UT San Antonio awarded $44 million NIH contract to advance landmark RURAL Cohort Study

Effort focuses on persistent health challenges in the rural South

Contact: Steven Lee, (210) 450-3823, [email protected]
Content provided by Fidel Flores

SAN ANTONIO, April 30, 2026 - The University of Texas at San Antonio (UT San Antonio) has been awarded a five-year, $44 million contract from the National Heart, Lung, and Blood Institute of the National Institutes of Health for a landmark study focused on persistent health challenges in the rural South.

The Risk Underlying Rural Areas Longitudinal (RURAL) Cohort Study uses a custom-built, 50-foot mobile examination unit equipped with advanced clinical and imaging technology - including a CT scanner - that travels to rural areas to bring research directly to the community doorstep, with participants undergoing comprehensive health assessments.

The funding, which began April 22, will complete the first examination phase and launch a second examination of participants in Alabama, Kentucky, Louisiana and Mississippi. The award underscores UT San Antonio's growing national leadership in population health, community-engaged research and large-scale scientific collaboration.

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.

"The RURAL Cohort Study takes the science to the people," Ramachandran said. "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."

A first-of-its-kind rural health study

The 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 examines how rural communities are resilient in the face of health-related challenges.

Participants receive:

• 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; and 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

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 multidisciplinary RURAL Study team includes investigators, staff and collaborators from 16 institutions, working closely with local rural communities in the four states to ensure the research is responsive, locally relevant and impactful.

UT San Antonio has one of the nation's leading academic health centers, UT Health San Antonio, where the RURAL Cohort Study advances efforts to improve the health of rural communities 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 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).

The Kate Marmion School of Public Health at The University of Texas at San Antonio (UT San Antonio) serves South Texas by addressing rural and community health issues, as well as improving access to care. The school provides a unique public health education by integrating advanced health research and offering academic programs that build public health leaders who are dedicated to serving the local and regional community to mitigate our greatest public health challenges. The school began accepting students in its Master's Program in Public Health (MPH) in 2024 and plans to offer a doctoral program in the near future. To learn more, visit https://uthscsa.edu/public-health/. Stay connected with the Kate Marmion School of Public Health on Facebook, X, Instagram, and YouTube.