School of Medicine (A.E.J., M.B.T., E.B., A.J.C., E.M.D., P.K.D., L.M.D.C., U.R.E., A.M.G., M.V.H., A.J.J., C.R.J., N.L.J., L.M., M.A.N., G.S.N., O.O., S.O.-A., A.J.C.S., T.L.S., O.T., R.T., E.U., J.D.W., J.E.S.-P.).
Veterans Affairs Pittsburgh Health System, PA (A.E.J., U.R.E., M.A.N., O.O.).
Circulation. 2021 Jun 15;143(24):2395-2405. doi: 10.1161/CIRCULATIONAHA.121.053566. Epub 2021 Jun 14.
In the United States, race-based disparities in cardiovascular disease care have proven to be pervasive, deadly, and expensive. African American/Black, Hispanic/Latinx, and Native/Indigenous American individuals are at an increased risk of cardiovascular disease and are less likely to receive high-quality, evidence-based medical care as compared with their White American counterparts. Although the United States population is diverse, the cardiovascular workforce that provides its much-needed care lacks diversity. The available data show that care provided by physicians from racially diverse backgrounds is associated with better quality, both for minoritized patients and for majority patients. Not only is cardiovascular workforce diversity associated with improvements in health care quality, but racial diversity among academic teams and research scientists is linked with research quality. We outline documented barriers to achieving workforce diversity and suggest evidence-based strategies to overcome these barriers. Key strategies to enhance racial diversity in cardiology include improving recruitment and retention of racially diverse members of the cardiology workforce and focusing on cardiovascular health equity for patients. This review draws attention to academic institutions, but the implications should be considered relevant for nonacademic and community settings as well.
在美国,基于种族的心血管疾病护理差异已经被证明是普遍存在的、致命的和昂贵的。非裔/黑人、西班牙裔/拉丁裔和原住民/印第安人患心血管疾病的风险更高,而且与他们的白人美国同龄人相比,他们获得高质量、基于证据的医疗护理的可能性更小。尽管美国人口多样化,但提供急需护理的心血管劳动力却缺乏多样性。现有数据表明,来自不同种族背景的医生提供的护理与少数族裔患者和多数族裔患者的护理质量都更好。心血管劳动力多样性不仅与改善医疗保健质量有关,而且学术团队和研究科学家之间的种族多样性与研究质量有关。我们概述了实现劳动力多样性的障碍,并提出了克服这些障碍的基于证据的策略。在心脏病学中增强种族多样性的关键策略包括改善心脏病学劳动力中不同种族成员的招聘和留用,并关注患者的心血管健康公平。本综述提请注意学术机构,但也应考虑到对非学术和社区环境的相关影响。