Considering the Impacts of Health Disparities, Inequalities, and Inequities on Early Diagnosis of Pulmonary Arterial Hypertension

Abstract

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King, Jr. Early recognition, diagnosis, and treatment of pulmonary arterial hypertension (PAH) is a worthwhile endeavor in that it remains underdiagnosed in an era where 9 FDA-approved treatments are available, which have shown to provide clinical improvements and prolonged survival.1 Furthermore, despite the significant advances in understanding the etiology of PAH, the time from onset of symptoms to recognition of the disease has not improved over the past 2 decades, the delay of which results in progression of pathologic changes that are life threatening and irreversible when left untreated. This is particularly concerning in that the potential for optimal clinical outcomes and survival is diminished even after a 2-year delay in diagnosis.2 The aim of this article is to evaluate the current public health framework to highlight social determinants that influence and may result in barriers in achieving optimal health outcomes, with a focus on factors that may contribute to delayed diagnosis of PAH.3