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Abstract Cardiovascular disease is the leading cause of death in the United States; it is also a major factor in rising health care costs. Risk factors for the disease are present in childhood, at the time when lifelong health habits are forming. Thus, strategies for improving the cardiovascular health of children through programs and policy may be expected to have a maximum effect. The cardiovascular health in children study identified the prevalence of cardiovascular risk factors in 2209 children age 8 to 11 years, attending 21 rural and urban public schools in North Carolina. Schools were randomly selected from three regions of the state (coastal, piedmont, mountain) in which the frequency of cardiovascular disease differs. Initial results of the study demonstrate the use of such findings in formulating health policy and in designing intervention programs.