Health
46% of US counties have no cardiologists
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A study conducted by a team from Brigham and Women’s Hospital in Boston, Massachusetts and GoodRx in … [+]
You may not think about finding a cardiologist every day, like you would at a coffee shop or gas station. But what if one day you suddenly have a major heart problem, like a heart attack, and you know something that can’t wait? Don’t assume cardiologists are like Starbucks; that it will be easy to find them. Millions of people in the US live in what are considered “cardiology deserts,” defined as locations where cardiologists are completely absent. according to a research letter recently published in the Journal of the American College of Cardiology. In fact, the survey that formed the basis for this research letter found that nearly half of all U.S. counties do not have a single cardiologist.
Yes, that’s right. A total of 1,454 U.S. counties – or 46% of them – had no practicing cardiologists in 2023. These counties without cardiologists include approximately 22 million U.S. residents. In any of these cardiology desserts, you will not be able to find anyone who is specialized and adequately trained in diagnosing and treating different types of heart diseases.
This can make you feel a bit ‘abandoned’ if you have a heart attack in one of these countries. Will you be able to find someone who can perform an emergency cardiac catheterization, the kind of procedure needed to keep your heart functioning, in the words of that? Titanic song? The chances aren’t great. And your heart is pretty important in life and stuff like that. Yes, such a finding certainly does not deserve a heart emoji.
These alarming findings emerged after a team from Brigham and Women’s Hospital in Boston, Massachusetts (Jeong Hwan Kim MD and Haider J. Warraich MD) and GoodRx in Santa Monica, California (Trinidad Cisneros PhD, Amanda Nguyen PhD and Jeroen van Meijgaard PhD ) had stopped their research. data from Healthlink Dimensions to determine the locations of practicing cardiologists. They then overlaid these locations on a map of all U.S. counties to yield the following map:
Image: Courtesy of GoodRx
As you can see, a large portion of these orange counties (i.e., cardiology deserts) fall in the southern US. And surprise, surprise, people living in the southern US tend to have worse heart health compared to people in other parts of the US. , based on a publication in Mayo Clinic procedure.
Many of these desert counties for cardiologists are in rural areas, with 86% of completely rural counties lacking a single cardiologist. But you might say, why can’t people just use telehealth to consult with cardiologists in such a location? Oh, that’s right, people in rural areas are less likely to have access to the internet. Additionally, you cannot perform a cardiology procedure such as a cardiac catheterization via telemedicine. Imagine the doctor says, “Okay, after you anesthetize yourself, you’ll insert the catheter into your vein.”
Here’s another shocker. Black Americans disproportionately lack access to cardiologists. Yes, I know, I know, it’s stunning to hear that a racial minority has less access because all the resources and wealth in the US are so evenly distributed among different racial and ethnic groups, right? Still, the study found that more than 16.8 million Black Americans live in counties with limited or no access to cardiologists, while more than two million live in counties where such specialists do not exist at all. Consider the states with the highest number of desert counties in cardiology: Georgia, Mississippi, Virginia, Alabama and Louisiana. Each of these has a significant black population.
Please take these findings to heart. But not only to the heart. Tori Marsh, MPH, director of research at GoodRx, explained that this was just the latest analysis from Good Rx and associates that suggested the presence of many medical and healthcare deserts. “In 2020, we conducted pharmacy desert analyzes that showed many of the same locations had no pharmacies,” Marsh said. As she added, it is very likely that other health care services are lacking in cardiology dessert areas. It’s not like officials in a province are saying, “Let’s take care of every part of the body except the heart, because we want a total blackout of the heart.”
This is not an easy problem to solve. “A lot is being done to establish practices,” Marsh emphasizes. “It can be influenced by things like access to basic insurance.” She spoke of the need to change conditions and systems in these cardiology deserts to convince more cardiologists to move to remote areas. And of course, different areas of healthcare and medicine are connected in a system, just like body parts. Just as you don’t see the rectum and the heart flowing in different directions, you need different specialists located in a certain area so that they can communicate with each other.
Marsh did indicate that some of the next steps could be to look at other populations — such as other racial minorities and immigrants — to see how their access to health care may also be limited. It will not be surprising to find that other populations face different disparities in access to health care, as they too have differences in the levels and outcomes of health and well-being. After all, poorer access to healthcare is generally linked to poorer health outcomes.
If you think that cardiological deserts are only problems for those who live in such deserts, then you need to change your mind. If these deserts ultimately lead to worse health outcomes, they could impact you, assuming you pay taxes and health insurance, both of which can increase to cover the costs of health problems. Plus, you never know when you’ll have an emergency in one of these deserts.