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Heart disease, stroke and the risk factors behind them that can be changed do not fall evenly across the United States. They vary with race and ethnicity, with the social determinants of health, and with where people live.
Structural racism, discriminatory economic policies and other systemic forces have widened these gaps. They add financial stress, breed distrust of the medical system, limit access to good health care and push people into unsafe, unhealthy neighbourhoods. As a result, some people have a harder time:
- paying for medicines, home blood pressure monitors, or preventive care such as cardiac rehabilitation;
- getting help to quit nicotine;
- exercising safely;
- breathing air free of smoke and particle pollution.
Million Hearts 2027 aims to advance health equity through policies, processes and practices that give everyone fair access to what heart health takes. It puts deliberate emphasis on five groups, each with policies that would help.
| Priority group | Policies that would help |
|---|---|
| People from racial and ethnic minority groups | Offer medication therapy management, self-measured blood pressure monitoring and other hypertension care in trusted places such as barbershops, salons and churches; support banning the sale of flavoured tobacco, menthol included |
| Pregnant and postpartum women with hypertension | Promote self-measured blood pressure monitoring for hypertensive disorders of pregnancy; extend Medicaid to cover monitoring devices and medicines, and to one year after birth |
| People with lower incomes | Extend Medicaid to cover monitoring devices, medicines and cardiac rehabilitation; support loaner programmes for blood pressure monitors |
| People in rural areas and other "access deserts" | Make strong virtual and remote cardiac rehabilitation available; support home blood pressure monitoring with telehealth |
| People with behavioural health conditions who use tobacco | Remove barriers to Medicaid coverage for quitting tobacco; build tobacco cessation into mental health and substance use care |
Further reading
- Race, Ethnicity, Hypertension, and Heart Disease, a JACC Focus Seminar — a clinical review of racial and ethnic differences in hypertension and how social determinants affect heart care and outcomes.
- Structural Racism as a Fundamental Driver of Health Disparities, a presidential advisory from the American Heart Association — structural racism as a root cause of poor heart health, and possible remedies.
- CDC's work on health equity science: CDC priorities.
Sources
- Million Hearts® (U.S. Department of Health and Human Services; content from CDC's Division for Heart Disease and Stroke Prevention), "Focusing on Health Equity." https://millionhearts.hhs.gov/about-million-hearts/health-equity/index.html
- Infographic: Million Hearts; its text from the description page.
- Rewritten in hubnx's own words.
Licens: CC0 1.0 (allmän egendom) · Bearbetat efter millionhearts.hhs.gov
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