Barriers to Early Detection and Treatment
In 2021, the American Medical Group Association (AMGA) conducted a roundtable to explore the barriers to early PAD detection and treatment across diverse communities. (8) They engaged with 18 experts from geographically and medically varied backgrounds to understand the systemic challenges facing PAD patients. The findings highlighted the following barriers:
Peripheral Arterial Disease disproportionately affects communities that face economic and social challenges. Key social determinants such as health care access, neighborhood conditions, and education all contribute to disparities in PAD outcomes (1). Additionally, certain ethnic groups and women are at higher risks for more severe PAD complications.
Understanding these factors is critical to closing the gap and improving care for those most vulnerable.
Disparities in PAD:
A Growing Concern
Social Determinants of Health (SDoH) and PAD
Health Care & Quality
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Insurance Coverage
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Health Literacy
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Transporation to Health Care Facilities
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Copays
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Provider Availabilities
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Quality of Care
Ethnic and Gender Risk Factors in PAD
David Fornell, 5-time winner of the Jesse H. Neal award interviews Dr. Kumar Madassery, Rush University, Chicago (2)
“What we see in Chicago mirrors what we see around the country, in that these healthcare deserts where there is low access to care or detection of disease is only in late stages, are the same areas with the highest amputation rates.” – Kumar Madessery, MD
African American
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1 in 3 Black American adults may develop PAD compared to Hispanics or White (3)
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Present with more severe disease
Hispanic/Latino
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Adults with predominantly sedentary lifestyles have a higher risk of PAD, even in the absence of other risk factors (4)
Women
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30% more likely to have PAD than men(5)
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Symptoms or exertional leg pain is absent with >60% of women with PAD (6)
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Intermittent claudication tends to present 10 - 20 years later than Men (7)
PAD does not affect all populations equally.
Insufficient prioritization of PAD
Inadequate focus on care disparities
Lack of health system ownership of population health
Limited primary care provider engagement in early evaluation
These barriers underscore the importance of healthcare reform and community-based initiatives aimed at improving PAD awareness, accessibility, and care.
Read the full study here: Perspectives on Lower Extremity Peripheral Artery Disease: A Qualitative Study of Early Diagnosis and Treatment and the Impact of Health Disparities
Taking Action: How We Can Address PAD Disparities (9)
Enhancing Healthcare Access
Community health programs and mobile clinics can bridge the gap for those living in underserved areas,
bringing early PAD testing and preventive care closer to those in need.
Taking Action: How We Can Address PAD Disparities (9)
Education and Awareness
Educational campaigns focused on PAD awareness, early symptoms, and risk reduction can empower individuals to seek care sooner.
Training healthcare providers on the importance of SDOH in PAD can improve culturally sensitive care.
Taking Action: How We Can Address PAD Disparities (9)
Policy & Advocacy
Advocacy for health equity policies can promote access to affordable, quality healthcare, while encouraging investments
in healthcare infrastructure in rural and underserved communities.
Taking Action: How We Can Address PAD Disparities (9)
Community Support Networks
Strengthening social support networks through partnerships with local organizations can improve patient outcomes and reduce health disparities.
Community resources for exercise, nutrition, and stress management can also play a vital role.
Challenges in
Managing PAD
Managing Peripheral Arterial Disease (PAD) is challenging due to its often asymptomatic nature, the need for early detection in high-risk populations, and the necessity of comprehensive care that addresses both lifestyle modifications and medical interventions.
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