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There has been little progress in reducing health care disparities since the 2003 landmark Institute of Medicine's report Unequal Treatment. Despite the higher burden of cardiovascular disease in underrepresented racial and ethnic groups, they have less access to cardiologists and cardiothoracic surgeons, and have higher rates of morbidity and mortality with cardiac surgical interventions. This review summarizes existing literature and highlights disparities in cardiovascular perioperative health care. We propose actionable solutions utilizing multidisciplinary perspectives from cardiology, cardiac surgery, cardiothoracic anesthesiology, critical care, medical ethics, and health disparity experts. Applying a health equity lens to multipronged interventions is necessary to eliminate the disparities in perioperative health care among patients undergoing cardiac surgery. [Display omitted] • Despite their higher cardiovascular disease burden, underrepresented racial and ethnic groups have less access to cardiovascular and cardiac surgical care, and worse postoperative outcomes. • Various factors, including racism and social determinants of health, contribute to perioperative health care disparities. • Applying a health equity lens to multipronged interventions may reduce disparities and improve cardiovascular outcomes among patients undergoing cardiac surgery. [ABSTRACT FROM AUTHOR]