A comparison of cardiovascular disease risk factors in farm and non-farm residents: The Wisconsin Rural Women's Health Study

Objectives: The purpose of this paper is to describe the baseline difference in cardiovascular disease risk factors between farm and non-farm women in the Rural Women's Health Study. Methods: Women aged 25 to 75 years were recruited from the Central Marshfield Epidemiologic Study Area, a geographically defined area surrounding Marshfield, Wis. (population 19,000), where more than 95% of residents seek their health care from the Marshfield Clinic. The baseline examination included measurements of blood pressure, skin folds, height, weight, fasting blood lipids, and blood glucose. Health behavior information collected included smoking, dietary intake, reproductive health, physical activity, medical history, social support, occupational strain and symptoms of anxiety and depression. Results: Between 1995 and 2001, 825 non-farm residents and 675 farm residents were examined (58% of eligible women). The farm residents were similar in age to the non-farm residents (mean 47.6 years and 47.0 years, t-test=-0.91, P value=0.36). The total number of modifiable risk factors for atherosclerosis ranged theoretically from 0 to 6, and actually from 0 to 5, with a small percentage of women having either none or 5 risk factors. The percentage of women with 3 or more modifiable risk factors was 26.1% (95%CL=23.9, 28.4). The median number of total risk factors was 2 and the frequency distribution was not significantly different between farm and nonfarm residents (X² 5 df=4.6, P=0.47). The prevalence of current cigarette smoking was significantly higher in the non-farm residents, while the prevalence of hypertension and obesity was significantly higher in the farm residents. Overall, obesity prevalence is significantly higher in the study cohort than US women in general (35% versus 23%). Only 5 (0.7%) of the farm residents and 10 (1.2%) of the non-farm residents reported a previous myocardial infarction. Conclusions: These data suggest that the prevalence of risk factors for atherosclerosis, and hence future coronary heart disease, is very high in rural women. Obesity prevention through increased physical activity would be appropriate for both farm and non-farm residents, while quit smoking campaigns should be specifically targeted towards non-farm resident women.