When Dr. Forso Facorede moved to the Mississippi Delta in 2015, he was shocked and upset by the high rate of peripheral artery disease and other cardiovascular disease among blacks.
Fakorede, an interventional cardiologist in Cleveland, Mississippi, said, “You go to the grocery store and you see patients walking with dialysis catheters in their necks, or patients with amputated legs with walkers on tennis balls. It’s a common thing to see,” he said. “You may be wondering if this is America. We are a very wealthy country that sells health care, but the results don’t match the spending on treatment.”
To ameliorate the persistently poor outcomes and lack of preventive care in the Mississippi Delta region, particularly in areas with a high proportion of black residents, Fakorede established Cardiovascular Solutions for Central Mississippi. His mission is to educate and provide access to quality health care for all.
For his life-saving efforts, Fakorede received this year’s Louis B. Russell Jr. Memorial Award. Fakorede will be honored at the AHA’s National Volunteer Awards Virtual Public Ceremony on June 14 from 6:00 p.m. to 8:00 p.m.
Since starting the clinic, Fakorede has focused on raising awareness of peripheral arterial disease among the community, including patients (mostly low-income), physicians and policy makers.
Fakorede said he was particularly disappointed with how common PAD-related leg, toe, and foot amputations are among black people. However, many of the people he meets in the area have never heard of a condition in which arteries are narrowed, reducing blood flow to the arms and legs.
As a result, Fakorede and his staff do more than wait for patients to show up at the clinic. Instead, they go to congregations, schools, civic groups, and medical schools to raise awareness about PAD.
Their efforts, including aggressive screening and intervention strategies, resulted in an 88% reduction in amputation rates over 4 years in Delta.
“As a black doctor, I felt compelled to support this marginalized community and be the face of justice for them. I’m here.”
Fakorede, who grew up in Nigeria and moved to the United States when she was 14, said she decided to become a doctor when she visited a clinic in Nigeria where her mother was a nurse. There he saw how much respect patients and staff had for the resident cardiothoracic surgeon.
Facorede then attended Rutgers University and the Robert Wood Johnson Medical School and completed residencies at New York-Presbyterian/Weill Cornell Hospital and Cooper University Hospital in Camden, NJ.
Over the years, Fakorede found that a confluence of factors contributed to significantly worse outcomes for black and Hispanic patients. For example, a black person is up to three times more likely to develop her PAD. However, they are less likely to be diagnosed and treated promptly.
Also, peripheral arterial disease has historically not been taught in many medical schools, so some attending physicians may not be familiar with the symptoms.
Another problem, Fakorede said, is that the United States Preventive Services Task Force, an organization that makes preventive services recommendations, does not recommend early screening of patients at high risk for PAD.
“There is an argument that there is not enough patient data, but if people of color have historically not been recruited in clinical studies, how do we get that data?” Facorede said. “However, we know that black and brown patients die young and early[from complications of diseases for which screening is not recommended]and that social determinants play a large role in patient health.” This is a systemic failure.”
In 2018, as part of a congressional delegation, Facorede testified before the Capitol to end preventable amputation and support legislation to improve research, education and treatment of PAD.
He also co-chaired the Association of Black Cardiologists’ PAD initiative and played a key role in the AHA’s PAD National Action Plan aimed at reducing PAD.
“Addressing these issues will require courage and perseverance in the face of injustice and systemic racism in healthcare,” said Facorede. “But we have an opportunity to carve out tomorrow’s justice by closing the inequality gaps that have plagued marginalized communities for decades.”