Health
No cardiologists available in half of US counties as study reveals ‘incredibly concerning’ care gaps
Nearly half of all U.S. counties don’t have a practicing cardiologist on staff, according to a recent study published in the Journal of the American College of Cardiology (JACC).
Rural communities are most affected, with Americans in those areas dying earlier and more often from heart disease that could have been prevented, according to a May report from the Centers for Disease Control and Prevention (CDC).
The study, led by Brigham and Women’s Hospital in Boston, analyzed over 3,100 counties.
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Forty-six percent of the counties did not have access to cardiologists — meaning that 22 million residents would not have access to heart-related health care.
When looking just at rural counties, more than 86% of them did not have a cardiologist.
Nearly half of all U.S. counties don’t have a practicing cardiologist on staff, according to a recent study published in the Journal of the American College of Cardiology. (iStock)
“While cardiologists are not the only determinants of cardiovascular outcomes, the lack of access to cardiologists in areas with greater prevalence of heart disease and mortality is incredibly concerning,” said senior author Haider J. Warraich, M.D., director of the heart failure program at VA Boston Healthcare and an associate physician at Brigham and Women’s Hospital, in a press release.
How does this impact patients?
In counties without a cardiologist, patients have to travel an average of 87.1 miles to get the care they need, the study found.
“When a patient is having a heart attack, time matters,” said Dr. Bradley Serwer, a cardiologist and chief medical officer at VitalSolution, a Cincinnati-based company that offers cardiovascular and anesthesiology services to hospitals nationwide.
In the counties without a cardiologist, patients have to travel an average of 87.1 miles to get the care they need, the study found. (iStock)
“If a patient is unlucky enough to have a heart attack in a rural area, without cardiology services, they are sometimes transferred via ambulance or helicopter, but this takes time while the heart is dying.”
In some cases, these patients receive high-risk medications called thrombolytics to help stop the heart attack, according to Serwer, who was not involved in the new study.
“Thrombolytics are an inferior option to treat heart attacks compared to primary percutaneous coronary intervention (PCI), also known as stenting,” Serwer said.
“When a patient is having a heart attack, time matters.”
“Thrombolytics are a last resort when transfers are not possible or will take too long, as they are still better than the alternatives.”
Patients in rural counties have a higher age-adjusted cardiovascular mortality rate — on average, they live one year less than their urban cohorts, according to Serwer.
Why the lack of cardiologists?
Several factors may contribute to the scarcity of heart specialists in rural areas, according to Serwer.
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“Cardiologists train in academic hospitals with a wide network of colleagues, specialists and sub-specialists,” he told Fox News Digital.
“When they finish training, many of them want to join a large group practice or hospital practice, as there is comfort working alongside other cardiologists who can provide mentorship and guidance, especially early in one’s career.”
“These deficiencies cause a delay in care and can mean the difference between life and death,” a cardiologist said. (iStock)
Many cardiologists are unwilling to leave an urban environment to move to a remote location, he noted, particularly if they have children who need access to more schooling options.
Cardiologists in rural areas are also more likely to be overworked, Serwer said, due to the fact that the community may only have one or two heart specialists. Often, the community doesn’t have subspecialists such as CT surgeons, electrophysiologists or interventional cardiologists.
“These factors ultimately lead to less time with the family and an unfavorable work/life balance,” the cardiologist said.
Another challenge is that rural facilities require a complex system to transfer patients for a higher level of care, he went on.
“Inpatient and critical care beds at tertiary medical centers are hard to find,” Serwer said. “These deficiencies cause a delay in care and can mean the difference between life and death, which takes an emotional toll on rural health care providers.”
“Understand the importance of cardiac risk factor modification with healthy lifestyle, exercise, diet and medication compliance,” a cardiologist advised. (iStock)
There are also reimbursement considerations, as many rural hospitals don’t have the financial ability to pay their doctors adequately, according to Serwer.
There is also a great need for anesthesiologists in rural counties, he added.
“Nearly every hospital procedure requires an anesthesiologist, whether it’s cardiology, OB, orthopedics or general surgery.”
What needs to happen?
