Locking the Revolving Door: Racial Disparities in Cardiovascular Disease

Author:

Velarde Gladys1ORCID,Bravo‐Jaimes Katia2ORCID,Brandt Eric J.3ORCID,Wang Daniel2,Douglass Paul4ORCID,Castellanos Luis R.5,Rodriguez Fatima6ORCID,Palaniappan Latha7,Ibebuogu Uzoma8,Bond Rachel910ORCID,Ferdinand Keith11,Lundberg Gina12ORCID,Thamman Ritu13ORCID,Vijayaraghavan Krishnaswami14,Watson Karol2ORCID

Affiliation:

1. Department of Cardiology University of Florida Jacksonville FL

2. Division of Cardiology University of California Los Angeles CA

3. Division of Cardiology University of Michigan Ann Arbor MI

4. Division of Cardiology Wellstar Atlanta Medical Center Atlanta GA

5. Division of Cardiovascular Medicine University of California San Diego CA

6. Division of Cardiology and the Cardiovascular Institute Stanford University School of Medicine Palo Alto CA

7. Department of Medicine Stanford University Palo Alto CA

8. Division of Cardiology University of Tennessee Health Science Center Memphis TN

9. Division of Cardiology Dignity Health Gilbert AZ

10. Division Cardiology, Department of Internal Medicine Creighton University School of Medicine Omaha NE

11. Division of Cardiology Tulane School of Medicine New Orleans LA

12. Division of Cardiology Emory University Atlanta GA

13. Division of Cardiology University of Pittsburgh Pittsburgh PA

14. University of Arizona Phoenix AZ

Abstract

Racial disparities in cardiovascular disease are unjust, systematic, and preventable. Social determinants are a primary cause of health disparities, and these include factors such as structural and overt racism. Despite a number of efforts implemented over the past several decades, disparities in cardiovascular disease care and outcomes persist, pervading more the outpatient rather than the inpatient setting, thus putting racial and ethnic minority groups at risk for hospital readmissions. In this article, we discuss differences in care and outcomes of racial and ethnic minority groups in both of these settings through a review of registries. Furthermore, we explore potential factors that connote a revolving door phenomenon for those whose adverse outpatient environment puts them at risk for hospital readmissions. Additionally, we review promising strategies, as well as actionable items at the policy, clinical, and educational levels aimed at locking this revolving door.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

Reference98 articles.

1. Heckler, M. United States Department of Health and Human Services . Report of the Secretary's Task Force on Black and Minority Health. Washington DC: Department of Health and Human Services. National Library of Medicine; 1985. Accessed March 28, 2021. https://minorityhealth.hhs.gov/assets/pdf/checked/1/ANDERSON.pdf

2. Smedley BD, Stith AY, Nelson AR, eds. Study charge and committee assumptions ‐ defining racial and ethnic health care disparities. In: Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press; 2003.

3. Bernstein A Bilheimer LT Makuc DM. Health United States 2011; with special feature on socioeconomic status and health. National Center for Health Statistics (U.S.); 2012. DHHS publication; no. 2012‐1232. Accessed February 27 2023. https://stacks.cdc.gov/view/cdc/13680

4. The Coalition to Reduce Racial and Ethnic Disparities in Cardiovascular Disease Outcomes (credo)

5. Characteristics and Outcomes in African American Patients With Decompensated Heart Failure

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