NIH awards $44 million for landmark study on health challenges in the rural South

The University of Texas at San Antonio (UT San Antonio) has been awarded a five-year, $44 million contract from the National Heart, Lung, and Blood Institute of the National Institutes of Health for a landmark study focused on persistent health challenges in the rural South.

The Risk Underlying Rural Areas Longitudinal (RURAL) Cohort Study uses a custom-built, 50-foot mobile examination unit equipped with advanced clinical and imaging technology – including a CT scanner – that travels to rural areas to bring research directly to the community doorstep, with participants undergoing comprehensive health assessments.

The funding, which began April 22, will complete the first examination phase and launch a second examination of participants in Alabama, Kentucky, Louisiana and Mississippi. The award underscores UT San Antonio's growing national leadership in population health, community-engaged research and large-scale scientific collaboration.

Led by Vasan S. Ramachandran, MD, dean of the Kate Marmion School of Public Health at UT San Antonio and the study's principal investigator, the project is one of the nation's most ambitious efforts to systematically and comprehensively study rural health gaps.

The RURAL Cohort Study takes the science to the people. This award allows work to continue generating actionable knowledge that can improve prevention, treatment and long-term health outcomes for rural populations that have too often been overlooked in scientific studies."

Vasan S. Ramachandran, MD, dean of the Kate Marmion School of Public Health at UT San Antonio

A first-of-its-kind rural health study

The study was established to understand why residents of rural communities in the southeastern United States experience higher rates of heart, lung, blood and sleep-related diseases, along with shorter life expectancy and less-than-optimal overall health outcomes, compared to populations in other regions. The study also examines how rural communities are resilient in the face of health-related challenges.

Participants receive:

• Cardiovascular and lung health screening via mobile CT and pulmonary function tests
• Assessment of heart disease risk factors such as blood pressure, blood lipids and glucose; kidney function; and sleep and physical activity monitoring
• Lifestyle, family and environmental assessments through validated questionnaires
• Blood and genetic testing
• Measures of subclinical disease, such as coronary artery calcium scans and body fat distributions
• ArtificiaI Intelligence (AI)-guided cardiac ultrasound (echocardiogram)
• Enrollment in a RURAL smartphone-based mobile-health app

Launching Exam 2

The newly funded contract will support Exam 2, a re-examination of approximately 4,000 RURAL cohort participants across the four-state region. This next phase will provide critical insights into how the health of recruited participants changes over time and how environmental, behavioral, biological and social factors interact to influence heart and lung disease risk, and resilience over the life course.

The multidisciplinary RURAL Study team includes investigators, staff and collaborators from 16 institutions, working closely with local rural communities in the four states to ensure the research is responsive, locally relevant and impactful.

UT San Antonio has one of the nation's leading academic health centers, UT Health San Antonio, where the RURAL Cohort Study advances efforts to improve the health of rural communities through education, research, patient care and community engagement.