts to reduce cardiovascular health disparities and achieve health equity, help Americans achieve healthier dietary sodium levels, and assemble a comprehensive national heart health monitoring system.
Mark Your Calendars: National Forum’s 2013 Annual Meeting
The National Forum’s 11th annual meeting will take place on Wednesday, October 9, 2013 at the Barbara Jordan Conference Center (Kaiser Family Foundation) in Washington, DC. The Annual Business and Board of Directors meetings will take place on October 10, 2013.
Members Needed For Annual Meeting Planning Committee We are looking for National Forum members to serve on the Planning Committee for the Annual Meeting. We are striving for multi-sector representation on the Committee with around 10 members. If you are interested in joining the Planning Committee, please contact
National Forum News
New Website Address
That National Forum updated its website address to
www.nationalforum.org. Please update your bookmarks! The former address (www.hearthealthystrokefree.org) will now redirect to the new one.
National Forum Welcomes New Members
In February, The National Forum welcomed its two newest members: the Alliance for Aging Research and the American Medical Group Foundation. We look forward to the expertise, support, and collaborative leadership these organizations will bring to the National Forum. We are pleased to introduce the National Forum’s two newest members: the Alliance for Aging Research and the American Medical Group Foundation. The National Forum now includes more than 65 member organizations.
The Alliance for Aging Research is the nation’s leading non-profit organization dedicated to supporting and accelerating the pace of medical discoveries to vastly improve the universal human experience of aging and health. Their National Forum delegate is Lindsay Clarke, Director of Health Programs.
The American Medical Group Foundation’s mission is to foster quality improvement in group practice through education and research programs in clinical quality, patient safety, service, operational efficiency and innovation. Their National Forum delegate is Jerry Penso, MD, MBA, Medical Director and Chief Quality Officer.
We look forward to the expertise, support, and collaborative leadership the Alliance for Aging Research and the American Medical Group Foundation will bring to the National Forum. Please join me in welcoming our newest members. Together we are building a collective voice for heart disease and stroke prevention in the United States and throughout the world.
For a full list of National Forum members, click here.
How Can The Policy Depot Help Your Organization?
Are you a member of the Policy Depot? If not, find out what everyone is talking about. It’s free, easy, and fast to sign up. We are exploring ways the Policy Depot can extend the range and impact of the work by National Forum member organizations. If you think the Policy Depot could be useful to your organization, please contact
The National Forum Health Equity Advisory Committee has a teleconference meeting on April 24th at 2-3PM ET. If you would like to participate in the meeting, or if you are interested in joining the Advisory Committee, please contact Julie Harvill.
Surveillance The National Forum Surveillance Team will participate in the June NHLBI Data Stakeholders Meeting in Washington, DC. Steve Sidney, Surveillance Team Chair, will lead the NHLBI meeting, and the National Forum Surveillance Team will play an active role by providing leadership on the Surveillance Strategic Priority. If you would like to learn more about the Surveillance Team, or to get involved, please contact Franz Fanuka.
Winner Of Million Hearts Risk Check Challenge Competition Announced
[From the HHS website] “A free, easy-to-use mobile application that helps people prevent heart disease is now available through iTunes. The app, created by the Marshfield Clinic Research Foundation as part of a nationwide competition, was announced today by Farzad Mostashari, M.D., the National Coordinator for health information technology, and Janet Wright, M.D., the Executive Director of the Million Hearts initiative. Launched in support of Million Hearts, the competition received submissions by more than 35 entrants…” The Marshfield Clinic Research Foundation has created an app to give people easy access to some of the most advanced health care analytics available to learn the factors that put them at risk for heart attacks and how to prevent them,” Dr. Mostashari said. “People can now get information about their risk and share what they know with their doctor to better manage their heart health.”
Marshfield Clinic Research Foundation’s winning mobile application, Heart Health Mobile, provides information about a person’s risk for heart disease based on answers to questions about height, weight, cholesterol levels and blood pressure, diabetes, and smoking status. In areas with participating pharmacies and other retail clinics, the app steers users to convenient locations for cholesterol and blood-pressure screening. A feature that tracks users’ histories allows people to easily see if they have made progress as they work to lose weight or lower cholesterol and blood pressure levels.
