Posted on by Marc N. Katz

Racial Disparities in Treatment of Heart Failure

Given existing disparities in access to health care the growing burden of heart failure in the US could disproportionately impact the African-American and minority community (1). 

Regardless of race or ethnicity, patients with heart failure (HF) have better outcomes when cared for by cardiology specialists than other specialties (e.g. internal medicine) (2,3).

However, prior studies on patients admitted for decompensated heart failure found those with lower incomes or patients who were AA were ‘significantly less likely to receive cardiology care when compared with younger, Caucasian, and more educated patients. Even after adjusting for severity of illness, social factors were strongly associated with receiving care from a cardiologist’ (4). 

In a larger database study published in 2018 of over 100k patients including over 20k AAs the authors found that Caucasians were 40% more likely to receive cardiology care than AAs(5).

As an editorial commented ‘can we continue to blame the disparity in care to lack of access or insurability? Is it not time to consider preconceived notions of access and inherent, although unrecognized, racial bias and stereotyping that lead to racial health disparities?’ (5).

I won’t pretend to be an expert in racial issues or healthcare policy but it is evident that generations of racial and socioeconomic disparities manifest in poor health and that we must recognize and challenge our own bias both personally and professionally.

For now, you can also head to https://justiceforgeorgefloyd.com/ or sign a petition to help get #JusticeForGeorgeFloyd.

Works Cited

  1. Piña, I. (2018). If It Is Not Health Care Access or Insurance Coverage, Then Why Do Racial Disparities Persist?. JACC: Heart Failure, 6(5), 421-423. doi: 10.1016/j.jchf.2018.03.013
  2. Uthamalingam S., Kandala J., Selvaraj V., et al. (2015) Outcomes of patients with acute decompensated heart failure managed by cardiologists versus noncardiologists. Am J Cardiol 115:466–471.Google Scholar
  3. Selim A.M., Mazurek J.A., Iqbal M., Wang D., Negassa A., Zolty R. (2015) Mortality and readmission rates in patients hospitalized for acute decompensated heart failure: a comparison between cardiology and general-medicine service outcomes in an underserved population. Clin Cardiol 38:131–138.Google Scholar
  4. Auerbach A.D., Hamel M.B., Califf R.M., et al. (2000) Patient characteristics associated with care by a cardiologist among adults hospitalized with severe congestive heart failure. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. J Am Coll Cardiol 36:2119–2125.FREE Full TextGoogle Scholar
  5. Breathett K., Liu W.G., Allen L.A., et al. (2018) African Americans are less likely to receive care by a cardiologist during an intensive care unit admission for heart failure. J Am Coll Cardiol HF 6:413–420.Google Scholar