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UNC: New Study Asks Why People in Rural South Suffer Poorer Health and Die Sooner

Dr. Robert Agans, associate professor in the Department of Biostatistics at the University of North Carolina Gillings School of Global Public Health, is helping lead a new six-year, $21.4 million study to understand why people born in rural communities in the South live shorter and less healthy lives than their counterparts elsewhere in the country.

The Risk Underlying Rural Areas Longitudinal Study (RURAL) focuses on uncovering the causes behind the high burden of heart, lung, blood and sleep (HLBS) disorders in select rural areas in the Southeastern United States and how they might be alleviated. With funding from the National Heart, Lung and Blood Institute, the multi-site longitudinal cohort study will include, in total, 50 investigators from 15 institutions.

To better understand why certain factors amplify risk in some rural counties and what renders some communities more resilient, researchers will study 4,000 participants representing multiple ethnic groups from 10 of the most economically disadvantaged rural counties in the southern Appalachia and Mississippi delta region.

“We aim to understand the health ‘penalty’ experienced by people living in rural areas in this region,” said Dr. Agans. “Our hypothesis is that individual differences arise from a complex interaction of exposures that span many domains, including adverse environmental factors and exposures, psychosocial factors, and behavioral and lifestyle choices.”

UNC researchers will comprise the Sampling and Survey Methods Core for the RURAL project. Their task is to guide how the project recruits a sample of eligible 25-64 year old residents in 10 counties in four U.S. states — Kentucky, Alabama, Mississippi and Louisiana — with sufficient representation from minority populations.

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