Why Do Some Rural Southerners Live Longer, Healthier Lives?

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New Study Will Explore Reasons Some Communities Combat Health Risks Better
Released: Wednesday, May 22, 2019

Dr. Stephanie Broyles

Baton Rouge, Louisiana -- A new study will attempt to find out why some people born in rural parishes and counties are more resilient when it comes to heart disease and other illnesses than their counterparts in similar rural areas.

Researchers from LSU’s Pennington Biomedical Research Center and other institutions will recruit 4,000 participants for a new longitudinal cohort study aimed at combating this issue.  The Risk Underlying Rural Areas Longitudinal Study (RURAL) will help researchers learn what causes the high burden of heart, lung, blood and sleep (HLBS) disorders in Kentucky, Alabama, Mississippi and Louisiana and offer clues to alleviate them.

“What is really novel here is that we are trying to figure out why some people living in rural areas are more resilient to heart disease while others living in what look to be similar areas, based on demographics and poverty, are less healthy,” said Dr. Stephanie Broyles, primary investigator of the Louisiana portion of the study and director of Pennington Biomedical’s Contextual Risk Factors Laboratory.  “So we aren’t comparing rural areas to non-rural areas. That’s been done. Instead, we are solely focused on rural areas to figure out what drives variations in health in rural environments.”

Dr. Broyles said the study has “immense potential” for improving the health of rural communities, which include some of the state’s most vulnerable populations.

“I’m confident that what we learn through this initiative will empower these communities to make changes to improve health, and will also provide our partner agencies – the Louisiana Department of Health and Cooperative Extension Services – the information they need to assist communities in becoming healthier,” Dr. Broyles said.

“We think that exposure to adverse structural and environmental factors creates greater wear and tear on the body, affects mental and emotional health and well-being and impacts lifestyle choices that influence the risk for heart, lung, blood and sleep disorders,” Dr. Broyles said.  “We believe this study will reveal some of the reasons why some rural communities are so much more vulnerable to these health issues than others.”

The scientists will recruit multi-ethnic volunteers from 10 of the most economically disadvantaged rural counties in the Southern Appalachia and Mississippi Delta regions.  Six of the counties are considered high-risk.  They have the highest age-adjusted mortality rates, 70 percent above the national average, because of heart, lung, blood and sleep disorders.  Four of the counties are considered lower-risk, with age-adjusted mortality rates 20 percent below the national average.

In Louisiana, the high-risk area is Franklin Parish.  The lower-risk area is Assumption Parish.  Pennington Biomedical will recruit about 700 participants from the parishes.

Rural Health Initiatives

Pennington Biomedical’s experience helping rural communities includes “West Carroll Health Communities 2014 Health Assessment.” 

The report identified the health areas that most needed attention, including behaviors related to obesity, diabetes and high blood pressure.

For the complete report, go to http://bit.ly/2vucJ4c

Scientists will use a self-contained mobile examination unit, “a research center on wheels,” to conduct a detailed, four-hour baseline exam on participants.  Familial, lifestyle and behavioral factors, along with medical history including risk for heart, lung, blood and sleep disorders (HLBS) will be recorded. Environmental and economic factors will also be studied, and standard and novel risk factors for HLBS disorders will be assayed.  Investigators will use smartphones and wearable activity monitors to help collect the participants’ health and lifestyle information.

“The rural health penalty in the South does not spare any race or ethnicity. These high-risk and economically challenged rural communities are vulnerable to clusters of multiple health problems,” explained Dr. Vasan Ramachandran, MD, FAHA, FACC, principal investigator and Boston University director of the renowned Framingham Heart Study, with which he has been affiliated for more than 20 years. “We aim to understand the rural health penalty in the AMD (Appalachia and Mississippi Delta) and share our findings with and offer health education to these rural communities.”

Coordinated by Boston University School of Medicine (BUSM) and funded by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, this six-year study will include 50 investigators from 15 other institutions and bring $1.6 million to Louisiana.

In addition to Pennington Biomedical, investigators from the University of Louisville, University of Mississippi Medical Center and University of Alabama at Birmingham will play a central role in participant recruitment, retention, follow-up, data return, return of results, community engagement and education.

The other institutions participating in RURAL are Duke University; Emory University; Johns Hopkins University; Los Angeles BioMedical Research Institute (UCLA); University of California, Berkeley; University of Massachusetts; University of North Carolina at Chapel Hill; Perelman School of Medicine at the University of Pennsylvania; University of Vermont; University of Virginia at Charlottesville and the Wake Forest School of Medicine.

What Louisiana Legislators Say About the Study

“Rural areas in Louisiana face many challenges, none more important than achieving better health during this time of major health care transition that threatens access in many rural underserved areas like Franklin Parish,” said Sen. Neil Riser, whose district includes Franklin Parish.

Sen. Rick Ward, whose district includes much of Assumption Parish, said improving rural residents’ health will better their quality of life, help them be more productive at work, and could also lower health care costs for them, their employers and the state.

“Assumption Parish, like many other rural parts of Louisiana, faces significant and very similar challenges, and health is among the most crucial,” said Rep. Beryl Amedee, whose district includes parts of Assumption Parish.

Rep. Chad Brown, who represents Assumption Parish, said lowering the risk of heart disease, and other chronic diseases, would be life-changing for many of Louisiana’s residents.

Rep. Steve Pylant, who represents Franklin Parish, said finding a way to reduce the risk of heart, lung, blood and sleep disorders would make a big difference for his constituents.

The research was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number U01 HL146382.


About the Pennington Biomedical Research Center

The Pennington Biomedical Research Center is at the forefront of medical discovery as it relates to understanding the triggers of obesity, diabetes, cardiovascular disease, cancer and dementia. The Center conducts basic, clinical, and population research, and is affiliated with Louisiana State University. The research enterprise at Pennington Biomedical includes over 450 employees within a network of 40 clinics and research laboratories, and 13 highly specialized core service facilities. Its scientists and physician/scientists are supported by research trainees, lab technicians, nurses, dietitians, and other support personnel. Pennington Biomedical is located in state-of-the-art research facilities on a 222-acre campus in Baton Rouge, Louisiana.