Socioeconomic Disparities in Women’s Cardiovascular Health in United States and Canada

Cardiovascular disease has been the leading cause of death in the United States and Canada for decades. Although it affects millions across a multitude of backgrounds, notable disparities in cardiovascular health are observed among women, and become more apparent when accounting for race and socioeconomic status. While intrinsic sex-specific physiological differences predispose women to poorer outcomes, social determinants of health (SDOH) and biases at both the individual provider and larger healthcare system, play an equal, if not greater, role. This review examines socioeconomic disparities in women compared to men with regards to cardiovascular risk factors, treatments, and outcomes. While various at-risk sub-populations exist, we highlight the impact of SDOH in specific populations, including patients with disabilities, transgender persons, South Asian and Indigenous populations. These groups are underrepresented in studies and experience poorer health outcomes because of structural barriers to care. These findings emphasize the significance of understanding the interplay of different socioeconomic factors and how their stacking can negatively impact women’s cardiovascular health. To address these disparities, we propose a multi-pronged approach to augment culturally sensitive and patient-centered care. This includes increased cardiovascular workforce diversity, inclusion of underrepresented populations into analyses of cardiovascular metrics, and greater utilization of technology and telemedicine to improve access to health care. Achieving this goal will necessitate active participation from patients, healthcare administrators, physicians, and policymakers, and is imperative in closing the cardiovascular health gap in women over the coming decades.