Across 82,999 US census tracts, nearly 50,000 lack adequate cardiologist access — yet a granular new analysis finds that only 4,765 of the highest-burden tracts possess sufficient digital readiness for immediate telehealth cardiology deployment. The remaining 21,752 high-burden, low-readiness tracts — clustered in the rural Southwest, Deep South, Mississippi Delta, and Gulf Coast — require infrastructure investment before digital cardiovascular care can be equitably implemented. The study linked cardiometabolic burden data, cardiology workforce supply, and digital readiness metrics at census-tract resolution, a finer geographic lens than typical county-level analyses.
This mapping exercise arrives at a critical inflection point: telehealth cardiology expanded rapidly post-pandemic, but uptake has been uneven, often benefiting digitally equipped urban populations while bypassing those with the greatest cardiovascular disease burden. The finding that neighboring census tracts within the same metro area can fall into opposite readiness categories underscores why county-level policy is too blunt an instrument. Practically, this framework could guide federal broadband investment, device subsidy programs, and community health worker deployment — though the study is descriptive and cannot demonstrate that digital interventions will actually improve outcomes where deployed. As a preprint posted to medRxiv and not yet peer-reviewed, the classification thresholds and readiness metrics remain subject to methodological scrutiny. Still, the public interactive dashboards represent a meaningful translational step, making this a practically ambitious, if ultimately confirmatory, contribution to health equity infrastructure research.