New Study Inspires Researchers to Hit the Road

A new $21.4 million RURAL study will examine rural, southern U.S. communities to find out why people there have more disease, shorter lives. Traveling in a mobile examination van, researchers will examine 4,000 study participants over the course of six years in 10 rural counties across Kentucky, Alabama, Mississippi and Louisiana.

Vasan Ramachandran, who leads the Framingham Heart Study at Boston University, is about to embark on the ultimate road trip with 50 other scientists. But this is not for adventure and sightseeing. The research team is part of a new study led by Ramachandran, called the Risk Underlying Rural Areas Longitudinal (RURAL) study, which has the goal of discovering why people in rural areas of the southern United States tend to live shorter, less healthy lives compared to the rest of the country.

With $21.4 million in funding from the National Heart, Lung, and Blood Institute, Ramachandran and his team plan to use their know-how from the Framingham Heart Study—the longest-running heart disease study in the country—to ask the question, “What causes the high burden of heart disease, lung disease and stroke in the rural South?”

To find out the answer, the researchers will travel by custom van, built as a “mobile examination unit,” to examine 4,000 study participants over the course of six years in 10 counties across Kentucky, Alabama, Mississippi, and Louisiana. Throughout the entire US, heart disease is the number-one killer of both men and women, but rates are even worse in southern states. People living in these areas also have higher rates of lung, blood, and sleep disorders compared to the national average.

“We hope that what we do [in RURAL] changes the lives of common human beings who live in these communities, who are robust individuals like you and me,” says Ramachandran, a BU School of Medicine professor of medicine and epidemiology and chief of preventive medicine and epidemiology. “The burden of [health] risk is high, in part because of geospatial characteristics that we don’t fully understand.”

The most crucial aspect of the study, Ramachandran explains, is going to be listening. Partnering with 16 institutions, including universities in all four states, the researchers will work with participating communities to organize active discussions, working groups, listening groups, and community advisory boards. Their plan is to take the “science to the people and study these health issues at their doorstep,” Ramachandran says.

The mobile exam unit will be constructed after carefully consulting with community partners and participants, long before the examination process begins. Ramachandran says this will ensure that the space will be comfortable, accessible, and customized to the needs of specific areas. The van, once fully operational, will spend time in each county over the next few years. Counties in Alabama will be the group’s first stop to conduct baseline examinations.

“We do hope to build relationships within these communities to understand them better beyond the 4,000 people [who will participate] in RURAL,” Ramachandran says.

Six years might seem like a long time, but this is only the first step toward a much longer process and larger goal. Once the RURAL van completes its trip through all 10 counties, the cohort will continue working with the communities through advisory boards and participant networks. After the data is collected and analyzed, the team intends to share the results with district health officials and provide health recommendations based on their findings.