Bigger is usually better, but this isn't always the case when we're talking about businesses that offer above-average dividend yields. High dividend yields in particular are usually a sign that cautious investors are nervous about the strength of a stock's underlying business.

These two high-yield dividend stocks offer juicy dividend yields above 7% at the moment because investors are worried about their futures. A quick look below the surface, though, reveals strong underlying businesses in a position to deliver steady profit growth for the long run.

1. Medical Properties Trust

Medical Properties Trust (MPW 0.96%) is a real estate investment trust (REIT) that mainly owns hospitals in the U.S. and Europe. Shares of Medical Properties Trust offer a high yield of 7.4% at the moment because investors are nervous about the company's ability to fund new acquisitions in a rising interest rate environment.

So far it doesn't look like higher interest rates are slowing down Medical Property Trust's pace of growth. In the second quarter of 2022, the company added seven new properties to its portfolio, bringing the total to 447.  

Shares of Medical Properties Trust have also been under pressure due to concerns regarding its largest tenant, Steward. Investors will be glad to know that Steward's ship is hardly in danger of sinking. In fact, the hospital operator expects a return to sustainably positive cash flows in the fourth quarter of 2022.

It's great to see Steward get back on its feet, but it's important to point out that Medical Properties Trust can make money even if its tenants report losses. The REIT generally employs net leases that shift all the fluctuating costs of building ownership such as taxes and maintenance onto its tenants. With annual rent increases built into its long-term leases, Medical Properties Trust's cash flows remain highly predictable. 

Should Steward have problems again, the impact will be minimal because the company's diversification strategy is unfolding nicely. As of June 30, 2022, net leases to Steward make up less than 20% of this REIT's total portfolio. Instead of relying on a smaller number of big hospital operators, Medical Properties Trust has increased its portfolio to include behavioral health and rehabilitation facilities that are now responsible for about 20% of total revenue.

2. Enterprise Products Partners

Enterprise Products Partners (EPD 0.22%) has long been a popular stock among dividend investors because its pipelines generate reliable cash flows. Carrying oil, gas, chemicals, and refined fuels through pipelines is the most effective way to move energy products from point A to point B, and this isn't going to change anytime soon.

Shares of Enterprise Products Partners offer a very tempting 7.1% yield that is miles above the average dividend-paying stock in the S&P 500 index, which offers just 1.5% at the moment. Enterprise stock offers a relatively high dividend yield right now because investors are nervous about the company's ability to continue growing in the future.

The cancellation of the Keystone XL pipeline by one of Enterprise's peers in 2021 still looms over midstream energy companies like a dark cloud. The important thing to remember here is that Enterprise's well-run operation and fortress balance sheet could allow the company to continue growing through consolidation for a very long time.

Enterprise has been able to raise its dividend payout for 24 consecutive years. This was possible because the well-managed business produced steadily growing cash flows that only dipped slightly during the global financial crisis, the collapse of oil prices that lasted from 2014 through 2017, and the COVID-19 pandemic.

As a proportion of overall energy usage, fossil fuels should take a back seat to renewable sources. Overall demand for energy, though, will likely remain strong enough that the amount of fossil fuel flowing through Enterprise's pipelines, and its dividend payout, can continue rising indefinitely.