A study by the University of Georgia found that although fewer people in the Unites States overall are dying of cardiovascular disease, rural, Black and poor counties had higher rates of cardiovascular disease compared with more urban, predominantly white areas.

Published in the Journal of the American Heart Association, the study found that cardiovascular disease deaths consistently decreased at the county level from 2009 to 2018.

“Even though the rates of cardiovascular disease are decreasing, the gaps between rural and urban health and counties with more Black residents are not decreasing,” said lead study author Health Heejung Son, a doctoral student in the College of Public Health, in a University of Georgia news release. “The main point of our study is that we need to try to find ways to reduce those gaps.”  

Using data from the Department of Health and Human Services’ Agency for Healthcare Research and Quality, researchers analyzed more than 3,100 U.S. counties. They found that greater food insecurity and housing instability correlated with higher rates of cardiovascular disease and deaths. In fact, counties with higher household incomes and counties where a greater number of individuals had Medicare coverage had a significantly lower rate of death due to heart disease.

This research supports previous evidence that stress caused by low wages can lead to inflammation in the body that can progress to illness. These findings may help explain the link between low socioeconomic status and higher rates of cardiovascular disease deaths, according to researchers.

“The environment that we are born, live and grow in has an effect on our health,” study coauthor Zhuo “Adam” Chen, PhD, an associate professor of health policy and management, said in the news release. “Social factors, such as those that affect our income, housing conditions and transportation—people may not make the connection that those things affect our health as well.”

To decrease the gap between types of counties, Chen suggests expanding access to health care and nutrition assistance and addressing the lack of affordable housing and health care in the country.

“We need to be thinking outside of the box,” Chen said. “This study presents evidence for stronger interventions related to housing, income support and food security. We need to be proactive instead of waiting for people to get sick to provide medical care.”