Heart Health Mobile offers both a traditional version of the app and one that incorporates a game. Users who play the game earn points for completed tasks and awards for tracking their heart health and reaching their targets.
“The goal was to develop an app that helps Americans take simple steps to prevent heart disease, which is responsible for one in every three deaths in the U.S. Heart Health Mobile is simple and fun to use, and we hope will help people lead healthier lives,” said Simon M. Lin, M.D., app project leader and director of the Biomedical Informatics Research Center at Marshfield Clinic Research Foundation. “As health care moves rapidly toward preventing disease, technology such as Heart Health Mobile can help people take charge of their health.”
In support of Million Hearts and Heart Health Mobile, the cities of Baltimore, Chicago, and Tulsa, as well as Philadelphia and San Diego counties are encouraging residents to get cholesterol and blood pressure screenings, better understand their risk for heart attack and stroke, and take steps to improve it. Working with partners in their communities, these cities will encourage use of the app through a variety of ways, including print advertising; grassroots, community-based events; and other activities. Participating pharmacies in those communities will offer screenings and help patients communicate the results to their physician or other health care professional when follow-up is needed. Thousands of pharmacies and retail clinics across the U.S. are currently connected to the Heart Health Mobile application through the Surescripts network, including CVS Caremark Minute Clinics, and select Walgreens, H-E-B, and Thrifty White locations. Subsequent versions of the app will include additional locations.
“The development and launch of the Heart Health Mobile app is the kind of powerful partnership to reduce heart attacks and strokes that we want to see more of,” said Janet Wright, M.D., executive director of Million Hearts. “The combined commitment and expertise of these technology, pharmacy, and community leaders has produced an easy-to-use tool that will help people take control of their heart health—and help us keep a million more hearts beating strong.”
Heart Health Mobile uses Archimedes Inc.’s IndiGO tool to analyze the information a person enters into the app, calculating the individual’s heart disease risk and improvement over time. The app works on Apple iOS tablets, iPhones, and iPod Touch devices and can be downloaded free of charge from http://www.hearthealthmobile.com/ . Marshfield Clinic Research Foundation will release in March a web-based (HTML5) responsive design version that works on other devices.
For more information the about the winners of the app challenge please visit http://millionhearts.hhs.gov.
Is your organization a Million Hearts partner? To learn more about becoming a partner, please contact John Clymer.
The National Forum Member Spotlight for March is on the Alliance for Aging Research and its atrial fibrillation advocacy work.
People with atrial fibrillation (Afib) are at a greater risk of stroke: Around 15% of all strokes are in people with Afib. Although anticoagulant medications can reduce the risk of stroke, they also can cause a risk of internal bleeding. As people age, their risks of stroke and internal bleeding increase.
“We found there is a lot of confusion among healthcare providers when it comes to treating older patients with Afib,” said Cynthia Bens, Vice President of Public Policy for the Alliance for Aging Research. “Providers may be worried about their older patients having internal bleeding if put on a treatment for Afib, but they need to consider that person’s increased risk of stroke and be able to weigh the benefits and risks of treatment effectively. We need more clarity on how healthcare providers approach stroke risk and bleeding risk and how they discuss treatment choices with their patients.”
Tools exist to support physicians in calculating a patient’s stroke risk and bleeding risk, but they can be complicated and do not sensitively address risk factors for bleeding associated with aging. To help ensure that both healthcare providers and patients are more informed about proper Afib treatment, the Alliance for Aging Research formed the Afib Optimal Treatment Task Force in 2011.
The Task Force pushes for more predictive risk assessment tools to help determine appropriate treatment of Afib and helps form consensus on what the process for optimal treatment should be using existing tools, until new tools are available.
