Black adults living in rural areas of the United States have seen higher death rates from diabetes, high blood pressure, heart disease, and stroke compared to white adults over the past 20 years, according to a research letter published in the Journal of the American College of America Cardiology. In addition, racial disparities in rural areas improved only minimally over the period, while greater improvements were seen in urban areas.
The death rates for each disease studied have been highest in black adults living in rural areas in the past 2 decades. Mortality associated with diabetes and hypertension is two to three times higher in black adults compared to white adults, and the mortality rate for all diseases in rural and urban areas was higher in black adults compared to white adults, according to the study.
Between 1999 and 2018, the gap in death rates for diabetes and high blood pressure between black and white adults narrowed faster in urban areas than in rural areas. Similarly, racial disparities in heart disease and stroke mortality decreased in rural black adults.
“While modest progress has been made in reducing racial health inequalities in urban areas, large differences in death rates between black and white adults remain in rural areas, particularly for diabetes and hypertension. We have the racial differences in results for these areas are not significantly reduced. ” Conditions in rural areas for the past two decades, “said Dr. Rishi Wadhera, MD, MPP, MPhil, cardiologist at Beth Israel Deaconess Medical Center in Boston and lead author on the study, in a press release.” Given that diabetes, If high blood pressure and heart disease are preventable and treatable, targeted public health and policy efforts are needed to address structural inequalities that contribute to racial inequalities in rural health. “
Researchers used data from the CDC Wonder Database to assess age-adjusted death rates for black and white adults aged 25 and over stratified by rural or urban areas from 1999 to 2018. They concluded that racial differences in diabetes and hypertension are related. Mortality in rural areas can be caused by structural inequalities in access to primary, preventive and specialized care for rural black adults.
Conversely, improvements in heart disease and stroke mortality could reflect improvements in emergency medical services, expanding referral networks, developing centers for stroke and myocardial infarction care, and implementing time-to-procedure metrics like door-to-balloon.
REFERENCE
Racial differences in heart disease, high blood pressure, and diabetes have improved only minimally over the past two decades [news release]. EurekAlert; March 15, 2021. Accessed March 17, 2021. https://www.eurekalert.org/pub_releases/2021-03/acoc-rdi031121.php
