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No cardiologists available in half of US counties as study reveals ‘incredibly concerning’ care gaps

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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.

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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.

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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.”

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“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.

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“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.

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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. 

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“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)

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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.”

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“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. 

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“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.

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How Well Will You Age? Take Our Quiz to Find Out.

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How Well Will You Age? Take Our Quiz to Find Out.

Every day we’re faced with a zillion small choices: Go to sleep early, or watch one more episode of that Netflix drama. Call an old friend to catch up, or cruise social media. Of course, no single action will guarantee a long, healthy life or doom you to an early grave. But those little daily decisions do add up, and over the long term they can make a difference when it comes to both your longevity and your health span, the amount of life spent in relatively good health.

Scroll through this theoretical “day in the life” and select the option that best fits your typical day. Not every situation will apply perfectly, but think about which choice you’d be most likely to make. This isn’t a formal scientific assessment. The goal here isn’t to assign you a “good” or “bad” score, but to help you understand the central factors that shape the way we age and how long we live.

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Red hair may be increasing as study points to surprising evolution trend

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Red hair may be increasing as study points to surprising evolution trend

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A study from Harvard Medical School indicates natural selection has favored the red hair gene, resulting in a potential increase in the number of redheaded people as humanity continues to evolve.

By analyzing nearly 16,000 ancient genomes spanning 10,000 years, researchers identified a list of traits that nature is actively pushing forward. Among the most prominent were the genetic variants for red hair.

“Perhaps having red hair was beneficial 4,000 years ago, or perhaps it came along for the ride with a more important trait,” the authors noted.

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The study, published in the journal Nature, relied on a large database of ancient DNA from West Eurasia. Using new computing methods, the team was able to filter out random fluctuations in DNA to identify what it called “directional selection.”

Directional selection happens when a particular version of a gene gives an organism a strong survival or reproductive advantage, causing it to become more common in a population faster than it would by chance, according to experts.

Directional selection is when a specific gene provides such significant benefits that it rises in frequency across a population much faster than random chance. (iStock)

Prior to this study, scientists only knew of about 21 such instances in human history, one of which was lactose tolerance. This new research uncovered hundreds more.

“With these new techniques and a large amount of ancient genomic data, we can now watch how selection shaped biology in real time,” Ali Akbari, first author of the study and senior staff scientist in the lab of Harvard geneticist David Reich, said in a press release.

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The data showed that genetic markers for red hair are among 479 gene variants that have been strongly favored over the past 10,000 years. One likely explanation, the researchers said, is a major shift in human history: the transition to farming.

Scientists have long pointed to vitamin D synthesis as a likely driver for the rise of traits like fair skin and light hair. (iStock)

As humans moved away from hunting and gathering and settled into agricultural societies, their environment and behavior changed radically, triggering an evolutionary “acceleration.”

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While the Harvard study provides the first definitive statistical proof that red hair was actively selected during the rise of farming, the researchers noted that the exact prehistoric benefit still requires more study.

However, scientists have long pointed to vitamin D synthesis as a likely driver for the rise of these light-pigmented traits in northern climates.

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While redheads remain a minority of the global population today, the Harvard study’s analysis suggests that they may not be an evolutionary accident.

While redheads remain a minority of the global population today, the Harvard study’s analysis suggests they may not be an evolutionary accident. (iStock)

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Instead, the red hair trait was “boosted” by natural selection as humans adapted to the challenges of a modern world, according to the researchers.

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The researchers urged caution in how these findings are interpreted.

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“What a variant is associated with now is not necessarily why an allele propagated,” the authors noted.

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Aging in Place: How Technology Might Help You Grow Old at Home

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Aging in Place: How Technology Might Help You Grow Old at Home

Dr. Megan Jack, a neurosurgeon in Cleveland, often works 60 or 70 hours a week. And she’s completely unavailable when she’s in the operating room. That makes it tough to be a caregiver for her 76-year-old mother, who lives in a separate unit on Dr. Jack’s property, 30 minutes away from the hospital.

To help care for her mother, who has Alzheimer’s disease, Dr. Jack uses an array of high-tech tools, some of which didn’t exist just a few years ago. She manages her mother’s medications with a smart pill box. She changes her television channels with an app, sends appointment reminders through a digital message board — and, with her mother’s blessing, uses cameras for communication and monitoring.

“It’s been invaluable that I can both make sure she’s safe and make sure everything is going well,” Dr. Jack said, “but also give her the independence and the freedom that she still deserves.”

America is aging rapidly. Roughly 11,000 people are turning 65 each day in the United States. And many of them — 75 percent of people over 50, according to AARP’s most recent survey, from 2024 — hope to spend their remaining years in the comfort of their homes, rather than in assisted-living or other care facilities.

One thing that could help fulfill those wishes is the budding field of “age tech,” which encompasses tools that support older adults. Industry experts say that age tech is making homes safer for older adults and is easing the minds of their caregivers, especially those who live far away or work outside the home.

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Dr. Jack said that age tech had “really allowed me to integrate caregiving into my life, as opposed to caregiving taking over my life.”

If older adults don’t have loved ones who are both close by and able to help, they might believe they don’t have a ton of options. They can live independently, or, if they can afford it and qualify medically, they can move to an assisted-living facility or a nursing home, without a lot of choices in between. In-home help can be expensive without Medicaid and can also be difficult to find, given the serious shortage of home care workers.

