Scientific Associate II University Health Network Whitby, Ontario, Canada
Background: Cardiovascular disease is the leading cause of premature death in women across Canada. Understanding the current landscape of cardiac care for women is essential to inform future planning and guide targeted efforts to enhance the availability, access, and quality of women-specific cardiac health services across Canada. The purpose of this study was to assess the current state of cardiac care for women in Canada, and to identify perceived barriers to implementing women-focused cardiac programs.
METHODS AND RESULTS: A national key informant survey was developed with expert input from the Knowledge Translation working group of the Canadian Women’s Heart Health Alliance. The survey was piloted and launched in April 2021. It was distributed to healthcare institutions via REDCap link using the email lists of partner organizations such as Heart and Stroke and Canadian Cardiovascular Society. A total of 183 responses were received. After removing incomplete or duplicate responses (more than one person from an institution) 106 surveys were included in the final analysis. Most respondents (90%) were affiliated with a healthcare institution though typically not in a senior leadership or decision-making role. Seventy-five percent had over 10 years of professional experience. Respondents included nurses (38%), administrators (12%), and a diverse group of allied health professionals, researchers, and physicians(50%). Survey responses represented a range of settings; 40% from academic institutions and 60% from community-based practice settings. The majority (95%) were in urban areas and 5% in rural areas, representing all provinces. Sixty-nine percent of institutions reported having a cardiac-focused program, yet only 12% offered a women-specific cardiac program. Few sites provided specialized services targeting women’s cardiac health such as cardiac rehab (18%), cardio-obstetrics (6%), spontaneous coronary artery dissection (8%), or heart function clinics (5%). The most cited barriers to developing women-specific cardiac clinics included lack of funding (71%) and limited access to specialist care (52%). Only 20% of institutions reported routinely providing multi-disciplinary referrals for mental health and social supports for women following a cardiac diagnosis or event. Similarly, only 20% of institutions reported involvement in sex- or gender- focused research; 40% reported no sex- or gender-focused research, 26% were unsure, and 14% indicated it was not applicable.
Conclusion: This environmental scan highlights a significant gap in women-specific cardiac care across Canada. As awareness and knowledge of sex- and gender-based differences in cardiovascular health continue to progress, there is an urgent need to enhance the availability, accessibility and integration of tailored cardiac care services for women.
