Department of Cardiology University of Florida Jacksonville FL.
Division of Cardiology University of California Los Angeles CA.
J Am Heart Assoc. 2023 Apr 18;12(8):e025271. doi: 10.1161/JAHA.122.025271. Epub 2023 Mar 21.
Racial disparities in cardiovascular disease are unjust, systematic, and preventable. Social determinants are a primary cause of health disparities, and these include factors such as structural and overt racism. Despite a number of efforts implemented over the past several decades, disparities in cardiovascular disease care and outcomes persist, pervading more the outpatient rather than the inpatient setting, thus putting racial and ethnic minority groups at risk for hospital readmissions. In this article, we discuss differences in care and outcomes of racial and ethnic minority groups in both of these settings through a review of registries. Furthermore, we explore potential factors that connote a revolving door phenomenon for those whose adverse outpatient environment puts them at risk for hospital readmissions. Additionally, we review promising strategies, as well as actionable items at the policy, clinical, and educational levels aimed at locking this revolving door.
心血管疾病中的种族差异是不公正的、系统性的,也是可以预防的。社会决定因素是造成健康差异的主要原因,其中包括结构性和明显的种族主义等因素。尽管在过去几十年中实施了许多措施,但心血管疾病护理和结果方面的差异仍然存在,更多地存在于门诊而不是住院环境中,从而使少数族裔群体面临住院再入院的风险。在本文中,我们通过对登记处的审查,讨论了这两种情况下种族和族裔少数群体在护理和结果方面的差异。此外,我们探讨了可能导致那些门诊环境不利的人面临住院再入院风险的“旋转门”现象的潜在因素。此外,我们还回顾了有前途的策略,以及针对政策、临床和教育层面的可操作项目,旨在锁定这一“旋转门”。