Sixty-five percent of the patients we see are people of color ; 20 % do not speak English and 85 % are poor . The data based on race is revealing . For example , for patients with heart failure , there are guideline-based medicines they all should be on . Yet fewer Black people were on ACE inhibitors and fewer Hispanic people were on beta blockers . How is that possible when we are a free clinic for the poor and people of color ? Is it possible the cause of this data difference is random , or some implicit bias on my part ? How could a clinic designed to treat disparity have disparity ?
If we can ’ t cooperate and share each other ’ s professional data , we must use the data we have researched independently . We have discovered a lot . We know in large multicenter trials that people of color are less likely to get lifesaving medication for heart failure . We know that in large multicenter trials , people of color are less likely to get counseled on defibrillator treatment and are less likely to receive defibrillators even if counseled . We know that when people present to the emergency room with chest pain or are admitted to the hospital with chest pain that they are treated differently based on their race — white people are more likely to see a cardiologist than Black people . We have found when it comes to newer technology , such as percutaneous aortic valve replacement , that Black and Hispanic people are less likely to receive those therapies than white people . We know that people of color live shorter lives because of health disparity , and according to the Louisville Health Equity report published in 2017 , they die from heart disease at twice the rate of their white counterparts .
DIVERSITY & INCLUSION
At the Have A Heart Clinic , we started a preventive cardiology / lifestyle center for patients to ensure all are on guideline-based therapy . Our initial data shows we are succeeding . Our hope is to be able to share six-month and one-year-data follow up in 2021 .
We can achieve equality in health care . It isn ’ t going to be easy and will be even harder if there is not sharing of data so that specific areas can be addressed properly to achieve . I know it first begins with me , then with all of us as providers .
It is imperative to encourage our employers to share outcome data based on race : if not shared publicly , at least amongst those in our profession . Realistically , race cannot be taken out of the equation . We , in the medical field , know it exists and must take it into consideration or people of color , especially Black people , will continue to die younger and live less healthy lives . Dr . Imburgia is a practicing cardiologist and founder of the Have A Heart Clinic .
So , I am asking what can we do to change that ?
As health care providers , we cannot rely on our belief that we don ’ t see color , believe that we don ’ t make medical decisions based on race and we certainly cannot rely on being unbiased . Few of us in my position have any idea what people of color , especially those who are Black , have gone through in their lives . We simply can ’ t relate at the same level . I , and others acknowledge that we are biased and are trying to not only work harder at the discrepancies , but to change them . In a health system that rewards spending less time with patients , it ’ s a fight to accomplish equity . We need time with these patients . It takes time to relate , it takes time to gain trust and above all , it takes time to learn and empathize . To gain that type of trust and understanding , we need to spend more time and to ensure systems are in place to check for implicit bias and rectify it .
I discovered a study following outcomes of patients with hypertension , diabetes and high cholesterol from baseline year 2006 in Medicare Advantage plan participants . Results were revisited to those parameters in 2011 and only one region was found where the racial disparity equalized . The patients ’ conditions improved in all regions , but the disparity still existed between Black and white people — except for one region — the western US . The study findings were able to emplace specific programs to address and treat that disparity and in time was able to achieve equality in all those parameters .
PROFESSIONAL ANNOUNCEMENT PACKAGE
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CONTACT Amanda Edmondson Director of Communications & Marketing 502.736.6330 amanda . edmondson @ glms . org
FEBRUARY 2021 13