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Geographic Disparities in Heart Care Access Highlighted by New Study

A new study reveals that where you live in the United States significantly impacts your access to care for heart problems, with nearly half of U.S. counties lacking a practicing cardiologist. This shortage correlates with poorer heart health in those areas.

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Published on July 8 in the Journal of the American College of Cardiology, the study found that over 46% of U.S. counties don’t have a single heart doctor, while counties with cardiologists have an average of 24 practicing within them. These underserved counties are predominantly rural and economically disadvantaged. Specifically, almost 9 in 10 rural counties (86%) are without a cardiologist.

Researchers discovered that counties without a heart doctor face a 31% higher risk of heart disease. They also contend with more prevalent risk factors such as diabetes, high blood pressure, elevated cholesterol, and smoking. Consequently, people in these areas are more likely to die from heart-related health problems and have a one-year shorter life expectancy on average.

"While cardiologists are not the only determinants of cardiovascular outcomes, the lack of access to cardiologists in areas with greater prevalence of heart disease and mortality is incredibly concerning," said Dr. Haider Warraich, director of the heart failure program at VA Boston Healthcare and an associate physician at Brigham and Women’s Hospital in Boston.

The study highlighted the burden on residents of counties without a cardiologist, who have to travel an average of 87 miles round-trip to see a heart doctor, compared to just 16 miles in counties with cardiologists. These counties, primarily located in the South and away from the coasts, tend to have lower household incomes, fewer people with health insurance, poorer access to primary care, and less availability of healthy food.

People in these counties also experience more hospitalizations that could have been prevented with early treatment, researchers added.

"Our findings really highlight the critical need to find ways to mitigate deep disparities to improve cardiovascular disease outcomes for Americans living in rural and disadvantaged areas," Warraich said in a hospital news release.

To combat this lack of access, researchers suggest financial incentives for doctors to practice in underserved areas and the expanded use of telemedicine.

"The findings of this study are both enlightening and alarming, shedding light on the severe geographic disparities in access to cardiovascular care across the United States," said JACC Editor-in-Chief Dr. Harlan Krumholz. "This study underscores the urgent need for policy reforms and innovative solutions, such as financial incentives for clinicians and the expanded use of telemedicine, to bridge this gap."

The study emphasises the critical need for innovative solutions to ensure that all Americans, regardless of their location, have access to essential heart care.

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