RURAL Study looks to understand southeastern health concerns

A cardiologist at University of Mississippi Medical Center, Dr. Ervin Fox is well-decorated with 139 journal articles and 35 medical students, residents and cardiology fellows he has mentored at UMMC. But he is also the principal investigator for the Mississippi effort in the Risk Underlying Rural Areas Longitudinal (RURAL) Study.

For its weekly program on Monday, February 6, the Starkville Rotary Club welcomed Fox to talk about the RURAL Study, which is a national study funded by the National Institutes of Health that aims to address critical gaps in its knowledge of heart and lung disorders in rural counties in the southeastern US.

Fox, a Mississippi State graduate, says that some of the very first investigations into the RURAL Study actually took place at MSU, and now it's become a national awareness due to a steady trend.

“Back in the early years of America, those who lived in rural areas actually lived longer than those living in urban areas,” said Fox. “But around 1980, there has been an increasing number of people in rural areas dying from heart disease and strokes, relative to urban areas. Along the mid-1980s to the 1990s and the 2000s, there's been a steady increase.”

Why is that? Fox says there has been some investigation into that, but none that's “very comprehensive.”

“They would say, ‘They are older.' ‘They got more chronic disease.' ‘The socioeconomic status is worse in those rural areas,'” said Fox. “But what they found is that even adjusting for chronic diseases and for socioeconomic status, it's not only living in rural areas, but it's living in the southeastern rural areas. All rural areas are not created equal, even though the trend exists nationwide. But it's even worse if you come out to the southeastern states like Tennessee, Mississippi, Alabama, Georgia, Louisiana, Kentucky; it's in those areas where you see worse deaths from heart disease and stroke in rural areas relative to urban areas.”

Fox added that investigation also found out that even within rural areas, those counties that have the biggest disparity within incomes have a higher rate of death, but isn't sure as to why that is.

“It could be education, it could be what they eat and what's in their diet, it could be exercise; each one of those different components play a role,” Fox said.

What the RURAL Study does after investigation is get to work by taking a national look at what the answer is and how they can address and implement change in those rural areas.

“The National Institutes of Health is funding the RURAL Study, but it's not just the National Institutes of Health that's helping.the American Heart Association has put out a call to action, trying to understand the growing disparity that's been seen in rural areas,” Fox said.

For more information on the RURAL Study, you can visit their website at www.theruralstudy.org.