New report highlights inequities in cardiovascular care, death rates

As we commemorate Juneteenth 2024, the Journal of the American College of Cardiology has published "Excess Cardiovascular Mortality Among Black Americans 2000-2022: A Report Card," to highlight the persistent and tragic inequities in cardiovascular care and put in human terms the years of life lost to the Black community because of their higher cardiovascular disease death rates.

JACC Incoming Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC, said that the goal of the report card is to promote accountability and catalyze action that finally addresses this national tragedy.

"Our study reveals that Black Americans, because of their higher cardiovascular mortality rates compared with white Americans, have suffered almost 800,000 excess deaths, which translates to about 24 million additional years of life lost between 2000 and 2022," said Krumholz, who is also senior author of the study and the Harold H. Hines, Jr. Professor of Medicine at Yale School of Medicine. "This staggering figure highlights the critical need for systemic changes in addressing cardiovascular inequities."

In an accompanying editorial, Jennifer H. Mieres, MD, FACC, chair of the ACC Diversity and Inclusion Committee and Senior Vice President, Center for Equity of Care, at Northwell Health in New Hyde Park, New York, said the report card serves as a reminder that not all Americans have benefited equally from significant advances made in the treatment and prevention of cardiovascular diseases.

"We are reminded of the stark reality that Black Americans continue to face significant disparities in cardiovascular outcomes," Mieres said. "Bringing an equity lens to the redesign of CV health by addressing the social determinants of health and the systemic barriers that contribute to structural racism are critical for solving for cardiovascular health disparities and ensuring equity of care."

Social determinants of health have a detrimental impact in creating barriers that prevent the most vulnerable Americans from receiving the cardiovascular care they need. The ACC has established multiple programs to address these inequities. The Internal Medicine Program introduces groups who have been historically underrepresented in cardiology to a career in cardiology by connecting them with the mentors, peer network and resources they need to understand career opportunities in the field and be better prepared to address the unique and diverse health care challenges their patients face.

The Clinical Trials Research (CTR) program is intended to increase the number of individuals historically underrepresented in cardiology who serve as leaders in cardiovascular clinical trials research to ensure diversity of thought, experience and perspective, and ensure that the evidence base includes data more closely reflecting the demographics of actual cardiovascular patients.