Despite remarkable advances in cardiovascular medicine, persistent disparities continue to limit patient access to care. Three recent Viewpoints published in JACC: Advances argue that achieving equitable health outcomes will require a stronger focus on digital health connectivity, intentional implementation of evidence-based care, and long-term strategies that address social drivers of health across the lifespan.

Cardiovascular outcomes have reached a "disquieting plateau," with mortality rates stagnating despite major advances in treatment and investment, write Jennifer H. Mieres, MD, FACC, et al., in a Viewpoint outlining a health system blueprint for moving beyond innovation to implementation and meaningful action.

Modeled after a systematic process developed at Northwell Health's Cardiovascular Institute defined as "advancing health for all" (AHFA), the blueprint is centered around three steps: 1) data disaggregation; 2) disciplined inquiry; and 3) building an equity-focused quality and implementation ecosystem.

While challenges such as data governance, staffing, and analytic capacity remain, sustained progress will require cultural change, ongoing training and strong organizational alignment, say Mieres and colleagues. "ACC's call to action is an invitation for all of us to build the capacity to see our patients clearly, measure where health care fails them, and act purposefully to ensure that the mission of AHFA is realized for every patient."

Digital health connectivity was the focus of another Viewpoint authored by Amber Elaine Johnson, MD, MBA, FACC, et al., who note that the reliance of digital health on resources like broadband internet, smartphones and digital literacy, has the potential to unintentionally widen disparities in rural areas and underserved communities where these resources may be less available.

They highlight technologies like SIM-enabled medical devices that connect directly to cellular networks without requiring broadband or smartphones, as practical ways to expand remote monitoring and care access. "When the infrastructure for connection is uneven, the infrastructure for cardiovascular prevention and management is uneven as well," they write.

A life stage approach for longitudinal prevention of cardiovascular disease in women was the focus on another Viewpoint from Shantelle Bartra, MSN, APRN, AGACNP-BC, CPNP, FACC, et al. "Across all female life stages, inequities are cumulative and compound over decades, accelerating [cardiovascular] disparities if left unaddressed," they write.

Bartra and colleagues highlight evidence showing how factors such as poverty, housing instability, food insecurity, and limited educational opportunities play a major role in determining long-term cardiovascular outcomes and stress the need for a coordinated effort across health care, communities, technology and policy, with a focus on reaching those at greatest risk.

They also advocate for a life-course approach that addresses both medical and social needs, recognizing that cardiovascular risk is shaped by factors far beyond the clinic. They point to equity-focused quality improvement, telehealth, community partnerships, "food is medicine" programs, and health policy advocacy as key strategies for achieving lasting reductions in cardiovascular health disparities.