Solving the rural health care dilemma should start with greater awareness and a better understanding of the issues and limitations, according to Serwer.
One option is to set up “creative staffing models” to cover more parts of the country.”
“We need to reduce the hurdles and increase the incentive for physicians, nurses, technologists and administrators to provide rural health care,” he told Fox News Digital.
One option is to set up “creative staffing models” to cover more parts of the country, said Serwer.
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His company, VitalSolution, partners with rural facilities to provide long-term coverage for cardiologists, nurse anesthetists, nurses and cath lab technicians.
“Our physicians work seven days on and then get seven days off,” he said.
“This unique model allows our physicians to work where they are needed and live wherever they want — it’s a win/win for physicians and community hospitals.”
Technology-based clinical support — such as telemedicine — should also be used on a wider basis, a cardiologist recommended. (iStock)
Technology-based clinical support — such as telemedicine — should also be used on a wider basis, Serwer recommended.
“We also need more governmental financial support for rural community hospitals and incentives for physicians, nurses, technologists and administrators,” he said.
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Another option is to promote rural health care while in medical school by requiring rotations in those communities, the cardiologist said.
“These rural rotations can be very rewarding, and can help young physicians gain a more comprehensive understanding of the practice of medicine.”
“Establish a relationship with a primary care provider and know more about your chronic medical conditions,” a doctor advised. (iStock)
The study researchers also called for policy changes to expand internet availability for telemedicine access and to broaden health insurance coverage.
Managing modifiable risk factors for heart disease could also help to reduce risk in rural communities, they stated.
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“This study underscores the urgent need for policy reforms and innovative solutions, such as financial incentives for clinicians and the expanded use of telemedicine, to bridge this gap,” said Harlan M. Krumholz, M.D., editor-in-chief of JACC, in the release.
“Ensuring equitable access to cardiovascular care is a crucial step toward improving overall public health outcomes and reducing preventable cardiovascular mortality.”
Short-term fixes
For patients who are currently living in one of the cardiac care “deserts,” Serwer recommended becoming familiar with the medical care that is available.
“Establish a relationship with a primary care provider and know more about your chronic medical conditions,” he advised.
“Understand the importance of cardiac risk factor modification with healthy lifestyle, exercise, diet and medication compliance,” he also said.
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Those who have a cardiac condition should make a plan of where and how to seek cardiac care if needed, the doctor said.
“They can also write to their elected officials to ask them to do more to supplement the existing health care infrastructure,” Serwer added.
Welcome to the Brain Health Challenge! I’m Dana Smith, a reporter at The New York Times, and I’ll be your guide.
To live a healthy life, it’s crucial to have a healthy brain. In the short term, it keeps you sharp and firing on all cylinders. In the long term, it can reduce your risk of cognitive decline, dementia and stroke.
Practicing basic healthy behaviors, like eating nutritious food and getting regular exercise, is the best way to enhance your brain power and protect the longevity of your neurons. These types of lifestyle habits can benefit the brain at any age. And while they won’t guarantee that you’ll never develop dementia or another brain disease, several clinical trials have shown that they can improve cognition or slow decline.
Every day this week, you’ll do an activity that’s good for your brain, and we’ll dig into the science behind why it works. Some of these activities can provide a small immediate cognitive benefit, but the bigger reward comes from engaging in them consistently over time. So along with the neuroscience lessons, we’ll include a few tips to help you turn these actions into lasting habits.
To keep you accountable, we’re encouraging you to complete this challenge with a friend. If you don’t have a challenge buddy, no problem: We’re also turning the comments section into one big support group.
There are so many fascinating ways your daily behaviors affect your brain. Take sleep, for example.
Lots of studies have shown that getting a good night’s rest (seven to eight hours) is associated with better memory and other cognitive abilities. That’s because sleep, especially REM sleep, is when your brain transfers short-term memories — things you learned or experienced during the day — into long-term storage.
Sleep is also when your brain does its daily housekeeping. While you rest, the brain’s glymphatic system kicks into high gear, clearing out abnormal proteins and other molecular garbage, including the protein amyloid, which is a major contributor to Alzheimer’s disease. A buildup of amyloid is one reason experts think that people who routinely get less sleep have a higher risk of dementia.