The Task Force recently published “Effectively Assessing Stroke and Bleeding Risk In Anticoagulation Decision-Making”, a whitepaper that highlights the impact of Afib, its risk factors and treatment options, and current stroke and bleeding risk assessment tools. It also includes a consensus statement on how to approach treatment. “It is important for physicians to have balanced discussions with patients about the benefits and drawbacks of Afib treatments and their risk of stroke,” said Ms. Bens. The Alliance also recently updated their Silver Book on Thrombosis, a one-stop shop for facts, statistics, and data on Afib (and a host of other non-communicable diseases) in older patients.
In January of 2012, the Alliance brought together stakeholders to discuss current best practices on Afib treatment. “Although there is growing consensus on stroke risk assessment in Afib patients, that is not the case with bleeding risk assessment,” said Ms. Bens. “As new products and innovations come to market, we need to push for guidelines that ensure healthcare providers can properly assess and manage all risks associated with Afib in older patients.” Many of these themes were echoed during the American College of Cardiology’s Scientific Session in San Francisco in March 2013.
Changing how healthcare providers and patients approach Afib and its associated risks are only one way the Alliance is bringing attention to issues around healthy aging. “As a group who cares about aging people, we need to move the needle on the way older people are treated in our healthcare system,” said Ms. Bens.
Does your organization have news updates that you would like to share with leading national and international cardiovascular health organizations?
World Health Day 2013: Control Your Blood Pressure On April 7, 2013, individuals and organizations throughout the world will celebrate World Health Day. The theme for this year is high blood pressure. High blood pressure affects one in three adults worldwide and it leads to more than nine million deaths each year. (Click here to learn more about high blood pressure or to access World Health Day campaigns kits)
AHA Publishes Guide on Community Level Prevention Recommendations The American Heart Association published a 2013 update to its 2003 Guide for Improving Cardiovascular Health at the Community Level. The updated guide provides a comprehensive catalog of community level evidence-based goals, strategies, and recommendations for cardiovascular disease and stroke prevention. National Forum members Tom Pearson, James Galloway, David Goff, and Darwin Labarthe are among the guide’s coauthors. (Click here to access the updated guide)
Barbara Bowman Appointed Director of the CDC’s Division for Heart Disease and Stroke Prevention Dr. Barbara Bowman is now the permanent Director of the Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention. Since 2004, Dr. Bowman has served as the Associate Director for Science for CDC’s National Center for Chronic Disease Prevention and Health Promotion.
NYC Officials Announce Results of National Sodium Reduction Effort in Pre-Packaged Food [From New York City’s website] “Mayor Michael R. Bloomberg, Deputy Mayor for Health and Human Services Linda I. Gibbs and Health Commissioner Thomas A. Farley…announced 21 companies met one or more of their voluntary commitments to reduce sodium content in pre-packaged or restaurant foods. The sodium reduction targets were set by the National Salt Reduction Initiative – a partnership announced by Mayor Bloomberg in 2008, which is the first-ever nationwide partnership to reduce sodium in the U.S. food supply. These achievements demonstrate that food companies can make important, measureable improvements to the healthfulness of the foods that will appear on shelves across the United States. Most salt in the diet of Americans – nearly 80 percent – comes from packaged or restaurant foods, not table salt or home cooking, making it challenging for any individual to monitor sodium intake, and choose to decrease sodium intake. Approximately, 90 percent of Americans consume too much sodium, much of which comes from foods that do not always taste salty, such as bread, cold-cuts, cookies or tomato sauce. Cutting salt intake lowers blood pressure, a major preventable risk factor for heart disease and stroke, two of the leading causes of death in the United States. Researchers have estimated that reducing daily sodium intake by 1,200 milligrams can prevent up to 92,000 deaths and save up to $24 billion in health care costs each year. The Mayor made the announcement at City Hall where he was joined by by Russ Moroz, Kraft Foods Vice-President of Research, Development and Quality; Douglas Balentine, Unilever Director of Nutrition and Health; Vincent Unanue, Goya Foods Category Manager; Charles Bell, Consumers Union Programs Director; Laura Wilson, Mondelēz International Director of Scientific and Regulatory Affairs/Nutrition; Kevin Kane, Subway Public Relations Manager; John Leeman, Fresh Direct Chief Marketing Officer; and Jocelyn Paal, LiDestri Foods/Francesco Rinaldi Marketing Manager.
