According to an observational study, American people who live in rural locations are 19% more likely overall to get heart failure than those who reside in metropolitan areas.
American black men who live in rural areas are 34% more likely than their urban counterparts to experience heart failure. Compared to Black women in rural regions, Black women in urban areas had an 18% higher risk.
Also, compared to white women living in urban settings, white women in rural regions had a 22% higher risk of heart failure.
According to the U.S. Department of Agriculture, approximately 46 million Americans, or 14% of the population, resided in rural regions in 2020.
In the 1980s, the number of deaths per 100,000 people in rural and urban areas was roughly similar, but by 2016, there were 135 more deaths per 100,000 people in rural areas than in urban ones, according to a 2019 study.
According to the US Centres for Disease Control and Prevention, people who live in rural areas have a higher risk of dying from heart disease, cancer, accidental injury, chronic lower respiratory disease, and stroke than people who live in urban areas.
As per a sizable observational study conducted by scientists at the National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institutes of Health, and the Vanderbilt University Medical Centre in Tennessee, Americans who live in rural areas are 19% more likely overall to develop heart failure than those who live in urban areas.
Researchers acknowledged that this study is the first to examine the relationship between rural American life and heart failure cases that are newly diagnosed.
Study of heart failure in rural vs. urban areas
More than 2,700 persons in 12 states (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia) provided data that was collected over a 13-year period.
The information was obtained from The Southern Community Cohort Study, a National Cancer Institute-funded long-term health study of persons in the Southeast of the United States.
“At the end of the study period, the researchers found that living in rural America was associated with an increased risk of heart failure among both women and Black men, even after adjustment for other cardiovascular risk factors and socioeconomic status,” a news release for the study stated.
The National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institutes of Health (NIH), provided the majority of the funding for the study. The research results, which were developed in association with Nashville, Tennessee’s Vanderbilt University Medical Centre, were released in JAMA Cardiology.
Conduction of Rural heart disease study
The Southern Community Cohort Study (SCCS) included 27,115 persons who were the subject of the study.
Participants from Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia were among the first to be enrolled in the study by its researchers, which got underway in 2002.
Approximately 86% of those people were chosen from community health centers that offer medical care to underserved groups.
A little over 20% of the SCCS participants who were chosen for the study were residents of rural areas. This study only included participants who identified as Black or non-Hispanic White because, as the researchers explain in their publication, there were insufficient numbers of participants from other racial and ethnic groups.
Approximately 69% of the chosen individuals were Black. Participants’ ages ranged from 24 to 54. Only those participants were chosen for the trial who did not initially report having heart failure.
According to research, participants from rural areas had somewhat higher body mass indices and rates of hypertension, diabetes, cardiovascular disease, and hyperlipidemia than those from urban areas.
Both stroke and depression rates were lower among rural inhabitants than among their urban counterparts. Diet and exercise habits were comparable between the two populations. In addition to being more likely to be married and have less formal schooling, individuals from rural areas were also less likely to now smoke.
Greatest risk is for Rural Black men
Participants experienced 7,542 occurrences of heart failure between the study’s beginning and a median 13-year follow-up.
When the heart is unable to adequately pump blood throughout the body, heart failure results. Shortness of breath when performing daily tasks or difficulty breathing while lying down are symptoms.
1,865 of the heart failure incidents involved rural individuals, whereas 5,677 were city dwellers.
After accounting for variables like age, sex, and race as well as cardiovascular risk factors, health behaviors, and socioeconomic factors in their analysis, the researchers concluded that adults who live in rural areas have an overall higher risk of developing heart failure than their counterparts in urban areas of 19%.
Black men from rural areas had the highest risk of heart failure. Compared to their urban counterparts, this group had a 34% higher chance of developing heart failure.
Women were likewise more vulnerable. Rural Black and White women had an 18% and 22% higher risk of heart failure than women who lived in metropolitan areas.
“We addressed, as much as we could, things that we thought could be playing a role in our observation,” Roger stated. We anticipated that we would discover such a difference, but we did not anticipate the size of the difference we discovered.
Racial and gender biases play?
The fact that Black men and women had a higher chance of developing heart failure in rural locations wasn’t surprising to Keisha Ray, an assistant professor of bioethics and medical humanities at McGovern Medical School at UTHealth Houston in Texas.
“It is consistent with what health disparities scholars have consistently maintained—discrimination like racism and sexism touches all parts of Black people’s and women’s lives,” she said. “Racism also affects people’s access to the resources they need for good heart health, such as access to wholesome foods, leisure activities, adequate housing and income, and access to preventive healthcare.”
Because of chauvinism, health professionals frequently fail to take women seriously, Ray continued.
She stated that “women are frequently not believed when they complain of illness or their poor health is downplayed and dismissed.” This might delay the delivery of care that could save their lives.
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