A Global Perspective Health Inequity In Heart Failure An Issue Of Heart Failure Clinics

This special issue of Heart Failure Clinics examines heart failure with a truly global perspective, exposing health inequities in the treatment of heart failure.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Recent advances have changed the way heart failure is treated and have resulted in substantial improvements in heart failure management. Improving Outcomes in Heart Failure addresses innovative ways of dealing with issues such as quality of life, treatment compliance, effective patient and family education and counseling, nonpharmacologic therapy, and new health care delivery models for improving the management of heart failure. With an interdisciplinary approach, this reference shows how heart failure outcomes and health care resource utilization can be improved significantly. Written by the editors of the distinguished Journal of Cardiovascular Nursing, Debra K. Moser, DNSc, RN and Barbara Riegel, DNSc, RN, CS, FAAN are well-known and nationally recognized experts in the field of cardiovascular nursing. Moser and Riegel have received numerous prestigious awards and honors and have contributed to many renowned journals on a wide variety of cardiovascular topics.

This issue of the Heart Failure Clinics, edited by Drs. James Fang and Michael Givertz, is entitled "Advanced Heart Failure" and covers a wide array of topics relating to the subject. The issue will delve into the prevalence, history and prognosis of advanced heart failure; cardiorenal interactions; cardiohepatic interactions; the role of temporary mechanical circulatory support; guided therapy; the role of heart transplantation; palliative care; frailty; and novel biological techniques, among other topics.

With over 6 million patients affected only in the United States, atrial fibrillation (AF) is a major health problem with profound effects on both the individual patient and society at large. In this issue of Heart Failure Clinics, we have focused on AF and tried to cover the most important and relevant aspects in a comprehensive and contemporary review. A distinguished group of experts and leaders in basic and experimental electrophysiology, epidemiology, clinical pharmacology, interventional clinical electrophysiology, and cardiac surgery contributed state-of-the-art reviews and also shared their insight to the future of AF. Topics include but are not limited to: Risk Factors and Genetics of Atrial Fibrillation; Mechanisms of Atrial Fibrillation: Rotors, Ionic Determinants, and Excitation Frequency; Diagnostic Evaluation and Follow-Up of Patients with Atrial Fibrillation; Catheter Ablation of Atrial Fibrillation; Antithrombotic and Anticoagulant Therapy for Atrial Fibrillation; Postoperative Atrial Fibrillation: Incidence, Mechanisms, and Clinical Correlates; and Novel Upstream Approaches to Prevent Atrial Fibrillation Perpetuation.

Coronary artery disease continues to be a major cause of morbidity and mortality in the United States and throughout the world. This issue of the Heart Failure Clinics provides a contemporary and concise, yet extensive, review on all aspects of the management of patients with coronary artery disease. Topics include but are not limited to: Epidemiology, Traditional and Novel Risk Factors in Coronary Artery Disease; Acute Coronary Syndromes: Unstable Angina and Non–ST Elevation Myocardial Infarction; Calcium Scoring and Cardiac Computed Tomography; Coronary Artery Disease and Diabetes Mellitus; Cardiac Syndrome X; and Revascularization Options: Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention.

This issue of Heart Failure Clinics, devoted to Interventional and Device Therapy in Heart Failure, is edited by Deepak L. Bhatt and Michael R. Gold. Topics include The Role of Implantable Hemodynamic Monitors to Manage Heart Failure; Non-hemodynamic Parameters from Implantable Devices for Heart Failure Risk Stratification; Role of Percutaneous Revascularization in Patients to Improve Left Ventricular Function; Hemodynamic Support with Percutaneous Devices in Patients with Heart Failure; Transcatheter Aortic Valve Replacement for Patients with Heart Failure; Percutaneous Intervention for Mitral Regurgitation; Percutaneous Left Ventricular Remodeling; Stem Cell Therapy for Heart Failure; Implantable Cardioverter Defibrillator Therapy; Cardiac Resynchronization Therapy; Ablation of Atrial Arrhythmia in Patients with Heart Failure; Ablation of Ventricular Arrhythmic in Patients with Heart Failure; and Autonomic Modulation.

This issue of Cardiology Clinics, edited by Drs. Gerald Bloomfield and Melissa Burroughs-Pena, will cover a broad range of issues in the field of Global Cardiovascular Health. Topics covered in this issue include, but are not limited to Diagnosis and management of endomyocardial fibrosis; Chagas disease; Tuberculosis and the heart; Cardiovascular manifestations of human immunodeficiency virus infection; Improving global access to essential cardiovascular medicines; Innovative approaches to hypertension control in the community; Causes and treatment of infective endocarditis in developing countries; and Strategies for Patient Centered Blood Pressure Control in Low- and Middle income Countries, among others.

The World Health Organization defines the social determinants of health as "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." These forces and systems include economic policies, development agendas, cultural and social norms, social policies, and political systems. In an era of pronounced human migration, changing demographics, and growing financial gaps between rich and poor, a fundamental understanding of how the conditions and circumstances in which individuals and populations exist affect mental and physical health is imperative. Educating health professionals about the social determinants of health generates awareness among those professionals about the potential root causes of ill health and the importance of addressing them in and with communities, contributing to more effective strategies for improving health and health care for underserved individuals, communities, and populations. Recently, the National Academies of Sciences, Engineering, and Medicine convened a workshop to develop a high-level framework for such health professional education. A Framework for Educating Health Professionals to Address the Social Determinants of Health also puts forth a conceptual model for the framework's use with the goal of helping stakeholder groups envision ways in which organizations, education, and communities can come together to address health inequalities.

In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.