Age tech can help bridge some important gaps, said Emily Nabors, the associate director of innovation at the National Council on Aging, a nonprofit advocacy group. Already, AARP reports that 25 percent of caregivers are remotely monitoring their loved ones with apps, videos or wearables, nearly double the percentage from five years ago.

“We used to say homes are the health care settings of the future, but they really are health care settings now,” Ms. Nabors said. “Aging in place is very realistic.”

More than 700 companies are in AARP’s AgeTech Collaborative, a group that connects businesses, nonprofits and funders to help get new technologies off the ground. Altogether, the collaborative’s start-ups have raised nearly $1 billion in the past four years.

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The products include smart walkers, glasses with lenses that provide real-time captions of conversations for those with hearing issues, and a concierge service that connects older people to drivers and deliveries, even if they don’t have a smartphone.

Ms. Nabors does foresee some affordability and access barriers to age tech, including the lack of high-speed internet in rural areas, but she said one vital resource would be local aging agencies, which can offer advice and, sometimes, free support.

Janet Marasa leaned on the agency near her home in Rockland County, N.Y., to get a free robotic pet for her mother, Carol DeMaio, 80, who has dementia. The pets, manufactured by a company called Joy for All, aim to offer emotional support without the upkeep.

Ms. DeMaio named the robotic dog Sabrina, after a golden retriever who died. The new Sabrina stays at the foot of her bed at night. As soon as Ms. DeMaio stirs awake, the dog reacts. “She said it gives her a reason to get up in the morning,” Ms. Marasa said.

The dog has been a boon to her, too. “It provides comfort and interaction that I can’t provide every second,” said Ms. Marasa, who lives with her mother but works full time for the county government. “It gives her something that she can feel like is totally her own.”

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In Broward County, Fla., where the population of residents over 85 is expected to nearly triple over the next few decades, the local agency on aging has used state and federal money and private grants to provide technologies to nearly 4,000 of the county’s seniors at no cost.

Its offerings include a company that uses radar to sense falls and a program that allows seniors to make video calls through their televisions.

“The possibilities are endless,” Charlotte Mather-Taylor, the agency’s chief executive, said. “It’s pretty great to see all the new technology coming out so quickly, and I think that can only benefit our older population and also our caregivers.”

Even technologies not specifically marketed as age tech can help older adults maintain their independence, said Laurie Orlov, founder of the blog Aging and Health Technology Watch. She pointed to video-calling and telehealth platforms; remotely controlled thermostats and lights; and smart speakers, doorbells and watches.

“All technology can be customized to help older adults stay longer in their homes and help their family members feel good about it, or at least tolerate it,” Ms. Orlov said.

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That will only become more true with the continued proliferation of artificial intelligence, Ms. Orlov added. Some older adults are already using conversational A.I. to get answers about things like the weather or their medications. (Relying too heavily on A.I. can, however, have negative consequences because chatbots often give flawed medical advice and can lead patients astray.) A.I. can also assist in pattern detection: alerting caregivers to signals that might indicate declines in someone’s cognition or mental health, such as changing their speech pattern or leaving the house less frequently.

One A.I.-powered age tech tool is ElliQ, a tabletop companion robot that looks like a sleek silver desk lamp with a screen. About a year and a half ago, Camille Wolsonovich got one for free, thanks to a local nonprofit, for her 90-year-old father, Bill Castellano. He lives alone in a senior community.

Ms. Wolsonovich, who runs a consulting business, relies on ElliQ to lead her father in exercises and remind him to take his pills and drink water. The robot also asks her father about his sleep and mood via automated check-ins.

“Everything’s just another layer that gives us more confidence, from a caregiving standpoint, that he’s good,” Ms. Wolsonovich said. “I don’t have to necessarily track everything all the time and be overbearing.”

As for Mr. Castellano? He plays trivia digitally and converses daily with ElliQ. The robot, which has a friendly female voice, asks questions, cracks jokes and remembers his likes, dislikes and friends. “She’s great company,” he said. “Everybody around me wants one.”

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Clara Berridge studies the ethics of age tech at the University of Washington.

She has many privacy concerns, namely that most direct-to-consumer products aren’t subject to medical privacy laws, despite being privy to sensitive health information. Though she hopes the federal government will eventually step in to regulate these products, as it has in other countries, the onus remains on the consumer for now.

And even if an age tech product isn’t selling mom’s personal data to the lowest bidder, Dr. Berridge said there’s still the question of whether certain tools are ethical.

“It’s really important for caregivers to recognize that using these new technologies that give them more information about someone can represent greater intrusion into someone’s life,” she said.

What may be well-intentioned monitoring could reveal information that an older adult would rather keep private, such as issues with incontinence, or the comings and goings of a romantic partner.

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“It can lead to somebody feeling infantilized,” Dr. Berridge said. “Like there’s not a place to hide within your own home.”

Her research shows that adult children often underestimate how much their parents can understand about technology and how much they want to be involved in tech-related decisions.

She encouraged caregivers to have transparent conversations about privacy implications and to avoid ultimatums or the idea that any decision must be permanent. She said caregivers should put themselves in their parents’ shoes: Is this something they’d want their own children monitoring?

Dr. Berridge is working on an advanced directive for technology, which outlines older people’s wishes for how technology is used in their care. Ultimately, she hopes that questions about age tech will become a standard part of planning for the future.

“If you’re at the start of what, for many people, ends up being a long road of supporting someone potentially through the end of their life,” she said, “seeking to understand each other’s concerns and priorities better is time very well spent.”

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