16.8M Black People Face Subpar Specialty Care Access, Cardiology Deserts

Some 16.8 million Black people live in a place with suboptimal specialty care access, with a new GoodRx report showing particularly that Black people are more likely to live in cardiology care deserts than their peers of other races.

These findings come as Black people also tend to see poorer cardiology outcomes, indicating that they have a greater need for cardiology care access.

The assessment, which looked at more than 33,000 cardiologists and nearly 40,000 cardiology care sites across the country, showed that only around half (54 percent) of all US counties had a cardiology practice. That leaves more than 20 million people with no cardiologist in their county, around 10 percent (2.46 million) of them being Black.

An even bigger proportion of Black people live in areas with suboptimal cardiology care access. Defined as having a cardiologist-to-patient ratio that is worse than the national average, 16.8 million Black people live in a county with limited cardiology care access, the report showed.

What’s more, counties in which at least 14.2 percent of the residents are Black are more likely than others to be cardiology care deserts or have limited access to cardiology care. Nearly three-quarters (72 percent) of mostly Black counties have limited or no access to cardiology care, and more than 10.5 million Black people live in these counties.

These counties are concentrated in the South, the GoodRx researchers added. The states with the highest number of Black residents who do not have access to cardiology care include Mississippi (67 percent of Black people), Alabama (60 percent), Georgia (58 percent), Virginia (52 percent), and Louisiana (43 percent).

But it’s not just that Black people have limited access to cardiology care; they have limited access, plus they need it. The researchers found that areas with fewer cardiologists tend to be the places where there is a higher risk of developing cardiovascular disease.

Using the six-point cardiovascular risk index (CRI), the researchers mapped out which parts of the country had the highest risk for cardiovascular disease among Black people based on rates of diabetes, obesity, smoking, physical inactivity, alcohol consumption, and unhealthy eating. A lower score equated to a lower risk for cardiovascular disease.

Most counties with a sizeable Black population came in with a 5 or 6 on the CRI, indicating that most counties with a bigger Black population also had a higher risk for cardiovascular disease. That is well above the national average of 2.9 on the CRI, the researchers said.

This indicates that Black people, in general, are at higher risk for cardiovascular disease; when higher CRI scores are in places with a higher concentration of Black people, it is likely because Black people have a higher risk for illness, usually due to health system inequity. When zooming in further on counties with at least half the population being Black, the average CRI score is 4.6.

Having access to a cardiologist did offset some risk for cardiovascular disease in mostly Black communities.

While the lowest CRI scores were in places with fewer Black people and more cardiologists, mostly Black counties with a cardiologist still fared better than mostly Black counties with limited or no access to a cardiologist. The researchers reported a 3.06 on the CRI for mostly Black counties with typical cardiologist access compared to 4.51 on the CRI for mostly Black counties with no cardiologist.

Said otherwise, having a cardiologist in the community helped improve cardiovascular disease risk for Black people. However, the disparity in mostly Black communities with typical cardiologist access compared to other communities with typical cardiologist access (2.25 versus 3.06 on the CRI) indicates that other social determinants of health are still impacting outcomes.

The researchers said it will be essential to expand access to specialty care and cardiology care foremost by creating mechanisms for rural communities to access consultant clinics. Telehealth may be useful in that effort.

Additionally, increasing funding for medical residency programs in traditionally underserved areas may help ameliorate provider shortage problems in cardiology deserts.

Conducting more research into rural health and racial health disparities is another key step forward, the researchers added, as is bolstering public health. Particularly, public health education led by community health workers could help support traditionally underserved populations, like Black people.