Sociodemographic Disparities in Obtaining Cardiac MRI: Black, White, and Shades of Gray

Despite growing recommendations for CMR utilization in heart disease evaluation, access remains limited by geography and socioeconomic status. In this review we discuss the role of CMR in addressing health disparities, review barriers to CMR access, and finally propose solutions to increasing CMR testing globally and in the U.S.

CMR testing is higher prevalence in academic and urban centers in the Northeast and Midwest and remains sparser in Southern and rural areas which face a high burden of cardiovascular mortality. Globally, CMR is also limited in low- and middle-income countries. Barriers to CMR access include bias in physician referrals based on race, patient income, insurance status, language barriers, health literacy, and disparities in the multimodal cardiovascular imaging workforce. A multimodal approach involving policy makers, hospital systems, cardiologists, and health care personnel is essential to improving national and global barriers to accessing CMR.