Aortic dissection (AD) is a catastrophic but potentially preventable medical emergency. Delay in diagnosis and treatment of AD contributes to its high morbidity and mortality, especially in this population. We conducted a review of articles that describe the risk factors, gaps in management, and outcomes of AD in U.S. minority populations. Very few data exist on prospective, population-based AD, especially in underserved minority populations. AD confers significant burden on both the patient and the health system. From the economic and public health standpoint, disparities in access to health disproportionately affect minorities and can give rise to needless costs. Most of the risk factors for AD in minorities are modifiable and addressing them in a timely manner using a bidirectional approach ("Upstream" and "Downstream") could be cost-effective in reducing the burden of AD. Community health Workers (CHWs) have been shown to be effective in coordinating care for other emergency medical conditions in minorities but not for AD. We propose the integration of the CHWs and patientcentered medical home (PCMH) models into the care coordination effort for preventive and follow-up care of AD patients. Our main objective is to draw the attention of clinicians, researchers and policy makers to the current challenges of AD in minorities and sensitize them to our proposed evidence-based patient-centered, multidisciplinary community-based framework for addressing the burden of AD, in addition to conducting more prospective, population-based AD research in underserved minority populations.
Oloyede EO, Crawford RS, Harris DG, Sarkar R and Johnson WR
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