DEI in Cardiology

Diversity, equity and inclusion (DEI) are key to innovation, but the culture in the cardiovascular medical and research sector is often not supportive of diversity and collaboration.

Cardiopulmonary resuscitation (CPR) provided by a bystander has saved the lives of many patients with out-of-hospital cardiac arrest. Several factors have been hypothesized to contribute to the low rates of bystander CPR, including the race and/or ethnicity of the recipient and the location of the out-of-hospital cardiac arrest.

Cardiovascular researchers face a range of challenges, including reduced grant funding, job insecurity and a lack of diversity in leadership roles. In this Roadmap article, Marques and colleagues propose strategies to overcome these challenges, focusing on three key areas: capacity building, research funding and fostering diversity and equity.

As a Brazilian female cardiologist who has held leadership positions since my 40s, I understand the difficulties that women face in trying to achieve recognition and senior positions. I believe the awareness and joint efforts of both women and men can help build a more equitable future.

Women who are health providers face unique challenges when building their careers. Despite this, African female cardiologists should have a role in building equitable health systems and minimizing gender disparities in health care by mentoring girls and young women who aspire to a career in medicine and science.

When I have encountered obstacles in the three decades of my career, I have found that self-confidence and courage are the most effective traits for achieving my goals as a female cardiologist.

The proportion of female cardiologists is increasing in China, and they have special roles in clinical management and research. As the president of the Chinese Society of Cardiology, I believe female cardiologists excel in finding ways to balance family life with their career goals when they receive adequate support.

Globally, Black people have some of the highest rates of cardiovascular disease. Racial inequities in cardiovascular health must be tackled. Black In Cardio is a trainee-led initiative aimed at promoting Black people in the cardiovascular field and raising awareness about issues related to the cardiovascular health of Black communities.

Bullying is common in cardiology and can have substantial adverse effects. However, bullying can be addressed by substantive leadership, organizational and individual efforts to build an inclusive and respectful culture.

Childbearing cardiologists face a number of challenges before, during and after pregnancy, including radiation concerns, infertility, pregnancy-related complications, and inadequate parental leave and return-to-work structures. Institutions can promote an equitable work environment by creating policies to mitigate these challenges.

Mentorship is a crucial element to success and satisfaction among medical professionals. For a successful relationship, both mentors and mentees must examine their roles and goals. In this Comment article, a mentor–mentee pair discuss the necessary attributes for a productive partnership.

In this Review, the authors summarize the evidence on the different effects of sex and gender on the pathogenesis, clinical manifestations and treatment responses of patients with ischaemic heart disease or heart failure. In addition, they highlight unexplored areas of sex-related and gender-related factors in cardiovascular disease such as in individuals with gender dysphoria.

A new, very large genome-wide association study has uncovered many novel genetic factors associated with circulating lipid levels. The success of this study came partly from analysing many samples, but mostly from including individuals of non-European ancestry. So, why is studying genetic diversity important and how can it help to fight cardiovascular disease?

In this Review, Essien and colleagues discuss the contributions of social determinants, including race/ethnicity, financial resources, and rural or residential environment, to the evaluation, treatment and management of atrial fibrillation, identify gaps in the literature, and propose future directions to investigate and address social determinants of atrial fibrillation.

Large differences in cardiovascular disease (CVD) morbidity and mortality exist between migrant populations and host populations. Understanding the drivers behind these disparities may help to mitigate the unequal burden of CVD and identify new causal pathways that contribute to CVD risk in the population at large.

The homogeneity of cardiovascular clinical trial populations limits the generalizability of results and compounds health inequities faced by women, older adults and people of colour. This Comment highlights the importance of diversity in clinical trial populations and describes multifaceted interventions that might help to close the diversity gap in trial enrolment.

Burnout is prevalent in medicine and has been further amplified by the COVID-19 pandemic. Strategies must be developed to reduce burnout by addressing a culture of wellness, efficiency of practice, and resiliency. The entire health-care community has a role in addressing burnout and promoting well-being.

Growing evidence indicates that sexual and gender minority populations might be at greater risk of cardiovascular disease than the general population. Additional population and clinical health research is needed to inform the development of tailored, evidence-based interventions to promote the cardiovascular health of sexual and gender minority populations.

The disparities amplified by the COVID-19 pandemic present disturbing evidence that we are far from cardiovascular health-care equity. Individuals, leaders and institutions must prioritize research, policies and structures to advance diversity, equity, inclusion and belonging — Diversity 4.0, a justice imperative, essential to advancing workforce excellence and cardiovascular health.

Social determinants of health in the African diaspora drive the lack of disease testing, increased prevalence of comorbid disease and reduced access to drugs, resulting in disproportionately higher COVID-19-related mortality among Black individuals than the rest of the population. We urge decisive attention to and action against ethnicity-based inequities that undermine cardiovascular health.