The high prevalence of heart disease in Dallas County bucks the growing trend of health disparities being reported between rural and urban areas.

As recent research published in JAMA Cardiology demonstrated, living in a rural area comes with a 19% higher risk of developing heart failure compared to living in an urban center.

Yet in Dallas County, which is almost entirely urban, heart disease is the leading cause of death, as The Dallas Express reported.

Heart disease often leads to heart failure, which is when the heart cannot pump a sufficient amount of blood to meet the body’s needs, per the NIH.

This can cause fluid to back up into the lungs. It may also build up and cause swelling in the legs, ankles, and feet.

People with heart failure are often fatigued and experience frequent bouts of shortness of breath.

So why are the residents of Dallas County at a higher risk of heart failure than their urban counterparts?

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One answer is the proximity and availability of care, the absence of which puts the county on the same level as rural counties.

According to a report last year from Kaufman Hall, hospitals and health systems in the Lone Star State have been under extreme financial duress.

Over 9% of hospitals in Texas are at risk of closure overall, and the share rises to over a quarter in rural areas, per The Dallas Express.

Yet newer projections by Kaufman Hall suggest that larger hospitals struggle to cope with negative operating margins even more than rural ones, per D Magazine.

For instance, Dallas-based Tenet Healthcare saw a 28% drop in pre-tax operating income between 2021 and 2022.

In Dallas County, stressed hospitals and diminished infrastructure make for a challenge in dealing with a high rate of heart disease, per In Forney.

As The Dallas Express previously reported, the Dallas County Commissioners Court even launched an awareness-building campaign in February to raise the alarm so residents might reduce their risk for heart disease.

Risk factors include smoking and obesity. Dallas County has high rates of both, with 16% of adult residents smoking and 36% considered obese.

What’s more, the ongoing obesity problem in Dallas County is likely putting an extra drain on public health funding: Medical costs are between 30% and 40% higher per obese person compared to one with a healthy weight, per the NIH.

Dallas-Fort Worth has one of the highest rates of obesity of any major metro area in the country, as previously reported by The Dallas Express.

Obesity is prevalent in communities surrounding “food deserts,” or geographic areas devoid of grocery stores offering fresh food options, as previously reported by The Dallas Express. 

Since this qualification applies to several areas of Dallas County, it stands to reason that this is yet another reason why heart disease rates are so high.

The causes behind “food deserts” are complex, but the city’s high crime rate plays an important role. As The Dallas Express recently reported, targeted theft has shuttered multiple Dallas supermarkets.

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