Nearly half of the counties in the United States lack a practicing cardiologist, creating serious challenges for people needing specialized heart care.
This shortage is especially severe in rural areas, where residents already face significant health and economic difficulties.
A study published on July 8 in the Journal of the American College of Cardiology highlights that over 46% of U.S. counties lack even a single cardiologist.
This shortage is most acute in rural counties, with nearly 9 in 10 lacking a heart doctor.
These areas are characterized by higher rates of heart disease and related risk factors, such as diabetes, high blood pressure, elevated cholesterol, and smoking.
Dr. Haider Warraich, the study’s senior author and director of the heart failure program at VA Boston Healthcare, highlights the need for cardiologists in these underserved areas.
“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,” Warraich stated.
The impact of this shortage is stark. People living in counties without a cardiologist face a 31% higher risk of heart disease and generally have a shorter life expectancy by one year.
Additionally, residents must travel an average of 87 miles round-trip to see a cardiologist, compared to just 16 miles in counties with available heart specialists.
Economic and logistical barriers further compound the problem.
Counties without cardiologists tend to have lower household incomes, more residents without health insurance, worse access to primary care doctors, and less availability of healthy food options. Consequently, hospitalizations that could be prevented through early treatment are more common in these areas.
Dr. John Wagener, medical director of the Avera Heart Hospital in Sioux Falls, South Dakota, underscores the geographical challenges.
“We have people who live three, four hours away to come to see us,” he said, highlighting the extensive travel required for many patients to receive care.
Innovative solutions, such as telemedicine, are being explored to bridge this gap.
Telemedicine allows cardiologists to consult with patients remotely, providing critical care without the need for extensive travel.
This method is already being used effectively by teams like Wagener’s, who cover multiple counties across the Dakotas, Iowa, Minnesota, and Nebraska through remote consultations and collaborations with local healthcare providers.
Dr. Steve Ommen, a cardiologist at the Mayo Clinic in Rochester, Minnesota, advocates for remote care as a practical solution.
“For people who have bad hips or bad backs, sometimes it’s just a problem of getting out of the house,” he noted, adding that telemedicine can be a “great equalizer.”
However, for telemedicine to be effective, expanding broadband access in rural communities is crucial.
Alan Morgan, CEO of the National Rural Health Association, stresses the importance of this infrastructure, saying, “This highlights the critical importance of expanding broadband in these communities and ensuring that we have enough telehealth platforms.”
The findings of these studies shed light on the severe geographic disparities in access to cardiovascular care across the United States.
As heart disease remains the leading cause of death in the country, addressing these disparities through policy reforms and innovative healthcare solutions is essential for improving the health and longevity of Americans, particularly those in rural and disadvantaged areas.