The immigrant population in the U.S. faces significant barriers to accessing quality cardiovascular care, which in turn can have profound implications for their long-term heart health.

Language barriers, lack of access to affordable health care and other social determinants of health are among the leading challenges, along with underrepresentation of certain racial and ethnic groups in the cardiovascular workforce. Inadequate cultural competency and empathy from health care professionals, along with current fears surrounding immigration policies, can further exacerbate feelings of mistrust, resulting in reluctance to seek necessary screening or treatments.

Addressing these systemic issues by increasing diversity and representation within the health care workforce, improving language accessibility and fostering culturally sensitive approaches to care delivery are essential steps toward bridging the existing health care gap. Policymakers, health care organizations and clinicians must work together to develop targeted strategies like the ones below:

Address Social Determinants of Health: Recognize that access to healthy foods, safe neighborhoods and quality education can impact cardiovascular health. Advocate for policies and programs that address these social factors.

Increase the Diversity of the Cardiovascular Workforce: Work to recruit and retain more physicians, nurses and other health care professionals who are representative of the patient populations being served.

Provide Culturally Competent and Linguistically Appropriate Care: Ensure health care systems have the resources and staff to communicate effectively with patients who have limited English proficiency. This may include translation services, patient education materials in multiple languages and training on cultural beliefs and practices.

Target High-Risk Conditions: Implement tailored screening, prevention and management programs for conditions like obesity, diabetes and hypertension that disproportionately affect immigrant populations.

Expand Access and Reduce Barriers: Address financial, transportation and other logistical barriers that prevent immigrant patients from seeking and receiving timely cardiovascular care.

Spotlight on Hispanic/Latino Cardiovascular Health

Hispanic/Latino individuals make up nearly 20% of the U.S. population but account for only 7% of physicians – a stark mismatch that underscores broader disparities in cardiovascular care. These communities face a disproportionate burden of key risk factors: higher rates of obesity, diabetes, hypertension and chronic kidney disease compared to non-Hispanic White adults. Nearly half of Hispanic adults have prediabetes, 15% have diabetes and about half have some form of heart disease. Yet, access to care remains a persistent challenge, particularly for immigrants navigating language, insurance and systemic barriers.

Interestingly, despite higher rates of risk factors, Hispanic adults had lower age-adjusted cardiovascular mortality rates than non-Hispanic Whites between 1999 and 2018 – a phenomenon shaped by both genetic and social determinants. However, as risk factors climb and care gaps persist, that trend may not hold. Addressing these disparities is not just about improving outcomes – it's a public health imperative.

To help support conversations among patients and their clinicians, CardioSmart offers infographic posters and decision aid in several languages, including Spanish. Download these resources and use them in conversations with patients.

This article was authored by Luis E. Farfan, DNP, AGACNP-BC, CCRN, FHFSA, a nurse practitioner in the Cardiac Care Unit at New York Presbyterian Hospital - Columbia University in New York, and adjunct professor at Mercy University, School of Nursing.

Keywords: Cardiology Magazine, ACC Publications, Emigrants and Immigrants, Social Determinants of Health, Cultural Competency, Language, Delivery of Health Care