“Prior to our National Salt Reduction Initiative, there was no comprehensive approach to lowering sodium in foods, and many questioned whether companies would step up to meet a voluntary pledge,” said Mayor Bloomberg. “These companies have demonstrated their commitment to removing excess sodium from their products and to working with public health authorities toward a shared goal – helping their customers lead longer, healthier lives.”
“For those who are watching their sodium intake, the hidden salt in packaged foods – particularly in items that don’t even taste salty – can be a real challenge,” said Deputy Mayor Gibbs. “This initiative, and industries’ active and willing participation, can give consumers reassurance that some companies are taking active steps to remove excess sodium from their products.”
“I congratulate these companies for taking steps to make it easier for their customers to eat products with healthier levels of sodium,” said Health Commissioner Thomas Farley. “We set a high bar in New York City and I’m pleased to recognize these food company leaders that met or exceeded the NSRI targets.”
“Many Americans are interested in reducing their sodium intake, so we’ve been working to lower sodium levels in our products for several years,” said Russ Moroz, Kraft’s Vice President of Research, Development & Quality. “In fact, we recently announced the completion of our own three-year commitment to reduce sodium across our portfolio by an average of 10 percent.”
“Unilever agreed to participate in the National Salt Reduction Initiative as part of Unilever’s global salt reduction initiatives to reduce sodium across our foods and refreshment portfolio that started in 2004,” said Douglas Balentine, Director of Nutrition and Health at Unilever.
“We are very proud of the significant reductions we’ve made to the sodium levels of our menu offerings, which we have been able to do without sacrificing flavor or quality,” said Lanette Kovachi, Senior Dietitian for the SUBWAY® brand. “Last year, as a result of meeting a set of rigorous criteria including our sodium reduction efforts, the SUBWAY® restaurant chain became the first restaurant with meals to earn the American Heart Association’s Heart-Check Meal Certification. We have made a commitment to reduce sodium in all of our products and we expect to announce even more sodium reductions later this year. We are particularly pleased with our association with the New York City Department of Health and Mental Hygiene and the National Salt Reduction Initiative, which we view as a valuable partner as we pursue our goals in this area.”
“As a participant in the National Salt Reduction Initiative, Heinz reduced sodium across our U.S. Ketchup base product line by 15 percent to exceed the 2012 NSRI targets,” said Idamarie Laquatra, PhD, RD, Director of Global Nutrition, H.J. Heinz Company. “Our complete line of Classico red pasta sauces met the 2012 NSRI targets before the initiative was even launched, and Heinz has voluntarily reduced sodium in other brands in recent years. Reflecting our dedication to health and wellness, Heinz remains committed to reducing sodium across our portfolio as we look to meet or exceed the 2014 NSRI targets where feasible, while offering products that meet consumer expectations for quality and taste, as well as high food safety standards.”
“These brands, and the executives leading them, have stepped forward to help address one of the most significant public health threats in our food supply today,” said Nancy Brown, CEO of the American Heart Association. “Furthermore, these industry leaders have set the stage for all other food and beverage companies and outlets to make sodium reduction a priority.”
“The NSRI is a nationwide partnership of more than 90 city and state health authorities and organizations coordinated by New York City since 2009. The NSRI’s goal is to cut excess salt in packaged and restaurant foods by 25 percent over five years through voluntary corporate commitments – an achievement that would reduce the nation’s sodium intake by 20 percent.”
“Some of the nation’s food industry leaders have made great strides to cut sodium in their products. For example, sodium in Nabisco’s Teddy Grahams Honey flavor graham snacks made by Mondelēz International, the global snacking company formed following the spin-off of Kraft Foods Inc., was reduced 33 percent from 150 mg to 100 mg per serving. The sodium in Kraft Singles American Slices has been reduced by 18 percent per serving. Unilever, the company that makes Ragu pasta sauce, announced that it reduced the sodium in its Ragu Old World Style Traditional Tomato Sauce by 20 percent per serving.”
