The cardiologist shortage is here: 46% of all US counties have no heart doctors
Nearly half of all counties in the United States do not have a single practicing cardiologist, according to new data published in the Journal of the American College of Cardiology.[1] Counties with no cardiologists tend to be “rural and socioeconomically disadvantaged,” researchers noted, and associated with a heightened risk of cardiovascular disease.
The team behind the analysis examined HealthLink Dimensions data, calculating that 46.3% of all counties in the United States—and a whopping 86.2% of rural counties—do not have any cardiologists. That 46.3% breaks down to approximately 22 million residents in 1,454 counties.
For people who live in a county with at least one cardiologist, the average round-trip distance to the nearest cardiologist was 16.3 miles. In counties without a single cardiologist, on the other hand, the average round-trip distance was 87.1 miles.
Meanwhile, the cardiovascular risk index in counties without cardiologists was 2.8—much higher than the 2.1 for counties with cardiologists. Counties without cardiologists were also linked to a higher age-adjusted mortality rate, a lower life expectancy, a lower household income, higher percentages of uninsured residents and worse access to healthy food than counties with at least one cardiologist.
As one might expect “preventable hospitalizations” were also significantly more common in areas without a cardiologist.
Native Americans were the most likely to live in a county without a cardiologist, the researchers added, and southern counties had a higher cardiovascular risk index than those in any other part of the nation.
“Our findings really highlight the critical need to find ways to mitigate deep disparities to improve cardiovascular disease outcomes for Americans living in rural and disadvantaged areas,” co-author Haider J. Warraich, MD, an associate physician with Brigham and Women’s Hospital and assistant professor with Harvard Medical School, said in a prepared statement. “Policy reforms, such as financial incentives to clinicians to practice in areas with marginal access or better leveraging telemedicine are potential options. The integration and coordination of cardiovascular care—especially with regard to prevention and risk modification—with the primary care is crucial.”
“This study underscores the urgent need for policy reforms and innovative solutions, such as financial incentives for clinicians and the expanded use of telemedicine, to bridge this gap,” added JACC editor-in-chief Harlan M. Krumholz, MD, a veteran cardiologist with Yale University. “Ensuring equitable access to cardiovascular care is a crucial step towards improving overall public health outcomes and reducing preventable cardiovascular mortality.”
Read the full research letter here.