Editor’s note: In early 2020, in light of the global COVID pandemic, the American Heart Association, adjusted its organizational goals to focus on new 2024 Impact Goal replacing the 2030 Impact Goal addressed in this release.

Statement Highlights:

  • Addressing the unique health needs of people in rural America is critical to achieving the American Heart Association’s new 2030 impact goal for equitably increasing healthy life expectancy nationwide.
  • Innovative approaches are needed to improve rural health, and more scientific research is needed to identify which approaches work best.
  • The American Heart Association Presidential Advisory calls on health care and other stakeholders at the local, state and national levels to collaborate in efforts to address the needs of rural populations. The American Heart Association is committed to working with strategic partners to develop solutions to improve rural health in America.

DALLAS, February 10, 2020 – Innovative approaches that address social determinants of health and overcome inadequate health care services are essential to improve health care quality and outcomes in rural America, according to a new advisory published by the American Heart Association, the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke.

The document was published in the journal Circulation as an American Heart Association Presidential Advisory, a formal organizational review of the science and policy landscape surrounding urgent health issues that outlines key principles to guide practice, policy and research.

“Millions of people in rural America face inadequate and unaffordable health care and other systemic barriers that contribute to unacceptably poorer health outcomes,” said the policy statement’s leading authors, American Heart Association President Robert Harrington, M.D., FAHA and former Food and Drug Administration commissioner Robert Califf, M.D. “Addressing the unique health needs of people in rural America is critical to the American Heart Association’s mission to create a world of longer, healthier lives.”

The policy statement calls for innovative, evidence-based approaches to address and improve rural health in ways that:

  • Address the shortage of health professionals in rural areas and encourage the development of new rural-specific, team-based care models.
  • Leverage telehealth and digitally enabled health care to improve access to health services for rural populations.
  • Explore sustainable funding models that ensure the delivery of quality care and enable rural hospitals and other care facilities to remain viable.
  • Expand access to Medicaid and reform insurance markets to improve access to care and foster economic development in rural areas.

“Rural communities have higher death rates from cardiovascular disease and stroke, higher maternal mortality rates due in part to cardiovascular deaths and higher risk factors for chronic disease than urban areas,” said policy statement coauthors Regina M. Benjamin, M.D., MBA, who served as the 18th United States Surgeon General, and Eduardo Sanchez, M.D., MPH, the American Heart Association’s chief medical officer for prevention. “We must address inequities in health and health care resulting from disparities in income, education, housing, transportation and food security to optimize health in rural America.”

The advisory comes as the American Heart Association’s new strategic impact goals for the next decade call for equitably increasing healthy life expectancy from 66 to at least 68 years domestically and from 64 to at least 67 years globally by 2030. Last week, the Association released new principles for ensuring health care is adequate, accessible and affordable for everyone in the United States.

“Improving health in rural America requires a sustained commitment from a broad array of stakeholders at the local, state and national levels,” said Nancy Brown, CEO of the American Heart Association and a coauthor of the advisory. “The American Heart Association applauds the efforts of those focused on improving rural health and is committed to working with strategic partners in support of innovative solutions to improve the health of everyone in this country.”

There is a three-year life expectancy gap, on average, between rural and urban populations, with rural areas having higher death rates for cardiovascular disease and stroke than urban areas. Similarly, rural women face higher maternal mortality rates than urban women, with the growth in maternal mortality largely driven by an increase in cardiovascular deaths. In addition, rural populations have higher rates of tobacco use, physical inactivity and obesity, which have given rise to higher rates of diabetes and hypertension. People in rural areas also are more likely to experience mental and behavioral health challenges than those in urban areas.

“Addressing the barriers to accessing high-quality healthcare in rural communities is essential to achieve health equity in America and needs to be a priority for more funders and nonprofits,” said Walter Panzirer, trustee of The Leona M. and Harry B. Helmsley Charitable Trust. “Access is more than having insurance – it’s about having a well-trained workforce with the resources necessary to deliver high-quality care. The American Heart Association has been a valued partner in this work, and we welcome the call to action for innovation and attention to rural health care systems.”

“Collaboration between the policy community and health care stakeholders is necessary to create solutions specific to rural communities,” said Marilyn Serafini, director of the Bipartisan Policy Center’s Health Project. “The BPC has been listening to the full range of rural experts and stakeholders in developing task force-led, bipartisan recommendations for addressing rural health. We are encouraged to see the American Heart Association joining the conversation to focus on Americans living in rural areas who are at a greater risk of conditions including heart disease and stroke.”

 “Health care disparities impede the abilities of rural Americans to lead normal, healthy lives,” said National Rural Health Association CEO Alan Morgan. “We welcome the American Heart Association’s call for attention and partnership on addressing the unique needs of people in rural America.”

Additional Resources:


The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Heart Association

The American Heart Association is a leading force for a world of longer, healthier lives. With nearly a century of lifesaving work, the Dallas-based association is dedicated to ensuring equitable health for all. We are a trustworthy source empowering people to improve their heart health, brain health and well-being. We collaborate with numerous organizations and millions of volunteers to fund innovative research, advocate for stronger public health policies, and share lifesaving resources and information. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

For Media Inquiries:
Steve Weiss, 202-785-7905, steve.weiss@heart.org

For Public Inquiries:
1-800-AHA-USA1 (242-8721); heart.org