Vernon Marlo, McIndoe Brianna, Ryan Michael J, Behr Amanda, Ilatovskaya Daria, Chakraborty Ananya, Yellamraju Suma, Idun Ara, Sullivan Jennifer
Department of Obstetrics and Gynecology, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Biol Sex Differ. 2025 Aug 11;16(1):62. doi: 10.1186/s13293-025-00740-5.
In the United States, cardiovascular disease (CVD) is the leading cause of death among both men and women; CVD and associated risk factors particularly affect women who live in rural areas. This mixed-methods analysis aims to explore cardiovascular health (CVH) risk factors and healthcare experiences among women in rural Georgia, to identify barriers to care, and to inform strategies for improving long-term health outcomes in rural communities.
A convergent mixed methods design was utilized to evaluate CVH prevalence and associated environmental risk factors among women living in rural GA. Quantitative data from 159 Georgia counties were analyzed to compare rural and urban rates of CVD-related conditions and healthcare provider availability. Comparative analyses were performed between counties, urban and rural areas, and on sex differences. Concurrently, semi-structured interviews were conducted with 56 women and 11 healthcare providers to explore knowledge of blood pressure (BP) management, access to preventive services, and barriers to care. Qualitative and quantitative findings were analyzed separately and integrated during interpretation.
Rural counties have significantly higher prevalence of hypertension, obesity and stroke. General trends revealed higher rates of smoking, physical inactivity, and excessive alcohol consumption in rural counties compared to rates in urban counties of GA. Qualitative themes revealed affordability concerns, communication challenges between patients and providers, limited trust in telehealth, and the importance of delivering CVH education in community-based settings. Differences by age were also observed: younger women expressed less concern or awareness about CVH risks, while older women described greater engagement with care and health information. While the original aim included gaps in awareness and education, participants primarily described navigating systemic barriers across the care continuum.
Rural women face individual, provider, and structural barriers to cardiovascular health and care. This unique study identifies chronic disease disparities and risk factors, with a higher disease burden observed in rural counties. Contributing factors may include limited resources for promoting healthy lifestyle choices, and reduced access to healthcare providers. Integrated findings underscore the need for sex- and gender- informed, age-specific, and community tailored strategies that address both health system access, and communication to improve CVH outcomes in underserved rural populations.
在美国，心血管疾病（CVD）是男性和女性的首要死因；心血管疾病及相关风险因素对农村地区的女性影响尤为显著。这项混合方法分析旨在探究佐治亚州农村地区女性的心血管健康（CVH）风险因素和医疗保健经历，识别护理障碍，并为改善农村社区的长期健康结果提供策略依据。
采用收敛性混合方法设计，评估居住在佐治亚州农村地区女性的心血管健康患病率及相关环境风险因素。分析来自佐治亚州159个县的定量数据，以比较农村和城市地区心血管疾病相关病症的发病率以及医疗服务提供者的可及性。在县、城乡地区之间以及性别差异方面进行了比较分析。同时，对56名女性和11名医疗服务提供者进行了半结构化访谈，以探究血压（BP）管理知识、预防服务的可及性以及护理障碍。定性和定量研究结果分别进行分析，并在解释过程中进行整合。
农村县的高血压、肥胖和中风患病率显著更高。总体趋势显示，与佐治亚州城市县相比，农村县的吸烟率、身体活动不足率和过量饮酒率更高。定性主题揭示了对可负担性的担忧、患者与提供者之间的沟通挑战、对远程医疗的信任有限，以及在社区环境中开展心血管健康教育的重要性。还观察到了年龄差异：年轻女性对心血管健康风险的担忧或认识较少，而老年女性则表示更多地参与护理和健康信息。虽然最初的目标包括认识和教育方面的差距，但参与者主要描述了在整个护理过程中应对系统性障碍的情况。
农村女性在心血管健康和护理方面面临个人、提供者和结构方面的障碍。这项独特的研究确定了慢性病差异和风险因素，农村县的疾病负担更高。促成因素可能包括促进健康生活方式选择的资源有限，以及获得医疗服务提供者的机会减少。综合研究结果强调需要制定针对性别、年龄和社区的策略，以解决卫生系统可及性和沟通问题，改善服务不足的农村人口的心血管健康结果。
