Locking the Revolving Door: Racial Disparities in Cardiovascular Disease

Abstract

Racial disparities in cardiovascular disease are unjust, systematic, and preventable. Social determinants are a primary cause of health disparities, and these include factors such as structural and overt racism. Despite a number of efforts implemented over the past several decades, disparities in cardiovascular disease care and outcomes persist, pervading more the outpatient rather than the inpatient setting, thus putting racial and ethnic minority groups at risk for hospital readmissions. In this article, we discuss differences in care and outcomes of racial and ethnic minority groups in both of these settings through a review of registries. Furthermore, we explore potential factors that connote a revolving door phenomenon for those whose adverse outpatient environment puts them at risk for hospital readmissions. Additionally, we review promising strategies, as well as actionable items at the policy, clinical, and educational levels aimed at locking this revolving door.

Keywords: cardiovascular disease; disparities; racial.

Figure 1. The revolving door concept: while cardiovascular disparities in the inpatient setting have narrowed, they widen after crossing the hospital door.

Figure 2. Findings and actionable items from the American Heart Association scientific statement on social determinants of risk and outcomes for cardiovascular disease.

Figure 3. Promising strategies to reduce cardiovascular disease disparities and next steps.