by Lori Solomon

Between 2010 and 2022, cardiovascular mortality increased in rural areas and decreased in urban areas, according to a study scheduled for presentation at the American Heart Association Scientific Sessions 2024, held from Nov. 16 to 18 in Chicago.

Lucas X. Marinacci, M.D., from Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, and colleagues conducted an analysis of rural-urban differences in cardiovascular mortality using national death data from the CDC WONDER dataset (2010 to 2022).

The researchers found that between 2010 and 2022, age-adjusted mortality rates (AAMRs) were consistently highest in rural areas. Over time, AAMRs increased in rural areas (rate difference [RD], +3.4), while declining in urban areas (RD, −23.8), which was driven by a rise in AAMRs among younger rural adults (RD, +23.2).

Older adults experienced a decline in AAMRs, although this decline was greater in urban areas compared with rural areas. Overall annual percent change (APC) in AAMR decreased for all areas from 2010 to 2019. Younger rural adults saw a significant increase (+1.0%), which was not seen in large metro areas. There was a significant decrease for older adults across all areas.

The overall APC in AAMR increased significantly in rural areas (+3.1%), but not in large metro areas, between 2019 and 2022. Although cardiovascular mortality rose in most subgroups, younger rural adults experienced the largest increase (+4.2%).

"These findings highlight an urgent need to address widening rural-urban disparities, particularly among younger adults," the authors write.

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