Differences found in rates of mental illnesses between rural and urban areas

There are small but statistically significant differences in rates of common mental disorders between people living in urban and rural areas, according to a new study published in the January 2006 issue of the British Journal of Psychiatry.

People living in the country had slightly better mental health than their town-dwelling counterparts.

Some UK studies have reported higher rates in urban than in rural areas of the most common mental disorders of anxiety and depression. Suicide rates are also higher in urban areas in England and Wales.

This study used information from the British Household Panel Survey, which began in 1991 and is an annual survey of people aged 16 and over in a representative sample of private households in England, Wales and Scotland.

7659 adults aged 16-74 living in 4338 households in 626 electoral wards were studied. Common mental disorders were assessed using the General Health Questionnaire.

Age, gender, marital status, ethnicity, education, employment status, financial strain and the number of current physical health problems were all included in the analysis as possible individual-level influences on the results.

It was found that people living in rural areas experienced slightly, but significantly, better mental health than their non-rural counterparts.

Population density was significantly associated with the maintenance of episodes of mental disorder, but not with their onset. Rates of both episode onset and maintenance were lower in rural than in non-rural wards.

There was also a high rate of episode remission among people with common mental disorders at the beginning of the study who lived in the least densely populated areas.

Employment status, socio-economic status and household income were not associated with the effects of geographical location on the mental health of participants in the study.

The researchers comment that although they took into account household composition (and therefore living alone), they were not able to control for other factors that might have influenced mental health in rural and urban areas, such as social support and networks, access to transport and healthcare, and stigma associated with mental health problems.

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Revision date: July 7, 2011
Last revised: by Sebastian Scheller, MD, ScD