This week, the Journal of the American College of Cardiology published a study that found that about half of all counties in the United States don't have a practicing cardiologist. 10% of these counties only have one cardiologist for the entire county. The implications for Black populations across the country should go without saying. Let's look at the numbers to take a deeper dive into how this report can be interpreted to affect the population.
Most counties that don't have access to a practicing cardiologist are in rural communities. The U.S. Census Bureau defines "rural" as anywhere that is not urban. As of 2022, African Americans made up 7% of rural America. Although that may not be a significant number, it is important to note that even 7% matters when speaking about an already sizable population. The concerning thing is that heart disease is a prevalent issue both in the Black community and outside of the Black community.
The U.S. Department of Health and Human Services says that African Americans are 30% more likely to die from heart disease than non-Hispanic whites. Heart disease is the number one cause of death globally, based on data from the World Health Organization. For heart disease to be such a known threat and for there to be such a disparity of cardiologists in rural areas, there must be more said about this problem.
One of the possible solutions would be to have more doctors in rural areas. 20% of the population lives in rural areas, but only 10% of physicians practice in rural areas. The government has developed several programs to incentivize physicians to practice in underserved communities such as rural areas. Scholarships, loan forgiveness, and loan repayment are some of the few.
Another possible solution would be that more Black physicians, specifically, should be in rural areas. The reality is that there aren't enough Black physicians to fill this need. Black physicians only make up about 6% of physicians in the U.S. and about 4% of cardiologists. So, there aren't enough Black cardiologists either. Is it possible that the solution to this problem may be more upstream? Maybe as opposed to encouraging more physicians to go to rural areas, the work should be done to encourage more Black students to become physicians.
The barriers to entry to medicine are immense though. Becoming a physician is no small feat. We'll start at the beginning. You have to have a 4-year degree and take the medical college admission test (MCAT) before entering medical school. Between those two steps, however, you'll probably need to take a prep class to prepare you for the MCAT. Prep classes are not cheap. This doesn't include externships, internships, moving across the country for school, books, room, board, tutors, and everything else in between.
Often when looking at certain numbers, there is always a larger story. A shortage of cardiologists in rural areas is part of a larger story that the numbers help to illustrate. Whether the situation will be rectified is a question that only time will tell.