A recent study has uncovered a troubling rise in cardiovascular disease deaths among younger adults living in rural areas of the United States. The research, to be presented at the American Heart Association's Scientific Sessions 2024 and published in the Journal of the American College of Cardiology, reveals significant disparities in cardiovascular mortality rates between rural and urban populations. Analyzing death certificate data for over 11 million U.S. adults from 2010 to 2022, researchers found that cardiovascular disease death rates increased by approximately 21% for adults aged 25-64 living in rural areas. In contrast, rates declined by about 9% for adults aged 65 or older residing in urban areas during the same period.
The study's lead author, Dr. Lucas X. Marinacci, a cardiology fellow at Beth Israel Deaconess Medical Center, noted that rural communities face a disproportionate burden of cardiovascular risk factors, economic hardship, and healthcare system challenges. These issues were further exacerbated by the COVID-19 pandemic, contributing to the widening rural-urban disparity in cardiovascular mortality. Key findings from the analysis include that the age-adjusted cardiovascular mortality rate increased by 0.8% in rural areas between 2010 and 2022 but decreased by 6.4% in urban areas. Younger rural adults (ages 25-64) experienced a 21% relative increase in their cardiovascular death rate in 2022 compared to 2010, while the increase was only 3% for younger adults in urban areas.
Cardiovascular mortality rates declined among adults older than 65 between 2010 and 2022, with a 4.4% decrease in rural areas and an 8.5% decrease in urban areas. Following the onset of the COVID-19 pandemic in 2020, cardiovascular death rates increased nationwide, with a significantly larger relative increase in rural (8.3%) versus urban (3.6%) areas. The study highlights the urgent need for targeted public health initiatives to reduce cardiovascular risk among working-age rural adults. Dr. Marinacci suggests that community health workers could play a crucial role in strengthening connections between rural adults and healthcare teams, helping to manage chronic conditions more effectively.
Karen E. Joynt Maddox, M.D., M.P.H., FAHA, chair of the American Heart Association's Presidential Advisory on forecasting cardiovascular disease burden, emphasized the unique challenges faced by rural communities. These include a high burden of cardiovascular risk factors and limited access to specialty care and cardiovascular technologies. To address these alarming trends, experts recommend implementing new solutions such as telehealth-based specialist visits and policy interventions to improve the affordability and accessibility of care for rural populations. These measures could help reverse the concerning increase in cardiovascular deaths among younger rural Americans and narrow the growing health disparity between rural and urban areas. As the United States grapples with this public health challenge, the findings of this study underscore the importance of targeted interventions and policy changes to improve cardiovascular health outcomes for all Americans, regardless of their geographic location. The widening rural-urban disparity in cardiovascular mortality rates serves as a call to action for policymakers, healthcare providers, and public health officials to address the unique needs of rural communities and work towards more equitable health outcomes across the nation.
