Photo Credit: John Kevin

Close to half of U.S. counties do not have a practicing cardiologist, according to a research letter published in the Journal of the American College of Cardiology. Differences in characteristics of counties with and without cardiologists across the U.S. were examined. County-level estimates of practicing cardiologists were determined. For each county, a composite cardiovascular index was constructed by summing five cardiovascular disease risk factors. Researchers found that 1,454 counties (46.3%) of the 3,143 counties analyzed had no cardiologists, while 1,689 had 24 cardiologists each, on average; of 1,105 rural counties, 86.2% had no cardiologists. In counties with and without cardiologists, the average round-trip distance to the nearest cardiologist was 16.3 and 87.1 miles, respectively. The cardiovascular risk index was 31% higher in counties without versus with cardiologists (2.8 versus 2.1). In addition, there was a greater prevalence of all risk factors, as well as older age-adjusted cardiovascular mortality rates (281.6 versus 269.1 per 100,000); life expectancy was one year shorter, on average. Counties without cardiologists were more likely to be rural with lower household income, greater uninsurance, worse access to healthy food or primary care physicians, and more hospitalizations that were preventable.