Fig. 5.

Lack of resources for heart failure care in community settings compared with advanced heart failure centers. Structural racism and residential segregation have resulted in severe economic disinvestment in neighborhoods with greater proportions of minority residents. Residential segregation has also resulted in a deeply segregated health care system that perpetuates health care disparities. Black and Hispanic patients are more likely to receive care in local community settings and safety net hospitals. Because the most specialized and comprehensive care for heart failure is often only available in advanced heart failure centers, improving access to specialty care by ensuring equity in referrals to CV specialists is critical to decreasing disparities. CMR, cardiac magnetic resonance; CV, cardiovascular; GDMT, guideline-directed medical therapy; IV, intravenous; LVAD, left ventricular assist device; PYP, pyrophosphate.