New ABC campaign works to improve care in cardiology deserts

The survey revealed widespread knowledge gaps. According to Fletcher, 40% of respondents had no prior knowledge that there were two types of cholesterol. He said that the lack of understanding crossed racial and geographic lines, occurring in 54% of Black Americans and 49% of Hispanic Americans. In addition, 36% of all respondents did not know their own cholesterol levels.

Access to care has emerged as a major barrier in healthcare, especially in low-income urban and rural areas. Fletcher said one in four adults traveled over 20 miles to see heart specialists, and the rates were higher in Louisiana, Arkansas, Georgia and Mississippi. In those states, nearly one in five Black and Hispanic respondents reported never having had any cardiovascular screening.

The Cardiovascular Desert Campaign is targeting those four states with LDL-C education efforts, in part through funding from Amgen. The project has hubs in Little Rock, New Orleans, Jackson, and Atlanta to expand outreach efforts. The initiative includes free LDL-C screenings, community education and provider outreach.

“The lack of education about cholesterol is important in terms of knowing that it's a significant risk factor that can be modified, and knowing that there is a good and bad cholesterol. Then there is a need for more opportunity for access, someplace where you can go and get the cholesterol numbers checked,” Fletcher explained.

He also pointed to challenges on the provider side, saying that in some cases clinicians may not be aggressive enough in lipid management for high-risk patients.

“So often we see patients that were told by their providers that their cholesterol was okay. Well, it wasn't okay because they had pre-existing conditions such as diabetes, previous strokes, peripheral vascular disease, heart attacks, stents, etc,” Fletcher said.

A key component of the program is building relationships within communities that often do not embrace outsiders. 

“The goal is to go into these communities and establish trusted relationships,” Fletcher said. “You have to have people on the ground in these cities and rural areas that people trust.”

The initiative also leverages partnerships with local leaders, faith-based organizations and mobile health vans to reach people where they live. 

For providers working in cardiology deserts, Fletcher emphasized the importance of education and collaboration.

“Part of the cardiovascular initiative is to help provide that educational component to not only community members, but also to the providers that they understand per the 2022 consensus guidelines for management of lipid therapy, that we need to be more aggressive and that we do need to screen for primary prevention and secondary prevention,” he said.

Ultimately, Fletcher sees the pilot program as just the beginning of a much larger effort. 

“The second phase of that will be to expand to more states. And of course, the third phase of that will be to sustain the activities that we have going,” he said.

By starting with basic education, improving access and supporting frontline providers, ABC hopes the cardiovascular desert initiative can begin to close long-standing gaps in heart care across some of the nation’s most underserved regions.