Population
Density
Nearest PCI
Bivariate Map · PCI Access × Population Density · U.S. Counties

Who Actually Lacks Access
to a Cath Lab?

Drive time bands use the ACC/AHA 90-minute door-to-balloon guideline as the key threshold. Color encodes population density; hue encodes whether counties are within the guideline window. Distance from Census 2020 population-weighted centroids to 1,322 real Medicare PCI hospitals. Hover the legend to highlight counties on the map.

Hover any cell to highlight counties

← Dense · Population · Sparse →
>90 min30–90 min<30 min
← Drive time to PCI →

Key categories — hover to highlight

Dense + <30 min
168M people — 51% of US, well within guideline
Dense + 30–90 min
22.6M people — within ACC/AHA window
Sparse + 30–90 min
14.3M people — within window, low density
Sparse + >90 min
9.5M people, 745 counties — pharmaco-invasive territory
Moderate + >90 min
2.2M people — 51 counties, the realistic policy target
Dense + >90 min
Zero counties — this category does not exist
↑ Hover any legend cell or category above to highlight matching counties on the map
168M
Dense counties <30 min from PCI
267 counties — half the US population, well-served
22.6M
Dense counties 30–90 min from PCI
35 counties — within the guideline window
9.5M
Sparse counties >90 min from PCI
745 counties — pharmaco-invasive protocols apply
2.2M
Moderate counties >90 min from PCI
51 counties — the realistic policy target
Data: PCI hospitals from CMS Medicare Inpatient data DRG 246–251 (1,322 hospitals, geocoded via ZIP centroids). Distance from Census 2020 population-weighted county centroids (CenPop2020) via haversine formula. Drive time: miles × 1.3 road factor ÷ 45 mph + 15 min overhead. Guideline threshold: 90 minutes (ACC/AHA STEMI guidelines, door-to-balloon time). Population: ACS 2022. Density: sparse <45/sqmi, moderate 45–427/sqmi, dense >427/sqmi.

Visualization by Anish Koka MD · AnishKokaMD.Substack.com