Modern medicine has made unimaginable advances in the quality of care and the speed with which new medical interventions are developed – recent examples including tests and vaccines for Covid-19 are emerging at an almost unbelievable rate. However, it is clear that breakthrough medical advances do not always translate into tangible improvements in patient outcomes. So why is this so?Let’s consider the most recent example A study published in the Journal of the American Medical Association Death rates from heart disease and stroke in the U.S. rose 10 percent in eight years from 2011 to 2019, according to the Web. Given all the improvements in cardiovascular care, including improved interventions and medication, this is disappointing — but not entirely surprising.
I attend many conferences and the discussions usually revolve around the details of improving equipment and techniques, such as coronary angioplasty and stenting.Again, like my colleagues, I am amazed at our ability to continually improve the effects of these treatments, gaining additional percentage points in terms of success rates and expected outcomes – however, these advancements have time and time again enabled those who can already right to use care. A better coronary stent won’t help patients who can’t afford it, don’t know they need it, don’t have a doctor who can make a diagnosis and determine their needs, or even know how to access health care. To help these patients, we urgently need to focus on health equity.
How health equity can reduce deaths from heart disease
While the relevance and severity of health inequalities varies from place to place, there is no truly equal global health care system for all. In the U.S., the world’s largest economy, the effects of health inequality are evident across the spectrum, from the lack of access to skilled care in rural areas to the higher maternal mortality rate among black women to the disproportionate impact of Covid on communities of color. influences. The JAMA study also reported that from 2019 to 2020, the number of deaths from heart disease among vulnerable groups increased.This is also reflected in other contemporary reportingadds to emerging data on the importance of social determinants of health (SDOH), highlighting a number of social factors, including economic stability, access to healthcare, food and education, or racial/ethnic group, that may contribute to a patient’s health adversely affect.
In order to make some progress towards health equity and improved outcomes for patients with heart disease, we must try to address or at least consider such SDOH. Technological procedural advances of the kind described above seem trivial when considering the potential benefits of addressing these broader problems. The type of mitigation varies by patient and region, but approaches may include increasing access to care by providing free or reduced-cost transportation to low-income patients, providing translation services for patients more comfortable in their native language, and providing free or Provides low-cost care to uninsured or underinsured patients. Primary care physicians in their practice of treating vulnerable patients should also be trained to look for late warning signs and communicate with patients about the types of symptoms they should be aware of and report.
A key factor in advancing health equity is improving health education. Our collective efforts to date have been effective in educating the public about the symptoms of a heart attack, but not about what to do next or how to perform heart care. Calling 911 is a good step, but what questions should patients and caregivers ask a medical professional in this situation? What treatment should they expect? Will their insurance cover their care? Not knowing any possible answers to these questions in advance may prevent patients from seeking treatment under the assumption that they may be turned away or face financial hardship.
Covid’s impact on heart disease deaths
Covid has exacerbated some of the trends we’re already seeing in patient outcomes and presents unique challenges for patients seeking treatment – or, often, choosing not to seek treatment out of fear of exposure to the virus in crowded hospital wards . Those who did choose to go to the hospital then faced shortages of ICU beds and medical supplies, overworked nurses and medical staff, and a system overwhelmed by the pandemic. We know that the systemic effects of COVID-19 infection, including blood clots and inflammation, are more likely to affect patients with heart disease, who are also more likely to suffer from long-term disease effects—and, in turn, are more likely to be under-resourced /underserved/disadvantaged.
We have to deal with this trend
We can’t just blame the coronavirus for an increase in heart disease diagnoses and deaths. The fact remains that heart disease trends predate the pandemic, and death rates were on the rise a decade before Covid arrived in the United States. This tells us that the problem is systemic – the tools to solve the problem must also be implemented system-wide. Today, developments in health technologies such as telehealth visits, wearable health devices, apps, etc. exist, but are not yet widely used or accessible. To reverse this trend of heart disease deaths, we need to ensure that patients have access to the tools we already have, and those that are currently being developed. Only by creating and distributing medical interventions with health equity in mind can we as an industry make the changes necessary to improve patient outcomes across the board.
Photo: hudiemm, Getty Images
