Heart failure (HF) mortality rates are dispropor-tionately rising among racial/ethnic groups of color who may be eligible for heart transplant (HT). 1 Among the age group receiving the most HTs in the United States (35–64 years of age), HF mortality rates of African American patients are 2.6-fold higher than of White patients. 1 During the past decade, racial/ethnic groups of color represented 36% of US adult HT recipients2 and 40% of the US population. It is unclear whether states vary in ratio of HT rate to HF mortality rate by race/ethnicity. Because structural inequalities related to bias and organizational culture may contribute to disparities in HT allocation, 3, 4 it is important to identify geographic areas with gaps in care so that structural interventions may be designed to reduce existing disparities.