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Gan, Zoe Su Wen; Choi, Wansuk; Lin, Feng-Chang; Tippett, Rebecca M.; Joodi, Golsa; Pursell, Irion; & Simpson, Ross Joseph, Jr. (2019). Factors Underlying Increased Incidence of Sudden Unexpected Death in Rural Counties in North Carolina. Journal of General Internal Medicine, 34(6), 815-817. PMCID: PMC6544666


Sudden unexpected death (SUD) is a common syndrome that has not been well-characterized in urban and rural populations. Previous work has found a higher incidence of sudden cardiac death (SCD)1 in rural populations. However, as strict criteria for SCD based on reported cause and timing of death often exclude deaths from non-cardiac causes that have potential epidemiological overlap with SCD, it is important to take an inclusive approach.2 As rural areas are also challenged with shortages of primary care providers, mental health providers, and health insurance,3 we hypothesize that the incidence of SUD is higher in rural counties than in urban counties due to discrepancies in these measures of health care access. In this study, we (1) compare the incidence of SUD between rural and urban counties in North Carolina (NC) and (2) determine if specific measures of health care access are independent predictors of SUD. In these ways, this work is a preliminary step towards risk stratification for the development of targeted, population-level preventive strategies.


Reference Type

Journal Article

Year Published


Journal Title

Journal of General Internal Medicine


Gan, Zoe Su Wen
Choi, Wansuk
Lin, Feng-Chang
Tippett, Rebecca M.
Joodi, Golsa
Pursell, Irion
Simpson, Ross Joseph, Jr.