Thread by @ShrillaB

Our paper, Racism & Cardiology: a global call to action published in @CJCOpen.

sciencedirect.com/science/articl…

As Black History month ends, we look at how racism & racial bias influence CV health of ethnic minorities with viewpoints of cardiologists from 🇬🇧🇺🇲🇨🇦@DrQuinnCapers4

There are 3 major forms of racism:
1️⃣Explicit:easily detectable,easy to condemn
2️⃣Implicit:unconscious association of positive/negative attributes w/different racial groups
3️⃣Structural:results from yrs of policy-making;gives advantage to some racial groups at expense of another

Racism, Health, and Heart Disease in Canada
Recent reports, incl Canada’s Truth and Reconciliation Commission Report (2015), state that the poor health statistics of the country’s First Nations, Inuit and Metis peoples are due in part to systemic racism and discrimination

This popl has the highest CVD burden in 🇨🇦, due to policies and history that have -> to poorer socioeconomic status, lower quality healthcare, less primary CVD prevention, poor access to nutritional foods and a shift away from traditional practices of Canada’s First Nation people

In USA CV care, racial disparities seen in the management of #AMI & #AICD implantation.
#BIPOC more likely to suffer a 1st cardiac arrest & live in areas where bystander CPR or AEDs are less common. Blacks & women are less likely than White males to receive ICD. @NMHheartdoc

In UK ethnic minority ACS pts have longer ER wait times, delayed angiography & intervention & less likelihood of receiving GDMT.
Part of this inequity is structural, but not fully explained by clinical factors/differential access to care – implicit biases likely…@aayshacader

Racial disparities in Rx of AMI is a global problem. Black, Hispanic, Asian, Indigenous, & other minorities less likely than Whites to receive evidence-based care in several countries. This has been further accentuated by the COVID-19 pandemic.@mmamas1973

Alarmingly, it's been shown that if physicians unknowingly hold negative/ positive implicit biases about a patient, these biases influence clinical decision making &interpersonal communication and can be measured by the computer-based Implicit Association Test (IAT) @liznyawade1

There's some evidence that just becoming aware of one's bias can help reduce it. While data are lacking that CV outcomes are improved by bias mitigation training, educating HCW in strategies to override racial and other biases may enhance inclusivity & patient trust.@sashnhs

Schematic of strategies to reduce the impact of racism on cardiovascular care @DrMarthaGulati

Racism and racial bias negatively impacts the health of people of colour and Indigenous populations. The effects of racism and the SDOH are intertwined. Racism impairs mental and physical health and drives poor CVS health and outcomes in minority individuals. @ncurzen @WomenAs1

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