Transcript Williams ABC 2010 Diversity

Three hundred years ago the majority
of us of African descent would have
been slaves. Now we have CEOs of
major fortune 500 companies, we have
had tremendous success in sports and
entertainment and who would have
thought we would have an African
American living the White House?
However, this progress could make us
complacent or worse blind to the needs
that still exist. In spite of the victories
many have not benefited. The disparity
in health outcomes emphasizes this
point. “That all is not what it seems.”
— Dr. Marcus L Williams, President of the ABC,
Remarks at the Presidential Address 03/13/2010
Our Mission …
… is to champion the elimination of cardiovascular
disparities through education, research and advocacy
Education
Research
Advocacy
• CME programs
• Clinical Trials
• National
Conferences
• Steering
Committee
• ABC
eNewsletter
• Regional
Symposia
• Investigator &
Patient
Recruitment
• Online/Enduring
• Spirit of the
Heart
• Fellowships
• Mentoring
• Information
Dissemination
• Basic Research
• Every Patient
First-QI
• Community
programs-CHAT
• Lobbying
• Partners
ACC/AHA
• Committee
Engagement
• FDA, NIH, CDC
Leading Causes of Death by Race
White
36.2%
Black
33.6%
21.6%
23.1%
CVD
Cancer
Hispanic
29.6%
19.7%
Asian
34.8%
26.4%
National Vital Statistics Reports. 2003;52(9):Table E; http://www.cdc.gov/nchs/data/nvsr/nvsr52/nvsr52_09.pdf
Courtesy of Keith C. Ferdinand, M.D.
Heath Care Disparities
• AA men are 76% more likely, and AA women
are 54% more likely and to die of stroke
than Whites
• AA men and women have higher prevalence of
hypertension and diabetes
• AA have higher mortality rate for CVD
• AA less likely to be treated according to
evidence based guidelines
Smedley BD, Stith AY, Nelson AR [eds]: Unequal treatment: Confronting racial and ethnic disparities
in health care. The Institute of Medicine. Washington, DC, National Academies Press, 2002, p 83
Source: CDC/NCHS and NHLBI. * Preliminary
Source: NHANES 2000
Circulation 2002; 106:3143-3421
continued
Heath Care Disparities
cont.
• AA are 3 times more likely to be operated on
by “high risk” surgeon
• Over 50% of the Hispanic elderly are cared
for by 5% of American hospitals
• Some American Indian tribes have over 50%
occurrence of diabetes
• Death rate for heart disease was 40% higher in
poor men compared to wealthier ones
Data from AHA
Heath Care Disparities
Disparities In Resources
• Man power shortage for cardiologists in certain
ethnic groups
• Lost physician revenue means lost patient
access
• Disproportionate un-insured and under
insured
• Centralizing health care in hospitals threatens
access
continued
Heath Care Disparities
cont.
Disparities In Resources
• Lack of excellent/adequate research on
certain populations
• Divergent compliance with evidence-based
clinical guidelines
• Lack of empowerment in the community
• Low priority for local, state and federal
governments
The BIDIL Story
• Old drugs used in combination with outstanding
outcomes in AA with CHF
• Ineffective marketing and advocacy
• Issues of race bias and targeted studies
• Nitromed as a company fails
• AHA, ACC and CHF guidelines support outcomes and
use as a recommendation in AA
• Physicians and pharmacist lukewarm, fail to push it
• AA with CHF denied opportunity to received therapy
that might prolong their life
The
Paradox
• Excellent trial targeting an underserved population
• Luke warm reception by medical community
• Compliance poor in implementation based on the
guidelines
Today, 1 in 3 of All Americans are…
minorities
Minorities
35%
White
65%
Source: 2008 US Census Projections
By 2020
Minorities
40%
Source: 2008 US Census Projections
White
60%
And in 2050
Minorities
54%
Source: 2008 US Census Projections
White
46%
ABC 2020
Saving the Hearts of a Diverse America
20%
2010
CHD Mortality Rate
2020
Goal: To reduce disparity in CVD by 20%
by the year 2020
How can ABC and ACC work together?
• Credibility
• Connection
• Perspective
• Educate
• Targeted
EQUAL
PARTNERS
• National
prominence
• Resources
• Access
• Credibility
• Broad
Our Mission …
… is to champion the elimination of cardiovascular
disparities through education, research and advocacy
Education
• CME programs
• National
Conferences
• Regional
Symposia
• Online/Enduring
• Spirit of the
Heart
• Fellowships
• Mentoring
IDEAS:
1. Joint CME programs
a. Online
b. Conferences
c. Culturally competence programs
2. Joint community programs
3. Research and clinical fellowships
4. Mentoring programs: urban settings
Our Mission …
… is to champion the elimination of cardiovascular
disparities through education, research and advocacy
Research
• Clinical Trials
• Steering
Committee
• Investigator &
Patient
Recruitment
• Information
Dissemination
• Basic Research
• Every Patient
First-QI
IDEAS:
1. Targeted research
2. Genetic research
3. Outcomes
research
4. CQI
5. Out patient
compliance
Our Mission …
… is to champion the elimination of cardiovascular
disparities through education, research and advocacy
IDEAS:
1. Adjustment to reform
a. Lost revenue
Advocacy
• ABC
eNewsletter
b. Lost access
• Community
programs-CHAT
c. Greater barriers
• Lobbying
2. Improving access
3. Guideline compliance
4. Certifications
5. Cultural competence
• Partners
ACC/AHA
• Committee
Engagement
• FDA, NIH, CDC
“Of all the forms of inequality,
injustice in health care is
the most inhumane.”
— Martin Luther King, Jr.
Questions?
Marcus L. Williams, MD, FACC
President, Association of Black Cardiologists, Inc.
[email protected]
www.abcardio.org
Age-adjusted Death Rates
For Selected Causes of Death By Ethnicity,
United States, 1950–1998
Courtesy of Keith C. Ferdinand, M.D.
Smedley BD, Stith AY, Nelson AR [eds]: Unequal treatment: Confronting racial and ethnic disparities
in health care. The Institute of Medicine. Washington, DC, National Academies Press, 2002, p 83
CHD in Race & Ethnicity
Courtesy of Keith C. Ferdinand, M.D
Gettyimages.com
The Changing Face of America
Percentage of Population by Race/Ethnicity:
2000 and 2025
80
70
71.4
2000
2025
61.9
60
50
40
30
20
12.2 12.9
10
0
18.2
11.8
0.7 0.8
White*
*Indicates non-Hispanic
African
American*
3.9
6.2
American Indian, Asian and Pacific
Eskimo, Aleut*
Islander*
Hispanic Origin
(of any race)
US Census Bureau, 2000
ACT
Strategic Imperatives:
Ambassador … recruit and host
1
Be an
2
Bring
3
Use your
Cooperation … give, solicit, create
Talents … get involved with our
committees and programs
23