Background and purpose: Despite the known efficacy of cardiac rehabilitation (CR), referral rates remain low. The participation rate of minority populations, despite high risk and incidence, has not been carefully studied in the USA. Therefore, this study examined outpatient CR participation rates and perceived barriers to care of minorities in New York State (NYS).

Methods: Seventy-four AACVPR accredited outpatient CR facilities in NYS were asked to complete an anonymous online survey containing questions on: overall participation rates, short- and long-term compliance and barriers to care for Caucasian, African American, Asian, and Hispanic patients. Outcomes were summarized using descriptive statistics.

Results: Eighteen facilities completed the survey (24.3% response rate). Overall participation of patients by ethnicity was African Americans 4.1%, Asians 1.1%, Hispanics 1.9%, and Caucasians 92.9%. Short-term compliance (% of patients who completed >2 visits) was African Americans 94.3%, Hispanics 90.9%, Asians 100%, Caucasians 95.4%. Long-term compliance (% of patients who attended >75% of their scheduled visits) was African Americans 71.5%, Hispanics 63.6%, Asians 61.5%, and Caucasians 78.7%. Most frequently cited barriers to care, identified by program directors, were out-of-pocket costs 61.1%, lack of insurance 33.3%, lack of referral 33.3%, patient perception that CR is not important 33.3%.

Conclusion: Minorities are underrepresented in CR despite similar cardiac occurrence rates. The number of age-adjusted heart disease related deaths/100,000 in NYS in 2006 was Asians 342, Hispanics 397, African Americans 648, Caucasians 627 (National Center for Chronic Disease Prevention & Health Promotion). Given this data minority participation rates (particularly African Americans) in CR should be higher. Additionally, minority attendance rates for the first 2 visits were not markedly different from the overall CR population, but Asians and Hispanics had lower long-term compliance.