Focused Community-based Research for Eliminating CVD Risk Disparities in a Rural Underserved Population


Cardiovascular disease (CVD) is the leading cause of death and chronic illness in the U.S. In parts of the rural south disparities in both health care access and CVD health outcomes are pervasive. Descriptive analyses of community-based CVD risk factors are valuable to begin to unfold the complex nature of CVD mortality in specific rural, underserved populations.
To evaluate the prevalence of cardiovascular disease (CVD) risk factors among patients age 25 and over at a primary rural healthcare setting in a specific rural, medically underserved population to guide the development of community-based CVD treatment and prevention strategies.
This study used a descriptive retrospective explorative design. Data were collected through chart audits from a random sample of 197 patients at a rural health center in northwest Alabama, U.S. Cardiovascular risk factors were identified using health data, anthropometric measures and ICD-9 codes. Prevalence was evaluated and descriptive statistics were used to describe cardiovascular risk factors as well as socio-demographics variables.
In this rural medically underserved cohort (n= 197), the prevalence of selected cardiovascular risk factors was: smoking: 39.1%; hypertension: 58.4%; dyslipidemia: 15.1%; diabetes mellitus: 27.9%; and obesity: 44.5%. Smoking, hypertension and diabetes were noted to be higher in men, while women had higher rates of dyslipidemia and obesity. Rates of hypertension and diabetes increased with age as seen in similar studies. More than 48% of the study population ages 41-55 years were noted to have dyslipidemia.
This community-based CVD risk factor assessment can be used to guide future community-based research and interventions. The high prevalence and inadequate control of CVD risk factors seen in this population coupled with an existing shortage of physicians is an opportunity for nursing interventions. The use of advanced practice nurses for CVD assessment and interventions may be one practical strategy for this rural, medically underserved population.
Key Words
Prevalence, Cardiovascular Disease, Risk Factors, Disparities, Community-based research, Rural, Underserved, Appalachian

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