Multifaceted health equity interventions and scalable real-world interventions are key to promoting and achieving equitable cardiovascular care for all, according to an action plan developed by the ACC Board of Trustees (BOT) Health Equity Task Force.

The plan, published as part of a focused Health Equity issue of JACC: Advances, is centered around the following six "Health Equity Domains": 1) health care data, science and tools; 2) workforce diversity; 3) education and training; 4) membership partnerships and collaborations; 5) community advocacy and policy; and 6) clinical trial diversity. It also outlines a blueprint for implementing health equity and highlights future work necessary to achieve health equity.

"Despite almost 40 years of acknowledgment, analysis and research of the health disparities in medicine, we continue to be confronted with unacceptable morbidity and mortality statistics that expose health inequities primarily in underresourced and minority communities," says Task Force Chair Paul L. Douglass, MD, MACC. "The Health Equity Task Force provides this action plan in hopes of creating a framework that utilizes the strengths and resources of the ACC and a template for other organizations to identify their capabilities in confronting this major societal inequity."

The action plan highlights the importance of "having diversity reflected across cardiologists and all [cardiovascular] team members" and the need for engaging and inspiring youth from underrepresented populations as early as elementary school, as well as mitigating bias in selection processes for medical school, residency and fellowships.

"While the morbidity and mortality that results from cardiovascular disease can be mitigated by focusing on more equitable approaches to outreach and care delivery, this has proven difficult to implement and better guidance is needed. Efforts like this that provide a roadmap are critical to changing the status quo," says Phillip D. Levy, MD, MPH, FACC.

The importance of "meticulous data collection" and the incorporation of "cutting-edge analytical tools and scientific methodologies into health care data analysis" in creating a roadmap to guide the implementation of equitable care practices are an important focus of the document.

"For any strategic initiative, baseline data and metrics for success are critically important," says Robert Roswell, MD, FACC. "Given the magnitude of health inequities, it can be a daunting task to figure out a starting point and a path forward. A main takeaway from this paper is that we've always had the data, but perhaps now we can better utilize the data to help mitigate heath disparities."

The significance of education around health equity is another component of the paper that cannot be overstated.

"As we incorporate health equity into education and training and lifelong learning, it's vital to weave these concepts into our daily practices," says Katie Berlacher, MD, MS, FACC. "While health equity can stand alone as its own topic, lecture or module, we need to push ourselves past this model and build health equity into our approach to every patient, every lesson taught and everything learned, so it is always a part of our care."

Community and stakeholder engagement is another element of the framework, requiring trusted partnerships, shared decision-making and objective needs assessments. The Task Force highlights the value of patient education resources and co-designing interventions with community organizations and hospital systems to ensure strategies accurately reflect the needs and preferences of patients.

"Effective interventions will require multilevel engagement with community organizations, health care systems and health policy as well as the affected individuals," says Alison Bailey, MD, FACC. "I grew up in and have practiced in areas that are largely underresourced. I've seen firsthand the disparities that exist between the most advanced care we CAN provide and the care we DO provide. Much of this difference is related to health equity and is modifiable with knowledge, collaboration and advocacy."

On the patient front, clinical trial diversity is central to achieving health equity. The framework includes suggested solutions for overcoming current clinical trial challenges ranging from setting specific recruitment targets and fostering inclusive practices within a research community. Leveraging technologies to help encourage participation and mitigate bias is another solution.

According to Aubrey J. Grant, MD, FACC, it will be important to ensure that the benefits and opportunities of technological advancements are equitably accessible – a significant hurdle given the rapid speed at which new technologies are being developed.

"My inspiration to be part of this effort stems from a deep-seated commitment to health equity. Witnessing firsthand the detrimental impacts of implicit bias on patient outcomes galvanized my resolve to seek innovative solutions and led me to the intersection of technology and diversity."

Looking ahead, the Task Force stresses the importance of prioritizing and continuing to address social determinants of health in future initiatives, as well as through advocacy.

"Despite the complexity and polarization of politics, advocacy provides a tremendous opportunity to address health disparities at the local, state and federal level," says Akshay K. Khandelwal, MD, MBA, FACC. "Health care is a natural right, a human right, and good people must step up. Mahatma Gandhi said: 'the true measure of any society can be found in how it treats its most vulnerable members.' We can do better."

Additionally, look for the Action Plan to be an important resource for ongoing health equity work at the College, including at the Health Equity Hub at ACC.25 in Chicago and as part of current and future community engagement efforts.

"This project represented a pivotal opportunity to create transformative change at the College by developing strategies and interventions that address the root causes of inequities in cardiovascular health," says Biykem Bozkurt, MD, PhD, FACC. "The chance to collaborate with like-minded experts and contribute to a plan that can make a real difference in people's lives is incredibly inspiring. I am excited to be part of this transformative journey towards achieving health equity for all."

Clinical Topics: Cardiovascular Care Team

Keywords: Cardiology Magazine, ACC Publications, Health Equity, Diversity, Equity and Inclusion, Workforce, Delivery of Health Care, Data Science