On November 18th, 2025, the National Hispanic Council on Aging hosted a Cardiovascular Disease (CVD) Policy Roundtable, where it met with experts from various organizations with direct experience serving underrepresented demographics in the realm of cardiovascular care. Along with key members from NHCOA’s own staff, these notable figures in the world of advocacy gathered to discuss the barriers before them, the common plights of the underrepresented, and how to move forward in advocating for policies that better address an issue that speaks to the mortality of millions.
The event began with remarks from NHCOA’s President & CEO, Dr. Yanira Cruz, who was keen to provide much needed context surrounding such detrimental polices as Step Therapy and Prior Authorization—practices covered explicitly in previous NHCOA publications, and which remain a top priority in NHCOA’s mission to create more equitable healthcare for Hispanic and Latino communities. These policies, which prioritize profit for insurance companies and healthcare providers over the needs of patients, are particularly dangerous when it comes to something as life-threatening as CVD. Following Dr. Cruz’s remarks, two presentations were held.
Lindsay Miltenberger, Chief Advocacy Officer for the Society for Women’s Health Research (SWHR), offered valuable perspective on disparities in women’s CVD care and important considerations for clinical care. NHCOA was thrilled to host Miltenberger, as the intersection between SWHR and NHCOA’s data offers critical insight into the compounded disparities felt by women in Hispanic and Latino communities. Miltenberger was quick to note the historic exclusion of women from clinical trials, siting that it wasn’t until 2016 that NIH passed its policy of sex as a biological variable—meaning that hence forth an expectation was set that research and analysis should consider sex—and that even since then, in 2023, less than 8% of total NIH grant funding was allocated to women’s health research. By the end of her presentation, Miltenberger made thorough evidence to support the absolute necessity that greater effort be given to educating medical practitioners on the critical understanding of sex as a biological variable within diagnosis and treatment, especially when it comes to CVD, where a misdiagnosis could be fatal.
NHCOA’s Director of Programs, Christine Perez followed with a presentation on recent findings from NHCOA’s cardiovascular disease focus groups pertaining to knowledge, attitudes, and beliefs regarding LDL-C (“bad cholesterol”) testing, treatment, and management. Perez’s review of these findings offered insight into both the cultural and political obstacles that many Latino people are facing as they try to manage their heart health in the face of inadequate medical service—specifically that while many understand LDL-C, and its connection to comorbid conditions, the means of addressing it can be hard to achieve. Latino communities have a hard time adapting to the guidelines of more preventive measures in managing heart health, like changing their diet and lifestyle behaviors. They are constrained by lack of access to healthy foods, and lack of time to consistently cook healthy meals, not to mention the economic barriers in place that keep them from being able to afford such dietary changes. Lack of insurance, and a general apprehension to engage with medical care due to non-culturally nor linguistically appropriate care, also comes into play. Those who do seek treatment from healthcare providers are then encumbered with the strenuous practices of Step Therapy and Prior Authorization.
Dr. Cruz, Miltenberger, and Perez offered a foundation for participating experts to engage in, along with a testimonial from a Casa Iris resident, detailing her experience with CVD care as a Latina older adult. Participating experts included:
- Henry Paraison, Executive Director for Perfil Latino TV
- Alex Perilla, Director of the American Dream Academy at the Arizona State University
- Terry Wilder, Manager of Health and Economic Security Policy for SAGE
- Veronica Vital, President of the National Association of Hispanic Nurses
The Policy Roundtable yielded a consensus in these experts’ understanding of the barriers at play that must be addressed in order to improve cardiovascular care for underserved populations. A common truth remained consistent across the discussion that socio-economic and cultural conditions are simply not accommodated for in the current U.S. health care landscape. The cultural norms found within Latino communities are catalyzed by a system that does not seek to understand nor accommodate their needs such that devastating levels of isolation and distrust obscure these communities from greater heart health. Lasting change requires a comprehensive change across both educational and medical sectors, and immediate change requires critical review of Step Therapy and Prior Authorization.
The National Hispanic Council on Aging supports the Safe Step Act, as one such measure that would provide direct impact on the improvement of care received by underserved populations, which would create exceptions to the practice of Step Therapy, like with such fatal conditions as CVD.
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