Disparities greatest among younger adults and almost entirely explained by social risk factors
By Lori Solomon HealthDay Reporter
TUESDAY, April 8, 2025 (HealthDay News) — There are substantial rural-urban disparities in cardiometabolic risk factors and cardiovascular diseases among U.S. adults, according to a study published online March 31 in JAMA Cardiology.
Michael Liu, from the Beth Israel Deaconess Medical Center in Boston, and colleagues assessed differences in the burden of cardiometabolic risk factors and cardiovascular diseases between rural and urban areas of the United States, as well as contributing factors (e.g., health care access, lifestyle factors, and social risk factors). The analysis included 27,172 adults (aged 20 years and older) participating in the 2022 National Health Interview Survey.
The researchers found that compared with their urban counterparts, rural adults were more likely to smoke, be insufficiently physically active, and have more social risk factors. In rural areas, age-standardized rates of cardiometabolic risk factors were significantly higher, including hypertension (37.1 versus 30.9 percent), hyperlipidemia (29.3 versus 26.7 percent), obesity (41.1 versus 30.0 percent), and diabetes (11.2 versus 9.8 percent). A similar pattern was seen for coronary heart disease (6.7 versus 4.3 percent) but not stroke. The greatest rural-urban disparities were seen among young adults (aged 20 to 39 years) for hypertension, obesity, and diabetes. Rural-urban disparities in cardiovascular health remained after adjusting for measures of health care access and lifestyle factors. Rural-urban disparities in hypertension, diabetes, and coronary heart disease were completely attenuated when accounting for social risk factors (poverty, education level, food insecurity, and home ownership).
“These findings suggest that efforts to improve socioeconomic conditions in rural communities may be critical to address the rural-urban gap in cardiovascular health,” the authors write.
Several authors disclosed ties to relevant organizations.
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