Heart failure deaths are more stable in rural areas of the United States than urban areas

Deaths from heart failure are consistently higher in rural areas of the United States compared to urban areas, reports a new study by Northwestern Medicine. The research also showed that racial differences in heart failure are common in rural and urban areas with the greatest increase among Black adults under 65 years of age.

Heart failure deaths have been on the rise nationally since 2011, but these patterns vary greatly by race.

“This work highlights persistent and difficult rural disadvantage with significantly higher mortality rates in rural areas compared to urban areas,” said lead study author Dr. Sadiya Khan, professor of medicine at Feinberg School of Medicine Northwestern University and Northwestern Medicine cardiologist.

The study was published in the journal PLOS AON on this month.

Possible factors for the differences are higher levels of adverse social factors (e.g., lower income), risk factors such as obesity and diabetes in areas rural and fewer doctors, especially cardiologists.

“Research is needed to identify barriers and define best strategies to prevent heart failure and guide the best medical treatment with guidance, once heart failure develops,” said Khan.

Here is our first study:

• Focusing on geographical heterogeneity in rates of heart failure mortality by rural or urban area
• Shows that patterns of heart failure mortality are changing unfavorably with increases since 2011 in rural and urban areas; these increases are greater among younger adults under the age of 65 with the largest increases among black males under 65.

The study used national death certificate data from the Centers for Disease Control that captures all deaths occurring in U.S. Inspectors identifying cardiovascular deaths related to heart failure that occurred since 2011 and measures mortality rates and annual trends by age, in rural and urban areas, overall, by age groups and by race and gender.