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A Systematic Review of Cardiovascular Health Screening in Michigan: Are We Doing Enough?
Shadan Alrawi1, Andreanna C Ulery1, Manasvi Patel1
1College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, USA.
Insights
Cardiovascular disease (CVD) screening is less common in Black, rural, and low-income populations in Michigan. Interventions show mixed results, highlighting ongoing equity gaps in preventive care.
Area of Science:
- Public Health
- Cardiology
- Health Equity
Background:
- Cardiovascular disease (CVD) is a leading cause of death in the US.
- Significant disparities exist in access to preventive cardiovascular screening.
- Understanding factors influencing screening rates is crucial for public health initiatives.
Purpose of the Study:
- To systematically review how racial, geographic, and socioeconomic factors impact cardiovascular screening rates in Michigan.
- To analyze disparities in blood pressure and cholesterol screening across different demographic groups.
- To evaluate the effectiveness of interventions aimed at improving screening access.
Main Methods:
- Systematic literature search of major databases (PubMed, Embase, Scopus, Web of Science, Google Scholar) up to October 2025.
- Inclusion of 12 Michigan-specific studies reporting on blood pressure and/or lipid testing.
- Quality assessment using NIH tools and study-design-appropriate appraisal instruments.
Main Results:
- Black, rural, uninsured, and low-income populations showed consistently lower screening rates.
- Disparities ranged from 5%-15% points across racial and socioeconomic groups.
- Interventions like Medicaid expansion and mobile screening had variable and not uniformly sustained positive effects.
Conclusions:
- Preventive cardiovascular screening in Michigan is unevenly distributed, revealing persistent health equity gaps.
- There is a critical need for more consistent and effective statewide screening strategies.
- Addressing social determinants of health is essential to reduce CVD disparities.
Abstract:
Cardiovascular disease (CVD) remains the leading cause of death in the United States, with persistent disparities in access to preventive screening. This systematic review investigates how racial, geographic, and socioeconomic factors influence cardiovascular screening rates across Michigan, focusing on blood pressure and cholesterol screening across various groups. A systematic search of PubMed, Embase, Scopus, Web of Science, and Google Scholar was conducted for studies published through October 2025. Eligible studies reported Michigan-specific data on preventive cardiovascular screening, operationally defined as blood pressure measurement, and/or lipid testing in adults. Twelve studies met the inclusion criteria, and methodological quality was assessed using study-design-appropriate appraisal tools, including the NIH quality assessment instrument. Across studies, Black, rural, uninsured, and low-income populations consistently demonstrated lower screening rates compared with White, urban, and insured groups. Reported disparities in screening ranged from approximately 5%-15% points across racial and socioeconomic strata, depending on population and data source. Policy and community-based interventions, including Medicaid expansion and mobile screening initiatives, were associated with modest increases in screening, although effects were variable and not uniformly sustained. Overall, preventive cardiovascular screening in Michigan remains unevenly distributed, highlighting persistent equity gaps and the need for more consistent, statewide screening strategies.
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