Successful outreach program brings heart screenings to underserved communities
In the heart of western Louisville, a low-income area with high rates of cardiovascular disease, an innovative heart screening initiative is making a meaningful difference in the lives of underserved patients.
Kim Allan Williams Sr., MD, chair of the department of medicine at the University of Louisville School of Medicine and former president of the American College of Cardiology (ACC), is leading a grassroots outreach campaign to identify and treat cardiovascular risks before they lead to heart attacks, strokes, or death.
"We are finally doing what we've been hoping to do in cardiology for a long time, which is stop just mopping up the floor with fancier and fancier mops, but actually turning off the faucet and doing some prevention," explained Williams, who also serves as an ACC delegate to the American Medical Association (AMA).
The program, known as HEART ("Helping Everyone Address Risk Today"), conducts weekend screening events in churches and community centers, where residents undergo simple fingerstick tests for cholesterol and blood glucose along with blood pressure measurements. Using demographic information and a zip code-based social determinants calculator from the American Heart Association (AHA), the team estimates each participant’s 10-year risk of heart attack, stroke or death.
Those identified at high risk are connected with preventive services, such as coronary calcium scoring CT scans, lipid management or primary care follow-up. Some participants have required urgent care referrals on the spot, including those with critically high blood pressure of systolic 240, or blood sugar levels of 600.
"We're trying to get them to present a little earlier. We will screen 50 people in a church on a Sunday afternoon and two of them will be normal. Part of that is that the people from the congregation who decide to come to our table, they know there's been some abnormalities that have not been addressed," Williams said.
The effort began in Chicago when Williams worked at Rush University Medical Center and held similar screenings on the city's south and west sides. When he relocated to Louisville, he adapted the program to the unique needs and opportunities in Kentucky. Under provisions of the Affordable Care Act, Kentucky opted into a program allowing Medicaid to reimburse providers at commercial insurance rates, known as the average commercial rate (ACR). This made it financially feasible for the University of Louisville Health System to actively serve poor and uninsured populations.
"That's one of the reasons why I left Chicago and went to Louisville. It is a place that was going to benefit financially and had the desire to take care of the poor, but didn't have anybody who wanted to go and get them. So that's what I do," Williams explained.
However, Williams warned that legislation from Congress, such as House Resolution 1, could jeopardize this progress by undoing the funding mechanisms that support programs like HEART.
"Obviously we're concerned about the U.S. Congress and House Resolution 1, which could potentially undo some of the advantages that we've had in Kentucky for Medicaid payment," Williams stressed.
He also acknowledged the importance of representation and trust in building connections with the community. He said being a person of color helps, but the need is so great that his whole team is committed. Going into the community to seek out patients in need has worked, as many of these people are now regular patients under the care of the University of Louisville.
"One of my patients that I got from one of the churches said to me, 'we're all coming to you now because you came to us.' That's the thing that I would like to get everybody to understand. You've got to be willing to go out and find where the patients are, meet them where they are," Williams said.
Williams is also a past board chair (2008-2010) and a life member of the Association of Black Cardiologists (ABC). His work in Louisville (and prior efforts in Chicago) builds on a long legacy of ABC-led community outreach. As early as the late 1970s and early 1980s, ABC trailblazers Waine B. Kong, MD, and Elijah Saunders, MD, pioneered free blood pressure screenings in Black churches, barbershops, and beauty salons. That groundbreaking work helped reshape how preventive cardiovascular care reached underserved communities. This outreach continues today as part of ABC’s annual three-day signature Spirit of the Heart community programs. Watch a video about that program
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]