• Posted July 9, 2024

Nearly Half of U.S. Counties Lack Cardiologists Despite High Need

Where you live plays a vital role in how easy it is to receive care for heart problems.

Nearly half of U.S. counties don't have a practicing cardiologist, and those are places with the worst heart health, a new study says.

More than 46% of U.S. counties don't have a single heart doctor, even though the rest have an average 24 cardiologists practicing within them, according to findings published July 8 in the Journal of the American College of Cardiology.

Counties without a cardiologist are generally rural and poor, researchers found. In fact, nearly 9 in 10 rural counties (86%) don't have a heart doc.

Those counties without a heart doctor also have an average 31% higher risk of heart disease, and a greater burden of heart health risk factors like diabetes, high blood pressure, elevated cholesterol and smoking.

People are more likely to die from heart-related health problems, and on average have a one-year shorter life expectancy, researchers added.

"While cardiologists are not the only determinants of cardiovascular outcomes, the lack of access to cardiologists in areas with greater prevalence of heart disease and mortality is incredibly concerning,"said Dr. Haider Warraich, director of the heart failure program at VA Boston Healthcare and an associate physician at Brigham and Women's Hospital in Boston.

People in counties without a cardiologist have to drive about 87 miles round-trip on average to see one, compared with 16 miles round-trip in counties with a heart doctor, researchers found.

Counties lacking a cardiologist were unlikely to be on either coast of the U.S., results show. Meanwhile, counties in the South without a heart doctor had the highest risk for heart disease.

Counties without cardiologists tended to have lower household incomes, more people without health insurance, worse access to primary care doctors and less ability to buy healthy food, results show.

People in those counties also were more likely to experience hospitalizations that could have been prevented through early treatment, researchers added.

"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,"Warraich said in a hospital news release.

There are ways to combat this lack of access to heart medicine, researchers said. Doctors could be offered more money to practice in these counties, or telemedicine could be used to extend heart care into areas without a heart doc.

"The findings of this study are both enlightening and alarming, shedding light on the severe geographic disparities in access to cardiovascular care across the United States,"said JACC Editor-in-Chief Dr. Harlan Krumholz. "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."

More information

The U.S. Centers for Disease Control and Prevention has more on heart disease risk factors.

SOURCE: American College of Cardiology, news release, July 8, 2024