Does Cardiovascular Health Influence the Well-Being of People Living in Rural Areas: Findings From a 20-Year Study in US Adults.

Background: Cardiovascular health is associated with various trajectories of holistic well-being. However, how various psychosocial factors may impact the associations between cardiovascular health and well-being across adulthood is still underexplored. Methods: We examined participants enrolled in waves 1-3 (1995-2015) of the Midlife in the United States (MIDUS) study (N = 2,536). We measured holistic well-being by a composite flourishing score that included emotional, psychological, and social well-being, and categorized cardiovascular health status based on the parameters of Life's Essential-8 defined by the American Heart Association. We used a multiple linear regression model to examine whether ideal cardiovascular health is associated with better flourishing over 10 years and further examined whether long-term rural living or intermittent rural living moderates the cardiovascular health-flourishing association, compared to no rural living, while controlling baseline flourishing score and socio-demographic and health status. Results: Findings suggested that only 12.5% of participants had high cardiovascular health status. Ideal cardiovascular health at wave 2 was positively associated with flourishing at wave 3 (b = 0.332; SE = 0.150; p < .05). However, rural/urban living contexts do not moderate the above relationship. Conclusions: Future research should explore whether these associations vary in more vulnerable populations, such as long-term care residents, warranting new policy and practice recommendations.