Please mind the gap: 3 cardiologists discuss disparities in heart care outcomes

Mackenzie Bean, Gabrielle Masson and Anuja Vaidya -

Three cardiology leaders discuss the gaps in heart care outcomes and what steps can be taken to address them.

Editor's note: Responses have been edited for clarity and length and are presented alphabetically.

Question: What are the biggest opportunities for addressing gaps in heart care outcomes? What are your organization's goals with regard to closing those gaps?

Vivian Mo, MD, CMO of USC Care Medical Group and cardiologist with Keck Medicine of USC in Los Angeles

Some of the things that are being done to close the gap are really trying to target, I would say, cultural and ethnic beliefs. So, for example, many African Americans live in large family communities, that is, many generations of a family living in the same household. They're very tight-knit, and a lot of times caretakers in those households tend to forgo their own care to take care of the elderly or the children. So, we see African Americans — and also in our Latin-American populations and Mexicans — because they have such a strong family network, they tend to put the healthcare needs of other family members before their own. That is why we see many of the ethnic minorities in this country seek healthcare out later.

Also, there is an educational component. A lot of times we inform our patients of the risk of having cardiovascular disease. We talk to them directly from physician to patient, and we also try and reach out to the community, doing screenings for high cholesterol, diabetes and hypertension. But I think just like there are food deserts where there aren't good grocery stores for people to go and get good produce; there are pockets of knowledge gaps.

So even in a large place like Los Angeles that has five major medical centers within 60 miles of each other, even in that setting, many in the population have never had the opportunity to get that kind of education, to get that kind of exposure as to what their healthcare risks are, and maybe learn that they should be screening themselves or going to a screening event.

Even before 2020, those kinds of gaps — societal, cultural, ethnic, educational gaps — have been long present.

Subha Raman, MD, vice president of IU Health Cardiovascular Services in Indianapolis

We see great opportunities at the interfaces of disciplines to address gaps in heart care outcomes. For instance, at the intersection between metabolism and heart health is an opportunity to reduce the burden of cardiometabolic risk. Patients with conditions like diabetes often have worse cardiovascular outcomes, and novel treatments for metabolic problems like diabetes can actually help improve outcomes for heart patients. We're also leveraging our statewide, 17-hospital health system to close gaps in delivering consistently high-quality heart and vascular care across urban, suburban and rural populations.

Annabelle Santos Volgman, MD, professor of medicine and senior attending physician at Rush Medical College and Rush University Medical Center in Chicago

We can decrease the healthcare disparity among ethnic groups and among African Americans by doing a few important things that aren't hard to do: making sure blood pressure and cholesterol levels are under control and educating everyone about the value of doing this to lower the risk of strokes, heart attacks, kidney failure and premature deaths. With these easy, preventive care steps, we can improve the health of our community and decrease morbidity and mortality. Building on the relationships Rush has forged on Chicago's West Side, we can reach our neighbors who are at risk of heart disease, stroke, diabetes and other serious health conditions.
Rush is working with other health systems, nonprofit organizations, government agencies, faith communities and residents. These efforts can close the 16-year gap between the life expectancy of our neighbors on Chicago's West Side with Chicagoans who live downtown, only 6 miles away. Rush's commitment to community health is demonstrated not only in our neighborhood clinics but also in our support of residents who do not have a home, who are suffering from addiction, mental health and trauma and those recently released from prison.

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