Every year, thousands of Americans lose a limb to a disease most have never heard of: peripheral arterial disease (PAD). Affecting as many as 12 million people, roughly one in 20 adults over 60, PAD is the nation’s leading cause of amputations. Yet it remains underdiagnosed, undertreated, and devastatingly unequal in its impact.

The disparities are stark. African Americans are four times more likely to undergo PAD-related amputations than white patients. Native Americans face amputation rates more than twice the national average. These outcomes are not inevitable — they are the result of systemic gaps in care.

PAD develops when arteries in the legs narrow, restricting blood flow. The consequences are often catastrophic: wounds that won’t heal, heart attacks, strokes, amputations and premature deaths. More than half of patients who receive an above-the-knee amputation will not survive two years.

Here in Baltimore, where chronic disease and health inequities already run deep, PAD is a silent driver of preventable suffering. Smoking, diabetes, obesity and high cholesterol all heighten risk, yet access to early screening and treatment remains limited. Too often, patients discover they have PAD only after it is too late to save their limb.

It doesn’t have to be this way. PAD can be detected early with the ankle-brachial index, a simple, noninvasive test that compares blood pressure in the arms and legs. It takes 10 to 15 minutes — and can save lives and limbs.

That is why the proposed Amputation Reduction and Compassion Act of 2025 is so vital. The bill would require Medicare and Medicaid to cover PAD screening for at-risk patients without cost sharing, while also investing in education, new payment models and quality measures to drive down unnecessary amputations.

Congress has a chance to act — and Maryland’s delegation should lead. Preventing avoidable amputations is not only good policy; it is a moral imperative. As September’s PAD Awareness Month continues, we must break the silence, commit to early detection and reject preventable amputations as an acceptable outcome.

Yvette Conyers is an assistant professor at the University of Maryland School of Nursing and a health policy and media fellow at George Washington University.

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