"Recent research suggests that health equity for all racial and ethnic groups will not be achieved without an approach to quality measurement and improvement that acknowledges systemic racism at multiple levels and uses the methods and tools of QI to dismantle systemic racism in health care," according to a review on race, ethnicity and heart disease published as part of focused nine-part series in the Journal of the American College of Cardiology.

Eric C. Schneider, MD, FACC; Marshall H. Chin, MD, FACC, et al., provide a summary of racial and ethnic disparities in the quality of cardiovascular care and offer an approach for diagnosing and intervening on health equity factors in the form of the "Equity-Centered Quality Improvement Model and Roadmap to Advance Cardiovascular Health."

While strides have been made in reducing racial and ethnic disparities in cardiovascular disease, these disparities have not been eliminated and "may be increasing again, reversing earlier gains," due to factors like structural racism, according to Schneider, Chin and colleagues. They outline the importance of understanding the complex web of factors contributing to racial and ethnic disparities, including clinical risk factors, genetics and, more importantly, social and economic conditions. The also stress that "current quality and safety improvement programs may be more effective if interventions are designed to address the drivers of inequitable health outcomes both within and outside of health care."

Enter the Roadmap to Advance Cardiovascular Health, which involves five key areas of focus: 1) creating a culture of health equity; 2) identifying disparities; 3) diagnosing root causes; 4) designing and implementing care interventions to advance cardiovascular health equity; and 5) designing clinical performance reporting and payment systems to support and incentivize advancing cardiovascular health equity.

The Roadmap provides "practical guidance to improve the measurement and analysis of quality problems and the implementation of care interventions and policies that reduce racial and ethnic disparities in outcomes," said Schneider, Chin, et al. "Setting explicit organizational goals for equity should reflect emerging understandings of structural racism and engage people from local communities. Policymakers, payers, and accreditors must align financial incentives to reward those who tackle this insidious problem. Change is possible. Seizing the equity initiative today will offer hope to future generations and accelerate further reductions in [cardiovascular disease] morbidity and mortality."

Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, COVID-19 Hub, Heart Failure and Cardiomyopathies, Noninvasive Imaging, Prevention, Valvular Heart Disease, Atherosclerotic Disease (CAD/PAD), Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Echocardiography/Ultrasound, Hypertension, Sleep Apnea

Keywords: Cardiology, Prejudice, Racism, Selection Bias, African Americans, Algorithms, Asian Americans, Atrial Fibrillation, Bariatric Surgery, Cardiomyopathy, Dilated, Benchmarking, Cardiomyopathy, Hypertrophic, Cardiopulmonary Resuscitation, Cardiovascular Diseases, Community Health Services, Coronary Artery Disease, COVID-19, Cultural Competency, Death, Sudden, Cardiac, Defibrillators, Implantable, Diabetes Mellitus, Type 2, Dementia, Echocardiography, Economic Status, Sexual and Gender Minorities, Ethnic Groups, Evidence-Based Medicine, Food Insecurity, Glycated Hemoglobin A, Health Care Costs, Health Equity, Health Personnel, Healthcare Disparities, Heart Disease Risk Factors, Heart Valve Diseases, Hospitals, Hispanic Americans, Heart Failure, Housing, Hypertension, Implementation Science, Insurance, Insurance Coverage, Minority Groups, Motivation, Morbidity, Obesity, Organizational Objectives, Outcome Assessment, Health Care, Out-of-Hospital Cardiac Arrest, Patient Discharge, Patient-Centered Care, Peripheral Arterial Disease, Prescriptions, Policy, Prevalence, Public Health, Quality Improvement, Reference Standards, Registries, Religion, Renal Insufficiency, Chronic, Reward, Risk Factors, Social Determinants of Health, Social Justice, Social Responsibility, Stroke, Survival Rate, Telemedicine, Telemedicine, Treatment Outcome, Trust, Violence, Violence, Workforce

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