Cardiovascular disease (CVD) is the leading cause of death globally and in the United States, with a disproportionate impact on underserved communities (WHO; CDC 2023). To discuss the Bristol Myers Squibb Foundation’s focused strategy on addressing these disparities and driving equitable access to cardiology care, Grantmaker In Health’s Miranda Wesley spoke with the Bristol Myers Squibb Foundation’s Senior Program Director, Adrienne Gonzalez. This interview has been edited for length and clarity.

Describe the burden of cardiovascular diseases (CVDs) in the United States.

Adrienne Gonzalez: Cardiovascular disease is the leading cause of death for men and women in the US. Once you go deeper, you realize that there are disparities within that fact that get exacerbated based on gender, race, and socioeconomic status. For example, African Americans are two to three times more likely to die of heart disease than their white counterparts. African Americans are 50 percent more likely to have a stroke compared to their white counterparts, and African American men are 70 percent more likely to die from a stroke than their white counterparts.

For example, the stroke belt, which is a region within the American southeast, has a 34 percent higher rate of cardiovascular disease than the national average. Imagine if you are an African American man living in an underserved community within the stroke belt. The data says that your risk of dying from a cardiovascular event is quite significant. When you are coming from a particular group and/or community coupled with living in a certain part of the country—all of those things further impact a risk already present for the general US population.

What are the challenges faced by underserved communities in accessing quality cardiovascular care?

Adrienne Gonzalez: I would take a step back because if you’re living in an underserved community, access to primary care is challenging enough. Then, accessing specialty care—be it for a cardiac condition or another condition that requires seeing a specialist—can be even more difficult for those patients. Be it geography, financial awareness, things of that nature that just make it harder. So you have patients being diagnosed with uncontrolled hypertension or atrial fibrillation, an irregular heart rhythm—both which are manageable chronic conditions—only after they’ve suffered a stroke, which as we know can be catastrophic. Some of the projects we fund look to reach those patients and increase their access to a specialist and/or a primary care health professional who can help them manage the condition.

How can philanthropy most effectively address and break down these barriers?

Adrienne Gonzalez: This is an ongoing conversation about the role of philanthropy and how that continues to evolve as the world changes and evolves. What remains true is recognizing that we are only one of the stakeholders that can participate—we can’t do it all on our own. Being newer to philanthropy, I appreciate the conversation about philanthropy challenging itself to reflect on the power dynamic, unconscious biases, and the unintended impact of some of our processes. We need to listen better and more thoughtfully to the communities that we are seeking to serve and be more mindful of the power dynamic between funders and our nonprofit partners. Our team recognizes that it’s a privilege to be able to make our living trying to make a difference and are guided by the notion of how we continue to “do good, better” so that we empower our partners to achieve the intended impact in the right way.

Read the full article about cardiovascular disease by Adrienne Gonzalez and Miranda Wesley at Grantmakers in Health.