Influence of rurality on the awareness of myocardial infarction symptoms in the US

Abstract

Background: Myocardial infarctions (MIs) are the leading cause of death in the United States (US). Differences in MI mortality rates exist between rural and urban areas in the US. Early recognition of MI symptoms can lead to receiving prompt lifesaving treatment. In this study, we identified the influence of living in a rural area, rurality, on disparities in MI symptom awareness across the US. Methods: We examined 2007 and 2009 Behavioral Risk Factor Surveillances System survey data using logistic regressions to model the impact of rurality on MI symptom awareness while controlling for sociodemographic and MI clinical factors. From the results of these models, we created a type of marginal probability, known as average adjusted predictions (AAPs) and the difference in AAPs, called average marginal effects (AMEs), to determine patterns of awareness for each MI symptom between rural, suburban, and urban areas. Results: We found that there were similar odds and probabilities of being aware of all five MI symptoms between rural, suburban, and urban areas, although rural residents consistently had a slightly higher odds and probability of being aware of all five MI symptoms compared with suburban and urban residents. Rural, suburban, and urban residents had the highest probability of being aware of chest pain/discomfort (95.5–96.1%) and the lowest probability of being aware of jaw/back/neck pain (68.6–72.0%). After adjustment, more than 25% of rural, suburban, and urban residents were found to be unaware that jaw/back/neck pain and feeling weak/light-headed/faint were symptoms of MI. AMEs were greatest for all areas for jaw/back/neck pain (−3.5% to −3.2%) and smallest for chest pain/discomfort (−0.6% to −0.2%). Conclusions: The study’s results highlight the need to increase awareness of the MI symptoms of jaw/back/neck pain and feeling weak/light-headed/faint to shorten hospital delay and time to treatment, especially for rural areas where cardiovascular disease mortality is high.

Engaging social activities prevent stroke and myocardial infraction by raising awareness of warning symptoms: A cross-sectional survey study

“…Preceding studies have explained that national projects to spread the knowledge about CVDs may have been more actively promoted in rural areas where emergency treatment is not easily accessible ( 16 , 18 ). In addition, rural dwellers tend to establish closer connections with their neighbors than city dwellers, which can lead to a higher chance of sharing health knowledge ( 26 ). However, further investigations are needed since some studies have also demonstrated contradictory results in that the urban residents knew more about the CVD symptoms ( 13 , 15 , 25 ).…”

Spatial and temporal analysis of myocardial infarction incidence in Zanjan province, Iran

“…Majority of people living in rural areas are farmer and related to agriculture work and have a poor socio-economic status. Lifestyle, socioeconomic differences such as education and income, low access to preventive health care services such as cholesterol screening, cardiac rehabilitation and a routine physical checkup [ 2 , 35 ].The distribution of common MI risk factors (obesity, smoking) and mortality rate were considerably high at rural areas compared to urban areas in USA. The smoking and obesity rates in US rural are 29.6 and 39.6% compared to 24.2 and 33.4% in the urban USA population respectively [ 36 , 37 ].…”

Myocardial Infarction Iincidence at the Northwest of Iran 2014–2018: A Spatial Analysis

“…Majority of people living in rural areas are farmer and related to agriculture work and have a poor socio-economic status. Lifestyle, socioeconomic differences such as education and income, low access to preventive health care services such as cholesterol screening and cardiac rehabilitation and a routine physical checkup are the common risk factors of high incidence of MI in rural areas (2,35). The distribution of common MI risk factors (obesity, smoking) and mortality rate were considerably high at rural areas compared to urban areas in USA.…”