Could you discuss the key themes you will address in your talk, “COVID-19 as a catalyst to address inequalities in cardiovascular outcomes and inequalities in cardiovascular care delivery?”
In this session, we’ll look at how this pandemic has really devastated these populations: populations of color and women, even outside of heart failure, but with cardiovascular disease. I think some of the most important things we’ve learned is that there are systematic inequalities that gradually worsen to, possibly, the point of no return. It is imperative that we start taking the steps to address and correct them if we don’t want to keep talking about the differences year after year.
In this lecture, I will discuss some of the current problems associated with cardiovascular disease. It is the leading cause of death of all populations, but it kills disproportionately many people of color, especially black individuals. There are still many issues with vaccine receipts and allocation with the ability to work from home, with the opportunities to excel in a person’s workplace, and how all of these issues affect one’s health and one’s cardiovascular health. It is up to the community, our policy makers and our stakeholders to address the root of these problems – the structural racism, the social determinants of health and prejudice – if we really want to change the way things work. if we want to make things better, if we want to end this pandemic. That presentation focuses on that.
Before COVID-19, there were discussions about the fairness of CMS quality measures at both the AHA and ACC meetings. Discussions have focused on whether measures in heart failure are responsible for differences; as a result, the measures could penalize safety net hospitals that provide a higher proportion of patients who are socially and economically disadvantaged. What has been your experience?
There are clear disparities, clear problems with current policies and structures that need to be looked at a little differently. I’m in favor of using tools like implementation science where we look at this policy and see whether or not it has changed and did what it was intended to do, and if not, to get the right feedback to see how we are changing it , how do we make the following iterations so that it can do what it’s supposed to do. I think there’s a plethora of data showing things like with the penalties for heart failure, readmission, that some changes are needed if we’re going to try to get policies to do what they were meant to do, which is to improve care, access to care to improve. Unfortunately, we know that with this policy, this policy has led to a reduction in hospital admissions, but an increase in mortality.
We must – with any policy put in place – make sure that it, 1, does what it’s intended to do, and, 2, we really care about justice and decide that equality is a priority, which means it’s not ‘What your race or No matter your gender, you will receive the care you deserve. That will require us to look at things through a racial lens, because we live in a racist society. I believe there is an intent to make these changes, but a lot of extra work is needed to actually implement them. With the education of the public and greater awareness, I hope that individuals will be willing to decide that they are going to do the work to make these changes, to speak out about things that may not affect them, but who they know affect their fellow human beings, and are willing to make us feel uncomfortable so that we can ensure that everyone gets a fair chance to receive the care they need and deserve.