What other behaviors play a big role in brain health? For today’s activity, we’re going to test your knowledge with a quiz. Share your score with your accountability partner and in the comments below — I’ll be in there too, cheering you on.
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An often-overlooked part of the body may reveal important clues about overall health.
Researchers from the University of Westminster in the U.K. discovered that the shape of the gluteus maximus muscle in the buttocks changes with age, gender, lifestyle and frailty, as well as certain conditions like osteoporosis and type 2 diabetes.
Using advanced MRI scans that create 3D images, researchers revealed “distinct” patterns in the gluteus maximus associated with type 2 diabetes.
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This suggested that the shape of the muscle, rather than the size, may “reflect underlying metabolic differences,” a press release stated.
The findings were presented in December at the annual meeting of the Radiological Society of North America (RSNA) in Chicago.
Butt shape may indicate underlying health conditions, according to new research. (iStock)
Unlike previous studies looking at muscle size or fat, the 3D imaging identified exactly where the muscle changes occur, according to the researchers.
As one of the largest muscles in the human body, the gluteus maximus “plays a key role” in metabolic health, according to lead study author E. Louise Thomas, Ph.D., professor of metabolic imaging at the University of Westminster’s School of Life Sciences.
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The researchers analyzed more than 61,000 MRI scans from a large UK health database to better understand the muscle’s structure.
The data also included the participants’ physical measurements, demographics, disease biomarkers, medical history and lifestyle habits. The researchers studied how these variables were linked to muscle shape over time.
An infographic from the Radiological Society of North America presentation displays research findings on the shape of the gluteus maximus. (RSNA)
“People with higher fitness, as measured by vigorous physical activity and hand grip strength, had a greater gluteus maximus shape, while aging, frailty and long sitting times were linked to muscle thinning,” study co-author Marjola Thanaj, Ph.D., a senior research fellow at the University of Westminster’s Research Centre for Optimal Health, said in the release.
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The researchers concluded that butt shape changes may indicate an “early functional decline” and “metabolic compromise” in type 2 diabetes patients.
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Men with type 2 diabetes showed muscle shrinkage, while women displayed enlarged muscle, likely due to “infiltration of fat” within it, according to the researchers.
These results suggest that men and women have “very different biological responses to the same disease,” Thanaj suggested.
Butt shape changes may indicate an “early functional decline” and “metabolic compromise” in type 2 diabetes patients. (iStock)
Men who were categorized as “frail” were recognized as having more “general shrinkage” across the gluteus maximus, but women experienced a “limited” frailty effect.
Building strong glutes for better health
Strengthening the glutes is an “investment in long-term health,” according to Tanya Becker, co-founder of Physique 57 in New York City.
“While full-body strength training is essential, focusing on your glutes — the largest muscle group in your body — deserves special attention,” she told Fox News Digital.
“While full-body strength training is essential, focusing on your glutes — the largest muscle group in your body — deserves special attention.” (iStock)
Becker refers to the glutes as the body’s “shock absorbers,” because they protect the lower back, knees and hips from taking on stress they weren’t designed to handle.
Larger muscle groups also burn more calories and help regulate blood sugar, the expert added, noting that muscles are often referred to as the “organ of longevity.”
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Strengthening the glutes also helps to protect the lower back, hips and knees, and also improves posture and balance, reducing the risk of falls and improving mobility.
“People with higher fitness, as measured by vigorous physical activity and hand grip strength, had a greater gluteus maximus shape.”
Becker recommends traditional weighted exercises like squats, lunges and bridges, although they are not suited for everyone, especially older adults with injuries and joint pain.
“Pilates and barre classes offer bodyweight exercises that are ideal for beginners or individuals with physical limitations,” she suggested. “They can be done anytime, anywhere, making them accessible for beginners before progressing to weighted versions.”
Glute bridges (demonstrated above) are a recommended exercise for strengthening those muscles. (iStock)
Becker shared the following three glute exercises that improve hip mobility, stability and overall strength.
