Prevention & lipidsCross-sectional study
Cardiovascular Health Among Rural and Urban US Adults—Healthcare, Lifestyle, and Social Factors
- Cross-sectional study
- nationally representative
Authors' conclusion
This national cross-sectional study found substantial rural-urban disparities in cardiometabolic risk factors and cardiovascular diseases, which were largest among younger adults and almost entirely explained by social risk factors.
Study context
- Population
- US adults aged ≥20 years, 2022 National Health Interview Survey
- Participants
- 27,172 adults
- Exposure
- Rural vs urban US adults
- Ruraln = 4,256
- Small or medium metropolitann = 14,741
- Urbann = 8,175reference
- Outcome
- Age-standardized rates of cardiometabolic risk factors (hypertension, hyperlipidemia, obesity, DM) and CVD (CHD, stroke)
Main finding
As reported in the abstract
Age-standardised rates, rural vs urban
Rural
37.1%
Hypertension · Hyperlipidemia 29.3% · Obesity 41.1% · Diabetes 11.2%
Rural vs UrbanRelative risk (95% CI)
hypertension: 37.1% vs 30.9%
1.20(1.13–1.27)
hyperlipidemia: 29.3% vs 26.7%
1.10(1.03–1.18)
obesity: 41.1% vs 30.0%
1.37(1.27–1.47)
diabetes: 11.2% vs 9.8%
1.15(1.02–1.29)
- CHD: same pattern (6.7% vs 4.3%)
- RR, 1.58; 95% CI, 1.35-1.85
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Rural-urban disparities, young adults aged 20-39 years (subgroup) — Rural vs Urban · hypertension | RR 1.44 (95% CI 1.12–1.86) | |
| Rural-urban disparities, young adults aged 20-39 years (subgroup) — Rural vs Urban · obesity | RR 1.54 (95% CI 1.34–1.77) | |
| Rural-urban disparities, young adults aged 20-39 years (subgroup) — Rural vs Urban · DM | RR 2.59 (95% CI 1.54–4.38) | |
| Disparities adjusted for social risk factors — Rural vs Urban · hypertension | aRR 0.99 (95% CI 0.93–1.06) | |
| Disparities adjusted for social risk factors — Rural vs Urban · DM | aRR 1.02 (95% CI 0.90–1.15) | |
| Disparities adjusted for social risk factors — Rural vs Urban · CHD | aRR 1.08 (95% CI 0.91–1.29) | |
| Disparities adjusted for social risk factors — Rural vs Urban · obesity (partially attenuated) | aRR 1.29 (95% CI 1.20–1.39) | |
| 0.20.5125Ratio (log scale) |
Disparities adjusted for health care access and lifestyle factors
- Not meaningfully attenuated
Original publication
Cardiovascular Health Among Rural and Urban US Adults—Healthcare, Lifestyle, and Social Factors. JAMA Cardiol. Published 1 June 2025. doi:10.1001/jamacardio.2025.0538
Summarised from the published abstract; every number is checked against it