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Racism and racial bias influence the lives and cardiovascular health of minority individuals. The fact that minority groups tend to have a higher burden of cardiovascular disease risk factors is often a result of racist policies that restrict opportunities to live in healthy neighbourhoods and have access to high-quality education and healthcare. The fact that minorities tend to have the worst outcomes when cardiovascular disease develops is often a result of institutional or individual racial bias encountered when they interact with the healthcare system. In this review, we discuss bias, discrimination, and structural racism from the viewpoints of cardiologists in Canada, the United Kingdom, and the US, and how racial bias impacts cardiovascular care. Finally, we discuss proposals to mitigate the impact of racism in our specialty. RÉsumÉ: Le racisme et la discrimination raciale influent sur la vie et la santé cardiovasculaire des membres des minorités. Le fait que les groupes minoritaires tendent à présenter plus de facteurs de risque de maladies cardiovasculaires est souvent le résultat de politiques racistes qui restreignent les possibilités de vivre dans des quartiers sains et d’avoir accès à une éducation et à des soins de santé de grande qualité. Le fait que les minorités tendent à afficher les pires résultats lorsqu’une maladie cardiovasculaire se manifeste est souvent le résultat d’une discrimination raciale systémique ou individuelle à l’œuvre dans leurs interactions avec le système de santé. Dans le présent article, nous traitons de la discrimination et du racisme structurel du point de vue de cardiologues du Canada, du Royaume-Uni et des États-Unis. Nous abordons également l’incidence de la discrimination raciale sur les soins cardiovasculaires. Enfin, nous proposons certaines mesures visant à atténuer l’effet du racisme dans notre spécialité.

Graphical abstract

Vaccination coverage rates across Asian American subpopulations with atherosclerotic cardiovascular disease (ASCVD) and diabetes mellitus is not well-studied. We used data from the National Health Interview Survey (NHIS) from 2006 to 2018 and included participants with a history of ASCVD or diabetes. Vaccination coverage in White were compared with Chinese, Asian Indian, Filipino, and "other Asian" (Japanese, Korean, and Vietnamese) adults using univariable and multivariable logistic regression models. We included 50,839 participants, mean age 62.7 ± 0.1 years, 46.3% women, 89.1% US-born. Filipino (59%) and Asian Indian (56%) adults were less likely to receive influenza vaccine than "other Asians" (66%), Chinese (65%), and White (60%) participants (P0.001). In multivariable adjusted models, Chinese (OR = 1.66, 1.02-2.69), Asian Indian (OR = 1.50, 1.07-2.10), and "other Asian" ethnicity (OR = 1.81, 1.38-2.36) were associated with higher odds of receiving influenza vaccination compared with White. Influenza vaccine coverage remains suboptimal across all studied races/ethnicities.