No. 1: Quadruped leg lifts (strengthens entire core and glutes)
Start on the hands and knees, engage your core, and lift one leg off the floor (bent or straight). Pulse up and down a few inches for 30 to 60 seconds, then repeat on the other leg.
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No. 2: Clamshells (strengthens gluteus medius)
Lie on your side with knees bent at 90 degrees in front of you. Lift your top knee away from your bottom knee, then lower slowly.
For an increased challenge, lift both feet off the ground while keeping the heels together. Repeat for 30 to 60 seconds per side.
Strong muscles are responsible for maintaining metabolic health, according to Becker. (iStock)
No. 3: Glute bridges (strengthens lower back and glutes)
Lie on your back with knees bent and feet parallel, a few inches from your hips. Engage your abs, and squeeze your glutes to lift your hips toward knee height, then lower.
If you feel pressure in your neck, you’ve lifted too high. Perform for 30 to 60 seconds. Complete three sets with 30-second rests between them.
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Those looking to start a new fitness routine should first consult with a doctor.
Fox News Digital reached out to the study authors for comment.
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What if your New Year’s resolution could fit inside a tote bag? Social media users are trying the “analog bag” trend, replacing phones with offline activities.
The trend is widely credited to TikTok creator Sierra Campbell, who posted about her own analog bag — containing a crossword book, portable watercolor set, Polaroid camera, planner and knitting supplies — and encouraged followers to make their own.
Her video prompted many others to share their own versions, with items like magazines, decks of cards, paints, needlepoint and puzzle books.
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“I made a bag of non-digital activities to occupy my hands instead of the phone,” said Campbell, adding that the practice has significantly cut her screen time and filled her life with “creative and communal pursuits that don’t include doom-scrolling.”
“I created the analog bag after learning the only way to change a habit is to replace it with another,” she told Fox News Digital.
Social media users are trying the “analog bag” trend, replacing phones with offline activities like cameras, notebooks and magazines. (Fox News Digital)
The science of healthier habits
Research on habit formation supports the idea of the analog bag, according to Dr. Daniel Amen, a California-based psychiatrist and founder of Amen Clinics.
“Your brain is a creature of habit,” Amen said during an interview with Fox News Digital. “Neurons that fire together wire together, meaning that every time you repeat a behavior, whether it’s good or bad, you strengthen the neural pathways that make it easier to do it again.”
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Studies show that habits are automatic responses to specific cues — such as boredom, stress or idle time — that typically deliver some kind of reward, according to the doctor. When no alternative behavior is available, people tend to fall back on the same routine, often without realizing it.
Research suggests that replacing an old habit with a new one tied to the same cue is more effective than trying to suppress the behavior altogether.
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“[When] cutting out coffee — you need to have another drink to grab for, not just quit cold turkey. It’s how the pathways in our brains work,” Campbell said.
By substituting a different routine that still provides stimulation and engagement, people can gradually weaken the original habit and build a new automatic response.
Substituting another activity instead of scrolling on your phone can help quell the impulse to reach for it. (iStock)
“Simply stopping a behavior is very challenging,” Amen said. “Replacing one habit with something that is better for your brain is much easier. That’s how lasting change happens, one step at a time.”
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If alternatives are within arm’s reach, people will be more likely to use them, the doctor said. “Your brain does much better with small, simple actions than big, vague intentions.”
Instead of saying, “I’ll stop scrolling today,” the doctor recommends choosing a small habit you can do in a few moments in specific situations, like knitting 10 rows of a scarf on your commute or reading a few pages of a book while waiting at the doctor’s office.
“If alternatives are within arm’s reach, you’re more likely to use them,” a brain doctor said. “Your brain does much better with small, simple actions than big, vague intentions.” (iStock)
Campbell shared her own examples of how to use an analog bag. At a coffee shop with friends, she said, she might pull out a crossword puzzle and ask others to help with answers when the conversation lulls.
Instead of taking dozens of photos on her phone, she uses an instant camera, which limits shots and encourages more intentional moments.
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In casual outdoor settings, such as a park or winery, she brings a small watercolor set for a quick creative outlet.
“It’s brought so much joy,” Campbell said of the analog bag trend, “seeing how it resonates with so many.”
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