Disparities in cardiovascular care: Past, present, and solutions

Abstract

Cardiovascular disease has been the leading cause of death in the United States since the early 20th century. With advances in prevention and treatment, cardiovascular mortality rates are on the decline. Nevertheless, disparities in care persist, with devastating impact in select populations in the United States. This paper reviews the impact of disparate care on risk-factor burden, coronary artery disease, heart failure, and cardiovascular research.

Racial disparities and cardiovascular disease: One size fits all approach?

“…African Americans and Hispanic Americans account for 13% and 16% of the US population, however, the racial subgroups only contribute to 9% of the physician populace. Due to the underrepresentation in the workforce, African Americans and Hispanic Americans are more likely to be treated by physicians from different ethnic/racial backgrounds compared to Whites 8 . Evidence from a comprehensive review supports patient‐provider race‐concordance and its association with positive health outcomes in minorities 81 .…”

“…Due to the underrepresentation in the workforce, African Americans and Hispanic Americans are more likely to be treated by physicians from different ethnic/racial backgrounds compared to Whites. 8 Evidence from a comprehensive review supports patient-provider race-concordance and its association with positive health outcomes in minorities. 81 Similarly, medical education programs can greatly benefit the cultural competence of physicians, helping them acquire skills to interact with the marginalized patient groups, subsequently contributing to the elimination of health disparities.…”

“…Underrepresentation in medical research has far‐reaching implications, that significantly contribute to healthcare disparities. As the nation's population begins to grow, with an increasingly diverse and multicultural patient base, clinical studies have to incorporate other racial subgroups, such as Asian American cohorts, to better reflect CVD trends in the general population, which will enable generalizability of results to minority subgroups 8 …”

“…As the nation's population begins to grow, with an increasingly diverse and multicultural patient base, clinical studies have to incorporate other racial subgroups, such as Asian American cohorts, to better reflect CVD trends in the general population, which will enable generalizability of results to minority subgroups. 8 A prospective, observational study assessed those at risk for or with the atherothrombotic disease (CAD, PAD, and CVD) from seven racial/ethnic subgroups A 2-year follow up highlighted that Blacks had the highest cardiovascular mortality, and Asians had the lowest cardiovascular mortality. The study, however, does not define the underlying aetiologies (social, environmental, and cultural factors) amongst the ethnic subgroups, and their contribution to the cardiovascular outcomes, which could be a potential prospect for future research.…”

Sex-related Disparities in Access of Patients with STEMI to PCI Hospitals in Brazil: The Contribution of Blinder–Oaxaca Decomposition Method

“…Disparities in cardiovascular disease management present a unique challenge, even in developed countries. It may be due to access-related factors, appropriateness of interventions, socioeconomic status and sex, among others (Leifheit-Limson et al, 2015; Shiroma & Lee, 2010; Youmans, Hastings-Spaine, Princewill, Shobayo, & Okwuosa, 2019).…”