In a study from NIH/National Heart Lung and Blood Institute and elsewhere, scientists found adults living in rural areas of the United States have a 19% higher risk of developing heart failure compared to their urban counterparts.
The study underscores the importance of developing more customized approaches to heart failure prevention among rural residents, particularly Black men.
In the study, the team analyzed data from The Southern Community Cohort Study, a long-term health study of adults in the southeastern United States.
They compared the rates of heart failure among rural and urban residents in 12 states (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia).
There were 27,115 adults without heart failure at enrollment, who were followed for about 13 years. Nearly 20% of participants lived in rural areas; the remainder lived in urban areas.
Almost 69% were Black adults recruited from community health centers that care for medically underserved populations.
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.
Overall, the risk of heart failure was about 19% higher in rural residents than in their urban counterparts.
However, Black men living in rural areas had the highest risk of all—a 34% higher risk of heart failure compared to urban-dwelling Black men.
The study showed white women living in rural areas had a 22% increased risk of heart failure compared to white women in urban areas, and Black women had an 18% higher risk compared to Black women in urban areas.
No association was found between rural living and heart failure risk among white men.
The exact reasons behind these rural-urban health disparities are unclear and are still being explored.
The team says a multitude of factors may be at play, including structural racism, inequities in access to health care, and a dearth of grocery stores that provide affordable and healthy foods, among others.
Heart failure is a chronic and progressive condition that develops when the heart does not pump enough blood for the body’s needs.
Common symptoms include shortness of breath during daily activities or trouble breathing when lying down. The condition, which has few treatment options, affects about 6.2 million American adults.
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The study was conducted by Véronique L. Roger et al and published in JAMA Cardiology.
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