Why people in rural communities in the South live shorter and less healthy lives than those who reside elsewhere in the United States is the focus of a new national study that will be based at the University of Alabama at Birmingham (UAB).

The Risk Underlying Rural Areas Longitudinal, or RURAL, Study will allow researchers to learn what causes the high burden of heart, lung, blood, and sleep disorders in Alabama, Kentucky, Louisiana, and Mississippi.

“The purpose of this study is to understand whether living in the rural South equates to more health-related issues,” says Shauntice Allen, PhD, co-principal investigator of the study and an assistant professor in the Department of Environmental Health Sciences at the UAB School of Public Health, in a release. “The rural South matters to the entire country. When the rural South hurts, the entire country does. It’s important to understand the reasons and potential causes of chronic health issues in rural areas.”

With funding from the National Heart, Lung and Blood Institute, part of the National Institutes of Health, this six-year, $21.4 million multisite prospective cohort study will include 50 investigators from 15 other institutions.

To better understand why certain factors amplify risk in some rural counties and what renders some communities more resilient, the researchers will be recruiting and studying 4,000 multi-ethnic participants from 10 of the most economically disadvantaged rural counties in the South.

“The truly exciting thing about this research is we are working with multiple investigators from across the Southeast to develop and maintain community engagement in addition to participant engagement,” says Suzanne Judd, co-principal investigator of the study and a professor in the Department of Biostatistics at the UAB School of Public Health. “We are looking to go beyond a simple epidemiological study to do more than simply observe a population.”

To accomplish this, researchers will build a mobile clinic to provide the medical exams on study participants in their counties. Familial, lifestyle and behavioral factors, along with medical history including risk for heart, lung, blood, and sleep disorders, will be recorded. Environmental and economic factors will also be studied. UAB will be in charge of building the mobile clinic.

“This clinic will bring technology to rural communities that might not have ready access to specific types of diagnostic tests,” Judd says. “This is an engineering challenge, a community engagement challenge and a disease prevention challenge, which makes it incredibly exciting.”

“UAB is a major stakeholder in the state of Alabama,” Allen says. “Access to quality care, educational opportunities and employment are all things anyone would want their family to have. Access is a significant issue in rural communities. Bringing accessible health screenings to rural areas is important.”

In addition to UAB, investigators from the University of Louisville, Louisiana State University’s Pennington Biomedical Research Center, and University of Mississippi Medical Center will play a central role in participant recruitment, retention, follow-up, data return, return of results, community engagement, and education. The study’s coordinating center is Boston University School of Medicine.

Recruitment in Alabama will begin next year.