by Elaine
Chen
Many Black
Americans would have to travel across county lines just to find an open spot
with a cardiologist, a new analysis found.
About 16.8
million Black Americans roughly 1 in 3 live in counties with little or no
access to heart specialists, according to a report from GoodRx, a digital
health company that provides drug discounts and also researches health trends.
When zooming
in on counties that have sizable Black populations, the analysts found that 72%
of these counties are “cardiology deserts,” most of them concentrated in
southeastern states.
The findings
illustrate the barriers to accessing care for a population that already faces a
disproportionate burden from cardiovascular disease. It’s the leading cause of
death in the U.S., and Black Americans face a 30% higher risk of death from
heart disease than white people.
“We’re
missing a huge chunk of individuals who really need this care and are having to
jump through massive hoops to access that care,” said Tori Marsh, director of
research at GoodRx. “When you have to jump through those hoops, you’re likely
not going to.”
The analysts
used data from Health Link Dimensions, a health data provider, to identify
cardiologists across the country, and then mapped their locations to find which
counties have cardiology deserts.
Prior research shows that counties with a high proportion of Black and Hispanic people already have less access to primary care doctors, often the first type of provider that people go to.
But even if patients are able to get
primary care, they would still need to see a cardiologist to address specific
or urgent issues like heart failure and heart attacks, said Rishi Wadhera, a
cardiologist at Beth Israel Deaconess Medical Center.
He noted
that the report doesn’t account for how much access to telehealth services
people have. But still, many services like cardiac stress tests can’t be
performed remotely, said Wadhera, who’s also the section head of health policy
and equity at the Smith Center for Outcomes Research.
The
researchers also analyzed what the risk of heart disease looked like for people
living in cardiology deserts. Using data on diabetes, obesity, smoking,
unhealthy diet, physical inactivity, and excessive alcohol consumption, the
researchers assigned a score of 0 to 6 to counties, with a higher number
meaning a greater risk of heart disease in that county.
Compared
with the national average of 2.9, the counties with sizable Black populations
that had little or no access to cardiologists had average scores of 3.6 and
4.5, respectively. That means the areas where heart specialists are most
difficult to reach are also where specialists may be most needed.
Wadhera said
to address these deserts, the federal government could strengthen incentives to
encourage medical graduates to pursue practice in communities that have less
access to specialists.
Utibe
Essien, an assistant professor of medicine at UCLA who researches health
disparities, noted that research shows Black patients fare better under
the care of Black doctors in particular, but there are also deep issues
affecting the supply of Black doctors.
In the
South, where most of the cardiology desserts have been identified, there are
likely greater disparities in wealth and educational opportunities, and thereby
more barriers for Black people to become doctors in their communities, he said.
“The regions that we’re missing a lot of cardiologists are in the South and are in states, cities that likely have high rates of segregation,” he said.
