Millions of Americans are at risk of developing and succumbing to heart disease while residing in regions without access to cardiology specialists — commonly referred to as cardiology deserts. Recent research published in the Journal of the American College of Cardiology underscores a troubling reality: nearly half of all counties across the United States lack a practicing cardiologist.

Dr. Haider Warraich, the study’s senior author and a cardiologist at Brigham and Women’s Hospital in Boston, highlighted the critical need for cardiovascular expertise in these underserved areas. He pointed out that counties without cardiologists often harbor populations burdened with a higher prevalence of cardiovascular risk factors such as obesity, diabetes, smoking, high blood pressure, and high cholesterol — all significant contributors to heart disease incidence.

The study, conducted in collaboration with GoodRx, revealed that 46.3% of the 3,143 counties in the U.S. do not have a single cardiologist. The overwhelming majority of these counties, approximately 86.2%, are rural and characterized by lower income levels, limited access to nutritious food, and an overall shortage of healthcare providers.

Despite heart disease being the leading cause of death nationwide, rural residents face disproportionately higher mortality rates from heart-related issues that could be preventable with timely and accessible medical care. A report from the Centers for Disease Control and Prevention underscores these disparities, emphasizing the urgent need for targeted interventions.

Alan Morgan, CEO of the National Rural Health Association, highlighted the significant challenges faced by small communities where healthcare access is severely limited. He noted the profound impact of long travel distances required to seek specialty care, a barrier that can delay treatment and worsen health outcomes.

Dr. Warraich’s personal experience practicing as the sole cardiologist in Randolph County, North Carolina — serving a population exceeding 146,000 — illustrates the stark reality for many rural healthcare providers. He recounted the immense responsibility and isolation of being the sole specialist available, underscoring the critical need to expand healthcare resources in underserved regions.

Addressing potential solutions, the research indicated that counties with cardiologists have an average of 24 specialists available. However, approximately 10% of these counties rely on just one cardiologist to serve their entire population, highlighting the uneven distribution of healthcare resources.

Dr. John Wagener, a structural interventional cardiologist and medical director at Avera Heart Hospital in Sioux Falls, South Dakota, provided insights into the logistical challenges faced by healthcare providers covering vast rural areas across multiple states. His team, spanning 86 counties, employs a blend of in-person visits and telemedicine to bridge the gap in access to specialized care. This approach not only reduces the travel burden for patients but also enhances collaboration with local healthcare providers.

Dr. Steve Ommen from the Mayo Clinic in Rochester, Minnesota, emphasized the transformative role of telehealth in overcoming geographical barriers to healthcare access. He highlighted that remote consultations can significantly benefit patients with mobility challenges, offering a viable alternative to traditional in-person visits.

Alan Morgan echoed these sentiments, describing telehealth as a practical solution for delivering quality care in remote areas. He stressed the imperative of expanding broadband infrastructure and telehealth platforms to ensure equitable access to healthcare services across rural America.

In conclusion, while the shortage of cardiologists in rural areas remains a pressing concern, innovative approaches such as telehealth present promising avenues to mitigate healthcare disparities. As efforts continue to expand access to cardiovascular expertise, addressing infrastructure and resource gaps will be pivotal in improving health outcomes for millions of Americans living in cardiology deserts.