(May 22, 2019) Why are some people born in the rural South less healthy and prone to die sooner?
In an effort to understand why some people born in rural communities in the South live shorter and less healthy lives than their counterparts elsewhere in the same counties as well as across the country, researchers from the Larner College of Medicine at the University of Vermont (UVM) today announced they will be participating in a new longitudinal cohort study aimed at combating this issue.
The Risk Underlying Rural Areas Longitudinal Study (RURAL) will allow researchers to learn what causes the high burden of heart, lung, blood and sleep (HLBS) disorders in Kentucky, Alabama, Mississippi and Louisiana and offer clues regarding how to alleviate them.
With funding from the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, this six-year, $21.4 million multi-site prospective cohort study will include 50 investigators from 15 other institutions, including UVM University Distinguished Professor of Pathology and Laboratory Medicine Russell Tracy, Ph.D., FAHA, ABCC.
To better understand why certain factors amplify risk in some rural counties and what renders some communities more resilient, the researchers will be recruiting and studying 4,000 multi-ethnic participants from 10 of the most economically disadvantaged rural counties in southern Appalachia and Mississippi Delta and parts of the rural South.
Using a self-contained mobile examination unit, ‘a research center on wheels,’ a transdisciplinary team will conduct an approximately four-hour detailed baseline examination on the study participants. Familial, lifestyle and behavioral factors, along with medical history including risk for HLBS disorders 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 smart phones and wearable activity monitors in order to help collect health and lifestyle information of the participants.
“RURAL is a unique opportunity to work with participants in economically-challenged areas, people who have not had much opportunity to participate in NIH epidemiological studies,” says UVM’s Tracy, who has over 30 years of experience in population studies of heart disease, diabetes and other chronic diseases of aging, and currently directs a national-level biorepository at UVM with more than 4.5 million biosamples.
Tracy explains that UVM’s Laboratory for Clinical Biochemistry Research will help design the overall protocol, especially for the collection of biosamples, such as blood and urine. The lab will serve as the RURAL Biorepository, ultimately storing and making available hundreds of thousands of biosamples for future research. In addition, Tracy’s lab will also perform a variety of clinical and research measurements to help identify critical factors that determine better or worse health status in rural communities.
“The rural health challenge in the South does not spare any race or ethnicity. These high risk and economically disadvantaged rural communities are vulnerable to clusters of multiple health problems,” explained Vasan Ramachandran, M.D., 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 challenge in the South and share our findings with and offer health education to these rural communities.”
The study coordinating center is Boston University School of Medicine (BUSM). Investigators from the University of Louisville (Kentucky), LSU’s Pennington Biomedical Research Center, 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.
UVM’s Larner College of Medicine is one of 12 institutions participating in RURAL. Other participating institutions are Duke University; Emory University; Johns Hopkins University; Los Angeles BioMedical Research Institute (UCLA); University of California, Berkeley; University of Massachusetts Medical School; University of North Carolina at Chapel Hill; Perelman School of Medicine at the University of Pennsylvania; University of Virginia at Charlottesville; and the Wake Forest School of Medicine.