Association of Gender and Race With Allocation of Advanced Heart Failure Therapies

Abstract

Heart failure therapies are inequitably allocated to minority racial groups in the US.^1,2 Despite African American individuals representing the highest racial risk group for heart failure incidence and mortality,³ they are less likely to receive defibrillators^4,5 and care by a cardiologist compared with white individuals.⁶ Racial disparities are not fully explained by socioeconomic factors,^4-6 and may be related to bias. A 2019 study⁷ suggested that patient race is associated with the allocation process for advanced heart failure therapies, heart transplantations, and ventricular assist devices (VADs). Among vignettes of men patients with identical clinical and social histories, white men were favored over African American men for allocation to heart transplants.⁷ Variability in clinicians’ assessments of social support and adherence contributed to the racial bias.⁷