Strategic directions established by Heart & Stroke will guide the organization’s work through 2025. CEO Yves Savoie explains what’s at stake and why focus is critical to deliver results.
What is the strategy all about?
It’s about increasing our impact on the lives of people in Canada. That means improving quality of life for people who live with cardiovascular disease, reducing risk factors upstream, and eventually also lengthening life, reducing mortality.
We know a lot about what needs to be done. The title of the strategic plan, From Knowledge to Action, reflects the need to translate and apply some of that evidence – in the healthcare system, in policies, and in the choices we make as individuals and families.
To do this we are focusing in two areas that are real sweet spots.
One is the business of translating research evidence into benefits for people. It’s about implementing change to deliver real, concrete steps that improve our lives.
The other is a focus on change at the system-wide level, meaning changes that have a leverage effect. You know when you’re moving a big rock in the garden, sometimes you use a piece of plywood to put your weight behind it. You create a lever that helps you move something that you couldn’t move directly.
That leverage effect is what we seek, by focusing our energies on ways that double the impact.
Take vaping as an example. As parents, we can have conversations with our teenagers; that would have a certain impact.
But ensuring that convenience stores can’t advertise or promote vaping products at the cash – that would have a larger impact because it would be systemic.
This has actually been an area of strength for Heart & Stroke for many decades. But in the strategic choices that we are making as part of this plan, a focus on systemic change has been prioritized over initiatives at the individual level.
What is the biggest challenge facing Heart & Stroke over the next 10 years?
There are worrying signs in terms of the modifiable risk factors for disease — things like what we eat and how much weight we carry around the waist. With smoking, the recent data is alarming. It is reversing a 30-year trend.
These are big, big challenges that have many factors. They point to a future where people, including young adults, are being diagnosed earlier with type 2 diabetes, high blood pressure and high cholesterol. And this in turn points to more cardiovascular disease earlier in people’s lives.
That’s the biggest challenge no doubt.
As for the biggest organizational challenge, that would be capturing the generosity of Canadians in different ways.
Canadians are generous, but to get their attention and to cement their loyalty, we need to offer them a really clear understanding of how their engagement leads to concrete outcomes. That requires communicating and engaging people in different ways.
One example is our group of Heart & Stroke Young Leaders in the Toronto area. They’ve come together to learn, to mobilize each other, to raise money, and they have done it on their terms. That’s a really good illustration of our success.
I also think we can do better in anticipating people’s preferences. Take a donor who is contributing to Jump Rope for Heart because they have kids in elementary school. How do we accompany this person to the next stage of their life, and see their engagement grow? That challenge is a real one.
How will Heart & Stroke tackle these challenges?
There are two things that I find particularly exciting and that have broad relevance.
One is that we live in a time of digital transformation. This is making it possible for people to have access to information in ways that were never possible before.
We know that when people with chronic disease are well informed and are real partners with their health professionals, their health outcomes are better.
For example, take our powerful campaign to bring attention to the inequities in women’s heart health. We’re sharing the fact that women can experience the signs of heart attack very differently from men. A physician who recognizes the male signs of a heart attack might not see those signs in a woman. But now, the woman herself has the information to raise that possibility.
The challenge is that there’s a lot of information that is not particularly good. That’s an opportunity for Heart & Stroke because we are well recognized and we can help make sense of that jungle.
I’m also really excited about the work that we have done over the past 18 months to clarify the big opportunities for significant advances in people’s health, as we look to the research agenda for the next 10 years.
That clarity has come from a conversation with both scientists and people who have been touched by cardiovascular disease. And that for me makes it very exciting.
Heart & Stroke can influence the quality of clinical practice, policies and care across the country.
How did people living with disease help set research priorities?
The evidence is pretty clear that you improve outcomes when you engage patients at every level in the healthcare system.
That belief anchored an approach we designed to gather more than 100 people in a co-leadership model. So the co-leaders were scientists on the one hand, and on the other, people whose expertise draws every day from living with cardiovascular disease — either themselves or in a loved one.
The energy that came out of that process was just fantastic. People were respectful of these different domains of expertise. At what it gives us is a set of priorities that are tested for scientific feasibility, but also for relevance to people’s lives.
“Equity matters” is one of the new strategic directions for Heart & Stroke. What does this mean?
Health equity reflects the observation that some people have cardiovascular health outcomes (such as quality of life and mortality) that are much lower than the average, for reasons of bias or unfairness.
One example — a galling one — is that Indigenous people in Canada are up to twice as likely to develop heart disease compared to the general population.
The reasons for that have to do with systems, choices and policies. People who are Indigenous have less access to good food and much less access to healthcare services, even in urban centres. That inequity compels us to act.
Another example: women in Canada are 50% less likely than men to complete a course of cardiac rehabilitation after a heart attack. Yet we know that people who complete cardiac rehab are less likely to have a second heart attack.
These issues are and must be a priority for Heart & Stroke. They are complex. And it is important with humility to acknowledge that we are not the only actor in this space.
Addressing these issues will require big system changes. One example is something Heart & Stroke has already put in place: When we fund research, we now require the researchers to show that their conclusions can be generalized to both males and females. And Canada’s largest funder of health research, the federal government, has also made that choice.
Heart & Stroke has also funded two research chairs focusing on cardiovascular disease among Indigenous women. And we continue to build partnerships to further our commitment to responding to the Truth and Reconciliation Commission of Canada Calls to Action.
Changes like this are important stepping stones in repairing health inequities.
Why should people in Canada support Heart & Stroke?
For many people, including myself, being a donor to Heart & Stroke is a way of honouring the memory of cherished family members or friends, while also building a better future for people we love.
But there is more to the story. One of the dramatic changes happening in Canada today is that a lot of people are living in the community at home, and wanting to live at home, with relatively complex health conditions, including cardiovascular disease.
As an organization that has a view of the entire landscape, Heart & Stroke can influence the quality of clinical practice, policies and care across vast regions of the country. That influence will help more people in Canada experience optimal health living in the community.
That is a very compelling reason why people are drawn to Heart & Stroke.