Improving Health Care Access For Minority and High-Risk Populations

Despite advances in medical therapies and new treatment modalities for patients with or at risk for cardiovascular diseases, health equity and access to care remain significant areas of concern. African Americans are disproportionately burdened with the highest rate of heart disease and stroke of any racial or ethnic group in the U.S.  Moreover, there remains indisputable evidence that the presence of health disparities continues to be a major concern in the health care for cardiovascular disease and the black-white gap in life expectancy has persisted over the last several decades.

Access to quality health care remains a challenge, particularly for underserved minority patient populations with limited availability of evidence-based therapies leading to premature deaths, diminished quality of life and loss of optimal productivity. The cause of these disparities is complex, existing both within and outside of the health care system. What is promising is that there are remediable interventions with potential improved outcomes for all.

Key stakeholders and patients must be willing to take a comprehensive look at these issues with the intention of developing real solutions. It’s critical that we move beyond simply acknowledging issues related to patient access to identifying significant solutions that remove barriers to optimize health care. The challenge is to appropriately explore how we can overcome the divide and develop evidence-based, high-impact strategies for both health care providers and patients.

The challenge is to appropriately explore how we can overcome the divide and develop evidence-based, high-impact strategies for both health care providers and patients.

The Access to Health Care Initiative of the Association of Black Cardiologists (ABC), which I chair, has set as its mission to address these critical issues in a changing health care landscape by revealing disparities faced by minorities and high-risk patients and promulgating solutions to diminished access, especially to newer medications and therapies.

A critical concern is that the improvement in cardiovascular mortality has recently shown a deceleration in the rate of decline in cardiovascular disease, heart disease and stroke mortality. This is an alarming trend that warrants innovative approaches and we must be responsive to the unacceptable mortality rates among blacks from cardiovascular disease compared with whites. We will not be a healthy society until we begin dissecting these problems and finding solutions that lead to the elimination of disparities and equal care for all. The ABC Access Initiative takes an in-depth look at the key barriers to access quality care, such as unveiling how frequently prescriptions for new evidence-based therapies are delayed or denied. The most challenging obstacles are: cost of drugs to patients, suboptimal access to primary care, low number of referrals to specialists when indicated, socioeconomic determinants of health, lack of culturally competent providers, limited access to affordable generics and refusal of some health care providers to accept Medicaid or certain health insurances amongst others.

Five consensus-driven solutions have been identified by the ABC Access Initiative and its multidisciplinary team of stakeholders. These recommendations have been developed to improve patient access to care and innovative therapies by crafting definitive, collaborative solutions that expand existing services, streamline processes or address problematic policies. The solutions identified are the advancement of telehealth and telemedicine for minority populations, advocacy for policy reform, standardization of health plan authorization processes, promulgation of pharmacy-based programs and mobilized community health workers for greater patient engagement. As health care professionals, we need to be able to offer our patients evidence-based therapies, regardless of race, ethnicity or socioeconomic status. There must be an emphasis on understanding the importance of health literacy and the social determinants of health, including adverse environments and the stresses of having a disadvantaged socioeconomic status.

As cardiovascular and public health stakeholders, we encourage groups and organizations around the U.S. to join us in advancing and identifying solutions to aid minority or high-risk populations. The ABC consensus report, Improving Health Care Access for Minority and High-Risk Populations, supports its mission to promote the prevention and treatment of cardiovascular disease by eliminating inequalities and improving access to health care, including evidence-based treatments and newer modalities.  We can all be partners in this effort by contributing to the identified solutions. For more information on the summary of recommendations and the ABC, visit

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Keywords: ACC Publications, Cardiology Magazine

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