Darrell Dixon’s father was just 25 when he suffered a massive heart attack in rural Mississippi Delta. By his early 40s, a series of attacks had weakened his heart muscle, making it unable to pump enough blood to his body. He died in 2013 at age 49.
“It was a huge shock to our family,” recalls Dixon, 36. “It made me think about genetics and whether I could be next.”
The death prompted Dixon to take part in an unusual and ambitious new health study.
Public health experts from the nation’s leading research institutions have deployed giant medical trailers to rural parts of the South to test and study thousands of locals in an effort to understand why rates of heart and lung disease are dramatically higher there than in the rest of the country.
“This rural health disadvantage harms people whether they’re white or black,” said former project leader and Framingham Heart Study — The nation’s longest-running study of heart disease. “No race is exempt, but people of color are worse off.”
Researchers aim to test the heart and lung function of about 4,600 people from 10 counties and parishes in Alabama, Kentucky, Louisiana and Mississippi, and collect information about their environments, health histories and lifestyles. They also plan to give participants fitness trackers and repeat surveys over the years to look for any serious health problems.
Ramachandran, now dean of the University of Texas School of Public Health at San Antonio, said rural Americans rarely receive this kind of personal, long-term attention from epidemiologists. More than a dozen institutions are collaborating on the study, including Johns Hopkins University, University of California, Berkeley and Duke University.
The 52-foot-long (16-meter) and 27-ton trailer is outfitted with equipment to test for more general health markers, such as calcium in the arteries, heart structure, lung capacity, blood pressure and weight. An initial test can take more than three hours.
“They’re reaching out and going out into the community in ways we’ve never seen before,” said Lynn Sproule, mayor of Starkville, Mississippi’s Oktibbeha County, where the trailer arrived in 2022 and medical staff have tested more than 700 people.
the study and data According to U.S. health officials, the rural population of the U.S. unhealthy Southerners have a lower life expectancy than urban Americans. Health disparities are even greater: Death rates for people over 35 from heart disease, the leading cause of death in the United States, are more than twice as high in some rural areas as the national average. Lung diseases, such as chronic obstructive pulmonary disease (COPD), which has been studied, are also more common in the South.
Researchers offer several theories for these disparities: Many rural residents have limited access to health care due to hospital closures and doctor shortages; healthy food, fitness opportunities, and public transportation are often lacking; poverty rates are higher, and fewer people have health insurance through their employers; and in the rural South, poverty rates and the percentage of people without health insurance are even higher.
Smoking is the leading cause of heart disease At least 20% of adults in Alabama, Kentucky, Louisiana, and Mississippi smoke cigarettes.Obesity is another contributing factor, according to 2019 data from the Centers for Disease Control and Prevention: By 2022, 38% to 40% of adults will be 50% overweight or overweight based on their self-reported height and weight. Four States It belongs to the obese body mass index category.
By closely examining local residents and their environments, the rural study seeks clearer answers about what is causing the South’s growing health burden. Researchers also hope to understand why some rural counties in the South have better health outcomes than others.
“We’re interested not just in risk but in resilience,” said Lindsay Poole, an epidemiologist at the National Heart, Lung, and Blood Institute, which is funding the study with more than $40 million.
To achieve that goal, the researchers are also visiting rural areas in three states – Louisiana, Mississippi and Kentucky – that have similar demographics but a lower risk of heart and lung disease.
Oktibbeha County, home to Mississippi State University, is in eastern Mississippi near the Alabama border and is a low-risk area, which the researchers compared with Panola County in north Mississippi, about 60 miles (97 kilometers) south of Memphis, Tennessee.
Both counties have poverty rates above 20 percent and similar percentages of people under 65 without health insurance. But from 2019 to 2021, the death rate from heart disease among people 35 and older was 647 per 100,000 in Panola County and 395 per 100,000 in Oktibbeha County. CDC Data.
In urban Rankin County, Mississippi, which is part of the Jackson metropolitan area, the number was 331. The U.S. average for the same period was 326.
Dixon, who works for Panola County’s community development organization and is a consultant on the heart and lung study, helped recruit more than 600 Panola County residents for the project. Dixon said heart disease is so prevalent in the county that he often hears people talking about medications and their side effects in local stores and churches.
Mr. Dixon’s father, Darrell Dixon Sr., of Clarksdale, about 40 miles (64 kilometers) west of Panola County, had long suffered from high blood pressure and had a strong family history of heart disease.
Dixon said he suffered another massive heart attack after a close friend of his who served as a chaplain at the Mississippi State Penitentiary was executed, and then spent the last few years of his life in and out of hospital with congestive heart failure.
“My father was really suffering,” says Dixon, who hopes the study will shed light on unseen environmental factors that may have contributed to his father’s death and raise awareness among local residents about “how to live better”.
The trailer is currently located in Franklin Parish in northeast Louisiana, where the heart disease death rate from 2019 to 2021 was a staggering 859 deaths per 100,000 people over the age of 35, according to CDC data. In New Orleans, about 200 miles (322 kilometers) south, the rate was 340.
The NHLBI plans to extend the study through 2031, and researchers hope to examine all participants in person again.
“The longer we can follow people, the better we can understand the onset and progression of the disease,” said Poole, the epidemiologist.
