Sociodemographic Disparities in Coronary Artery Calcium Screening.

Abstract

Objectives: This study aimed to compare the demographic features and socioeconomic status of patients who underwent coronary artery calcium screening to that of their local population.

Background: Coronary artery calcium scores provide important evidence of subclinical atherosclerosis. However, insurance often does not cover coronary artery calcium testing, which could exclude people of lower socioeconomic status.

Methods: Demographic and occupational data were obtained for all patients referred for coronary artery calcium in a metropolitan area between October 2010 and August 2023. Household income and population reference information were taken from US Census Data and matched to zip code and regional metropolitan area.

Results: Coronary artery calcium tests were performed on 627 patients with a median age of 63 years and equal gender representation (52% female, 48% male). Patients were predominately White (77%) and English-speaking (98%), which is incongruent with local demographic data (P < .001). Healthcare workers were the largest workforce (22%), followed by people involved in education (12%), which is higher than the local healthcare workforce of 10% (P < .001). Those with graduate/professional degrees accounted for 32% of patients, significantly more than the local population (P < .001). The average median annual income ($94,116) of patients who underwent CAC testing was greater than that of the metropolitan median income of $81,264 (P < .001).

Conclusion: The disproportionate distribution of coronary artery calcium screening favoring educated, affluent, White English speakers indicates that higher-income and healthcare personnel are more likely to receive testing. Disparities in coronary artery calcium testing, especially in minorities and non-English speaking individuals, should be further explored.