University of Texas at San Antonio Awarded $43.99 Million NHLBI Contract to Advance Landmark RURAL Study
SAN ANTONIO, Texas — The University of Texas at San Antonio (UT San Antonio) has been awarded a $43.99 million, five-year contract from the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. The funding will complete the first examination phase and launch a second examination of participants in the groundbreaking Risk Underlying Rural Areas Longitudinal (RURAL) Study, focused on persistent health challenges in the rural South in four States (Alabama, Kentucky, Louisiana, and Mississippi).
The RURAL 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 is examining how rural communities are resilient in the face of health-related challenges.
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.
A First-of-Its-Kind Rural Health Study
The study utilizes a custom-built, 50-foot mobile examination unit equipped with advanced clinical and imaging technology that travels to rural areas to bring research directly to the community doorstep. Participants undergo comprehensive health assessments, including:
- 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, along with 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
“The RURAL Cohort Study takes the science to the people,” said Ramachandran. “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.”
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 award underscores UT San Antonio’s growing national leadership in population health, community-engaged research, and large-scale scientific collaboration.
The multidisciplinary RURAL Study team includes investigators, staff, and collaborators from 14 institutions, working closely with local rural communities in the four states to ensure the research is responsive, locally relevant, and impactful.
UT San Antonio is one of the country’s leading academic health centers, dedicated to improving the health of the rural communities it serves through education, research, patient care, and community engagement.
About the RURAL Cohort Study
Nearly 46 million Americans (one in six) live in rural communities, which play a vital role in the U.S. economy but face disproportionate health burdens, including higher rates of heart, lung, blood, and sleep disorders. Yet a critical gap remains in research data on the health of people in the rural South. So far, the Risk Underlying Rural Areas Longitudinal (RURAL) Cohort Study has examined approximately 4,600 residents across 10 rural counties in Alabama, Kentucky, Louisiana, and Mississippi to understand why some individuals in these regions live shorter, less healthy lives. Using a high-tech mobile examination unit that travels directly to RURAL participants, the study combines clinical research assessments, evaluations of the rural environmental and social context, and long-term follow-up to identify the root causes of rural health challenges. Findings will be shared with participants and their communities to guide future interventions and improve rural health outcomes. The research is led by a collaborative team from 16 U.S. institutions and funded by the National Heart, Lung, and Blood Institute (NHLBI).