“As part of its efforts to lower sodium, restaurant chain Subway reduced sodium in two of the restaurant’s most popular sandwiches: the sodium in the Subway Club has been reduced by 32 percent per serving and the Italian B.M.T. sandwich now contains 27 percent less sodium.”
“The food manufacturers that met 2012 NSRI sodium targets are: Butterball, Furmano Foods, Goya Foods, Heinz, Ken’s Foods, Kraft Foods, LiDestri Foods/Francesco Rinaldi, Mars Foods US, McCain Foods, Mondelēz International, Red Gold, Snyder’s-Lance, Unilever and White Rose. Restaurant chains include Au Bon Pain, Starbucks, Subway, and Uno’s Chicago Grill. Food retailers that met 2012 NSRI sodium targets include Delhaize America, Fresh Direct, and Target Corporation.”
“The NSRI has received extensive support from philanthropists and donors, including the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention, the W.K. Kellogg Foundation, Robert Wood Johnson Foundation, the New York State Health Foundation, the National Association of County & City Health Officials. This funding is administered by the Fund for Public Health in New York, a private non-profit organization that supports innovative initiatives of the New York City Department of Health and Mental Hygiene. Companies interested in joining this initiative and committing to 2014 targets can find more information at nyc.gov.”
Marc La Vorgna/Samantha Levine (212) 788-2958
Veronica Lewin (Health) (347) 396-4177
Key Observations from the World Economic Forum Richard Edelman, President and CEO of Edelman, recently shared his thoughts on the 2013 World Economic Forum annual meeting in his weekly blog, 6 A.M. “Health initiatives need to be localized,” Mr. Edelman wrote about non-communicable diseases. “There should be public-private partnership, with health insurers working together with corporate customers to encourage healthy behaviors through pricing.”
“Here are my impressions of the four days:
1. Environment at Tipping Point — The feedback loop on environment is now firmly set, with change accelerating. Fred Krupp of Environmental Defense Fund predicted the polar ice cap will have melted by summer, 2030. In the developed world, CO2 from livestock now equals that produced by cars. 75 percent of fish in the seas proximate to Europe are endangered. Companies are moving from focusing on the supply side (packaging, concentrates) to the demand side (altering consumer behavior) by use of QR codes to prove point of origin. The key challenge: 70 percent of consumers say they will buy sustainable products, but only 17 percent actually do.
2. Non-Communicable Disease Epidemic — The new focus for health officials is obesity, diabetes and other preventable diseases. As Linda Fried of Columbia University’s Mailman School of Public Health noted, 70 percent of health work must happen outside of the health care system. Health initiatives need to be localized. There should be public-private partnership, with health insurers working together with corporate customers to encourage healthy behaviors through pricing. The problem is that developing nations prefer to put their capital to work on infrastructure than to pay for health care.
3. Aging — Japan is the only nation that has 30 percent of the population over 60 years old today. That picture will change radically by 2040, when nations such as China, Chile, Vietnam and all of the European nations will have the same aging population. This will require a fundamental shift in retirement age, with older workers accepting a longer working life and likelihood of lower wages at the end of a career. We are moving toward a “life continuum,” with less structure around education, work and retirement.
4. The European Debate — Prior to Davos, UK Prime Minister David Cameron gave a speech promising to address the issue of continued participation in the European Union to the voters in 2018. He continued at Davos, bluntly asserting that Europe “was being out-competed and out-innovated.” The Prime Minister of Italy, Mario Monti, countered, “Eventually the Confederation of British Industry and other UK groups will support the EU. We want British state of mind without its ideology.” A roundtable of prime ministers from Holland, Denmark and Ireland concluded that “we must fix the labor market rigidities, reduce the power of local insiders by de-regulating and opening the markets.”
5. China and the World — At a CCTV panel, former Australian Prime Minister Kevin Rudd suggested China had been inwardly focused for the past 20 years, raising an unprecedented 600 million people out of poverty. “But the world now wants to know how China is going to do given its great power position.” The Chinese corporate sector is looking outwards, as evidenced by the rise in outbound investment from $3 billion in 2002 to $80 billion in 2012. China also has several other challenges to face: Chinese manufacturers are being forced to focus on efficiency and quality due to competitiveness.
