Early Deaths From Heart Disease Rising in Rural U.S.

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More people in rural America are dying from heart disease, a new study says.

Heart disease deaths increased among 25- to 64-year-olds in U.S. rural areas by about 21% between 2010 and 2022, researchers report in the Journal of the American College of Cardiology.

This occurred even as heart death rates declined 9% among seniors in urban areas, researchers found.

What’s more, this disparity between rural residents and urban dwellers widened during the COVID-19 pandemic, results show.

“Leading up to the pandemic, the cardiometabolic health of rural communities was already in decline, particularly among younger adults,” lead researcher Dr. Lucas Marinacci, a cardiology fellow at Beth Israel Deaconess Medical Center in Boston, said in a news release. “This may have made them more vulnerable to both the direct and indirect cardiovascular effects of COVID-19.”

For the study, researchers analyzed national death data for more than 11 million adults between 2010 and 2022.

“Previous research has demonstrated disparities in cardiovascular mortality between rural and urban Americans, with, historically, more people in rural areas dying from heart disease compared to people living in cities,” Marinacci said.

“Rural communities bear a disproportionate burden of cardiovascular risk factors, as well as economic hardship and health care system challenges, such as hospital closures, physician shortages and lack of public health infrastructure, all of which were exacerbated by the COVID-19 pandemic,” he added.

The heart disease death rate increased by just under 1% in rural areas during the 12-year span of the study, but decreased by more than 6% in urban areas.

Everywhere, heart disease deaths among seniors fell -– but they fell by only 4% in rural areas compared with 9% in urban areas.

And after the pandemic began in 2020, heart death rates increased nationwide – by more than 8% in rural regions versus under 4% in urban areas.

“Cardiovascular risk factor control worsened during the pandemic, and those in rural areas experienced greater interruptions in health care coverage, access and affordability,” Marinacci said. “The unprecedented surge in economic and psychosocial distress that occurred during the wake of the pandemic also disproportionately impacted rural populations.”

As a result, “a growing burden of cardiometabolic disease combined with other risk-enhancing factors — all of which were likely exacerbated by the pandemic — may have caused rural-urban disparities in death rates to widen even further during the 12-year study period,” he added.

Researchers also presented their findings at the annual meeting of the American Heart Association, which took place in Chicago.

“Rural communities face a number of unique challenges when it comes to cardiovascular health, including a high burden of cardiovascular risk factors like Type 2 diabetes and hypertension, as well as worse access to specialty care and cardiovascular technologies,” said Dr. Karen Joynt Maddox, chair of the association’s Presidential Advisory Forecasting the Burden of Cardiovascular Disease and Stroke in the United States Through 2050. She was not involved in the research.

“We need new solutions, including cardiovascular-specific interventions like telehealth-based specialist visits, as well as policy interventions to improve the affordability of care, to help people in rural areas reverse these alarming trends,” she added in the news release.

More information

The U.S. Centers for Disease Control and Prevention has more on rural health disparities.

SOURCE: American Heart Association, news release, Nov. 11, 2024

Source: HealthDay

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