2022 | HFSA

Bridging the Gap: Advancing Health Equity in Heart Failure

Patient News Heart Failure Awareness 365

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How Heart Failure Impacts Patients 
Heart failure (HF) is a chronic, progressive condition that occurs when the heart muscle is unable to pump an adequate amount of blood throughout the body to meet its needs for blood and oxygen. As a defense mechanism, the heart tries to compensate by enlarging, developing more muscle mass and pumping faster.

Understanding Health Disparities and Unmet Needs with HF Patients
Despite advances in therapy, HF morbidity and mortality remain high and the health and economic burden of HF disproportionately affects African Americans and continues to grow.

Healthcare disparities occur across socioeconomic status, age, geography, language, gender, disability status, citizenship status, and sexual identity and orientation. Many disparities persist due to systemic historic and cultural patterns, including racial/ethnic inequalities that impact socioeconomic status and differential healthcare accessibility and quality. Approximately 6 million patients in the US are affected by HF, and prevalence is expected to increase to 8 million people by 2030.2,3

How Healthcare Disparities Increase Risk for HF in Minority Communities
Type 2 diabetes, hypertension, obesity, and chronic kidney disease are risk factors that increase the likelihood of subsequent HF – all of which are common in African Americans and Hispanic populations.

In African Americans, the higher prevalence of HF can be attributed to modifiable risk factors such as hypertension, hyperglycemia, left ventricular hypertrophy, and smoking. Hispanics, one of the fastest-growing segments of the U.S. population, are also disproportionately impacted by HF because of increased risk for diabetes, obesity, atherogenic dyslipidemia, metabolic syndrome, and poorly controlled hypertension.4,5

Overcoming Disparities, A Multicultural Approach
To advance health equity in HF in communities across the U.S., we must recognize the need for a culturally responsive approach, including early awareness in all communities,  to ensure we are able to improve the health of all Americans. As a result, this can increase understanding of needs for the medically underserved, improve cultural competency and address social determinants of health. Below are recommended strategies that can be implemented across sectors6:

  • The Government: Monitor data and track health conditions with supportive partnerships between scientific researchers and community members.
  • Public Health Professionals: Use proven programs to reduce disparities and barriers to create opportunities for health and connect more people to healthcare providers.
  • Community Organizations: Train health workers in underserved communities to educate people about free or low-cost services and conduct effective health promotion programs in community, work, school, and home settings.
  • Healthcare Providers: Work with communities and healthcare professional organizations to eliminate cultural barriers to care.


  1. The American Heart Association. What is Heart Failure? https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure. Accessed July 12, 2022 
  2. Virani SS, et al. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation 2020; 141(9):e139–e596.
  3. Savarese G, Lund LH. Global Public Health Burden of Heart Failure. Card Fail Rev. 2017 Apr;3(1):7-11.
  4. Thomas MC. Type 2 diabetes and heart failure: challenges and solutions. Curr Cardiol Rev. 2016;12(3):249-255.
  5. Vivo R, Krim S, Cevik C, et al. Heart Failure in Hispanics. J Am Coll Cardiol. 2009 Apr, 53 (14) 1167–1175.
  6. Centers for Disease Control and Prevention. African American Health - Creating equal opportunities for health. https://www.cdc.gov/vitalsigns/aahealth/index.html. Accessed April 21, 2021.


Helpful Resources

Visit the HFSA Patient Hub to explore tools and resources to help patients stay healthy while living with heart failure. 

View Heart Failure Awareness 365 activities to stay up-to-date on tips for healthy living for people living with heart failure.