6. Nigeria and South Africa — Both President Goodluck Jonathan and President Jacob Zuma described investment opportunities in their nations saying that “our laws are business friendly. There is no restriction on the inward or outward flow of money.” Zuma noted that “The African National Congress (ruling party) has created certainty for policy by having a National Development Plan to emphasize tourism, agriculture, manufacturing and shale gas.” Jonathan said that Nigeria and fellow African states are now “stable politically.” Adding, “We need a private sector perspective. We want the private sector to help us to improve our airports, our roads.”
7. Russia — A panel of former government officials and academics concluded that the rising middle class will demand reforms. Former finance minister Alexei Kudrin said, “The negative signals are significant. The low level of growth and failure to overhaul institutions, in the context of weak oil prices, could jeopardize the public budget.” Professor Sergei Guriev, professor of economics and rector at the New Economic School (NES) in Moscow, said, “More income is no longer enough for the people. They are too urban and sophisticated to postpone change any longer. Russia is unprecedented in its level of education for such a corrupt government.”
8. Religion and Democracy —I attended a fascinating panel discussion of religious leaders debating its proper role in a democratic society. On one side were those who felt religion was a barrier to rapid development. A female minister said, “Religion can have a positive role in the free marketplace of ideas, but not when government imposes religious doctrine.” Meanwhile, an Indian professor noted that his nation has rich cultural identity and a functioning democracy. He quoted Gandhi as saying, “The human mind is not divided into political, social and religious compartments. Religion harmonizes… it is ordered moral government of the universe.”
9. Banking — I went to a panel with CEOs of major banks, including Doug Flint, chairman of HSBC and Peter Sands, CEO of Standard Chartered. The consensus of these executives was that the crises of 2012 stemmed largely from “bad behavior and poor ethics.” Sands noted that his bank has instituted a dual track performance review, focused on financial results and on living the values, with equal weight on both elements. Both cited an email to staff this week by the new Barclays’ CEO, Antony Jenkins, in which he said that his team should buy into values of client service and decent behavior or leave the firm. The matter of compensation, amazingly, was left unnoticed until a question at the end by former Mexican President Ernesto Zedillo, who suggested that the bonus culture was at the core of banking’s problem.
10. The Economy — There was general agreement on the economic forecast for 2013, as one of slow and steady growth. The best performer among the BRIC nations will be China, around 8 percent, India around 5 percent and both Russia and Brazil mired in 1-2 percent growth. The U.S. is expected to have a better year, with low energy costs, reindustrialization and in-sourcing helping to boost employment. Europe is expected to be in a zero growth environment, with Germany at the high end, while Spain, Italy and France struggle to gain any forward progress.“
“Here are a few personal anecdotes to wrap up my report. The Edelman Trust Barometer, launched on the first day of the conference, provided fodder for a debate on Thursday. As a European regulator was thrashing technology industry leaders about privacy and security, one of the CEOs stood up and said, “According to the Edelman study, the tech industry has four times as much trust as you government bureaucrats. Why don’t you just sit down.”
“I was invited to lunch with New York Yankees star Derek Jeter. My favorite story was how, as captain, he dealt with trouble makers who put themselves before the team. “I watch how they treat the locker room attendants and waiters at restaurants. I have learned to listen, to get their side of the story. But in the end they get on board or go.” His most memorable moment as a Yankee: “I don’t dwell on my achievements. I am looking to see what’s next.” It is indeed time for modesty.”
Does your organization have upcoming events that you would like to share with leading national and international cardiovascular health organizations? Let us know.
The Global Health and Innovation Conference Unite for Sight April 13-14, 2013 New Haven, CT
World Health Care Congress World Congress April 8-10, 2013 National Harbor, Maryland
TEDMED 2013 TEDMED April 16-19, 2013 Washington, DC
EuroPRevent 2013 European Society of Cardiology April 18-20, 2013 Rome, Italy
Healthy Kids Day YMCA April 28, 2013 Nationwide
Prevention & Wellness Congress 3.0 World Congress May 8-9, 2013 San Diego, California
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