New research published in JAMA Cardiology has shown that rural adults in America have a much higher chance of developing heart failure than urban adults, with the effect particularly pronounced for Black men.
The retrospective cohort study involved over 27,000 Black and White Americans who were part of the Southern Community Cohort Study and who received care through the Centers for Medicare & Medicaid Services. Participants in the study were part of a low-income, underserved population. At the start of the study, none of the participants had heart failure. They were then followed for a median of 13 years and monitored for the development of heart failure.
After adjusting for other factors, participants living in rural areas had a 19% greater chance of developing heart failure than those in urban areas. Black men in rural areas were particularly impacted by this effect; they had a 34% higher risk of developing heart failure than Black men in urban areas. White women also saw a big effect, with rural White women being 22% more likely to develop heart failure than urban White women.
The study’s corresponding author noted that the differences between urban and rural rates of heart failure were unexpectedly large and may point to a need for interventions that are specifically aimed at rural populations. While the reasons behind the large effect are somewhat unclear, it is likely that many factors are at play. Potential contributors include differences in access to healthcare and health services, lack of access to grocery stores with healthy food in some rural areas, and structural racism.
Sources: JAMA Cardiology, Science Daily