From the SWLA President: Impact of Rurality on Health

Identities and experiences are individual to each American - where we come from, who our family is, how we fit into those molds. Individual identity is largely impacted by environment, which heavily depends on zip code. People in 10001 of New York City, 90001 of LA, and 60007 of Chicago live in bustling cities full of energy and the glamours of city life, where people in 67764 of Logan, Kansas, in 59010 of Big Horn, Montana, in 35976 of Guntersville, Alabama, live in fields of green and have vastly different experiences. In those wide-open spaces, there is fresh air and cultural customs closely tied to the land. You will find close-knit communities of few, spanning many acres of land full of crops, livestock, usually the rural population’s livelihood. Where city dwellers are deprived of lush green fields, they are repaid in easy access to simple amenities such as grocery stores, doctors’ offices, esteemed school systems. Rural populations surrender those amenities in pursuit of a different mode of life. This edition of LipidSpin investigates the challenges of both doctors and patients living in rural America battling lipid-related health problems.

This topic was an easy choice as a healthcare professional who cares for patients in a largely rural part of Texas for more than 25 years, as well as the many Southwest Lipid Association members who serve a very large and diverse rural and semi-rural population. Residing in a rural, medically underserved area is independently associated with increased risk for cardiovascular disease (CVD). The increased risk is attributable to a myriad of causes, but most significantly, reduced access to effective heath care: although approximately 20% of Americans live in rural areas only 9% of physicians practice in these areas. Multiple landmark studies have established that morbidity and mortality from CVD can be reduced by identification and modification of CVD risk factors, but translation of this knowledge to rural communities is an unmet need of our healthcare delivery system. In addition to access both with respect to specialty providers, dieticians, and resources to treat cardiovascular diseases, individuals with lipid-related disorders are often faced with a limited choice of affordable and healthy food choices. Although patients living in these areas may literally be few and far between, many of them are the backbone of our nation – responsible for growing food for our shelves and cotton for our closets. Encouraging awareness to challenges faced by rural populations helps the health of America as a whole.

During my presidency of the Southwest Lipid Association for the 2020-2021 year, I was grateful for the support of the LipidSpin Staff and my colleagues and friends in SWLA, many of whom have made some remarkable contributions to this issue. I look forward to the future of this chapter and am glad to help in any way that I can and feel warm knowing I have left the chapter in great hands with Dr. Susan Dimick serving as the new president of the SWLA chapter and a physician who is well-acquainted with the barriers facing rural populations.