Participation in cardiac rehabilitation programs is significantly lower among Asian, Black and Hispanic adults compared to white adults, according to research in the Journal of the American Heart Association. The study showcases the alarming magnitude of enduring racial and ethnic disparities in accessing cardiac rehabilitation services across income levels, highlighting a need for initiatives to address these discrepancies and promote equitable cardiovascular health outcomes.
Cardiac rehabilitation programs combine physical activity, counseling on healthy living, and stress reduction techniques to help people recover from a heart attack, heart failure, heart surgery or angioplasty. Cardiac rehab also reduces the risk of recurrent cardiac events and hospital readmissions.
Still, research shows that few patients participate in cardiac rehab. A 2020 study found that only 25% of eligible Medicare beneficiaries participated in cardiac rehabilitation programs.
For this study, researchers analyzed data from over 107,000 individuals across the U.S. who were eligible for cardiac rehabilitation programs. "Overall, only about 26% of all study participants attended one or more cardiac rehabilitation sessions," explained Jared W. Magnani, M.D., M.Sc., senior study author from the University of Pittsburgh's Center for Research on Health Care.
Out of that 26%, Asian, Black and Hispanic individuals were generally less likely to attend cardiac rehabilitation programs, regardless of their income level. Asian adults were 31% less likely to attend cardiac rehabilitation compared to their white counterparts. Black people were 19% less likely, and Hispanic adults were 43% less likely.
"Disparities in cardiac rehabilitation participation have been well-documented. However, it is alarming to see the magnitude of the disparities that persist," said Joshua H. Garfein, M.P.H., co-lead study author from the University of Pittsburgh. "We were surprised to find that the racial or ethnic disparities did not decrease at higher income levels, which means we need to do more research to identify the barriers.”
The study relied on health insurance claims data, which excludes information from people without health insurance. The researchers said initiatives such as automatic referral systems, virtual delivery options, community-based programs, and evening or home-based programs could help address the gaps and increase overall participation. The American Heart Association supports legislative efforts like the "Increasing Access to Quality Cardiac Rehabilitation Care Act," which aims to expand resources and improve referral to cardiac rehabilitation programs.
Optimizing access to cardiac rehabilitation and promoting equitable cardiovascular outcomes requires a multi-faceted approach, involving health care professionals, targeted initiatives and legislative support. Bridging these gaps can enhance recovery, reduce recurrent cardiac events, and improve overall health outcomes for everyone.