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Rural/non-rural differences in rates of common mental disorders in Britain: Prospective multilevel cohort study

  • Scott Weich (a1), Liz Twigg (a2) and Glyn Lewis (a3)
Abstract
Background

Some UK studies have reported an urban excess in the prevalence of the most common mental disorders of anxiety and depression.

Aims

To investigate rural/non-rural differences in the onset and maintenance of episodes of common mental disorders, after adjusting for the characteristics of respondents and their households.

Method

A 12-month cohort study of 7659 adults aged 16–74 years living in 4338 private households, nested within 626 electoral wards in England, Wales and Scotland. Common mental disorders were assessed using the General Health Questionnaire (GHQ). Electoral wards were characterised by Office for National Statistics classification and by population density. Data were analysed using multilevel statistical modelling.

Results

Rural residents had slightly better mental health than non-rural counterparts. The effects of geographical location on the mental health of participants were neither significantly confounded nor modified by socioeconomic status, employment status or household income.

Conclusions

There are small but statistically significant differences in rates of common mental disorders between urban and rural residents. Quantifying between-place differences using population density alone risks missing important contextual effects on mental health.

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Copyright
Corresponding author
Dr Scott Weich, Division of Health in the Community, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK. E-mail: s.weich@warwick.ac.uk
Footnotes
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Declaration of interest

None.

Footnotes
References
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Amato, P. R. & Zuo, J. (1992) Rural poverty, urban poverty, and psychological well-being. Sociological Quarterly, 33, 229240.
Bailey, S., Charlton, J., Dollamore, G., et al (1999) The ONS Classification of Local and Health Authorities. London: Office for National Statistics.
Blazer, D., George, L. K., Landerman, R., et al (1985) Psychiatric disorders: a rural/urban comparison. Archives of General Psychiatry, 42, 651656.
Burrows, R. & Bradshaw, J. (2001) Evidence-based policies and practice. Environment and Planning A, 33, 13451348.
Costello, E. J., Keeler, G. P. & Angold, A. (2001) Poverty, race/ethnicity, and psychiatric disorder: a study of rural children. American Journal of Public Health, 91, 14941498.
Dorling, D. (2001) Anecdote is the singular of data. Environment and Planning A, 33, 13351340.
Goldberg, D. P. & Williams, P. (1988) The User's Guide to the General Health Questionnaire (1st edn). Windsor: NFFR-Nelson.
Goldstein, H. (1995) Multilevel Statistical Models. London: Edward Arnold.
Halpern, D. (1995) Mental Health and the Built Environment. London: Taylor & Francis.
Haynes, R. & Gale, S. (2000) Deprivation and poor health in rural areas: inequalities hidden by averages. Health and Place, 6, 275285.
Jarvis, S. & Jenkins, S. P. (1995) Do The Poor Stay Poor? New Evidence about Income Dynamics from the British Household Panel Survey (Occasional paper 95-2). Colchester: University of Essex.
Kendell, R. & Jablensky, A. (2003) Distinguishing between the validity and utility of psychiatric diagnoses. American Journal of Psychiatry, 160, 412.
Krueger, R. F. (1999) The structure of the common mental disorders. Archives of General Psychiatry, 56, 921926.
Lehtinen, V., Michalak, E., Wilkinson, C., et al (2003) Urban-rural differences in the occurrence of female depressive disorder in Europe. Social Psychiatry and Psychiatric Epidemiology, 38, 283289.
Lorant, V., Deliege, D., Eaton, W., et al (2003) Socioeconomic inequalities in depression: a meta-analysis. American Journal of Epidemiology, 157, 98112.
Macintyre, S., Ellaway, A. & Cummins, S. (2002) Place effects on health: how can we conceptualise, operationalise and measure them? Social Science and Medicine, 55, 125139.
McCulloch, A. (2001) Ward-level deprivation and individual social and economic outcomes in the British Household Panel Study. Environment and Planning, 33, 667684.
Meltzer, H., Gill, B. & Petticrew, M. (1995) The Prevalence of Psychiatric Morbidity among Adults Aged 16–64 Living in Private Households in Great Britain. London: Stationery Office.
Middleton, N., Gunnell, D., Frankel, S., et al (2003) Urban-rural differences in suicide trends in young adults: England and Wales, 1981–1998. Social Science and Medicine, 57, 11831194.
O'Campo, P. (2003) Advancing theory and methods for multilevel models of residential neighborhoods and health. American Journal of Epidemiology, 157, 913.
Paykel, E. S., Abbott, R., Jenkins, R., et al (2000) Urban-rural mental health differences in Great Britain: findings from the National Morbidity Survey. Psychological Medicine, 30, 269280.
Pevalin, D. (2000) Multiple applications of the GHQ-12 in a general population sample: an investigation of long-term retest effects. Social Psychiatry and Psychiatric Epidemiology, 35, 508512.
Romans-Clarkson, S. E., Walton, V. A., Herbison, G. P., et al (1990) Psychiatric morbidity among women in urban and rural New Zealand: psycho-social correlates. British Journal of Psychiatry, 156, 8491.
Rose, G. (1992) The Strategy of Preventive Medicine. Oxford: Oxford University Press.
Saunderson, T., Haynes, R. & Langford, I. H. (1998) Urban-rural variations in suicides and undetermined deaths in England and Wales. Journal of Public Health Medicine, 20, 261267.
Simpson, S. & Dorling, D. (1994) Those missing millions: implications for social statistics of non-response to the 1991 Census. Journal of Social Policy, 23, 543567.
Snijders, T. A. B. & Bosker, R. J. (1999) Multilevel Analysis: An Introduction to Basic and Advanced Multilevel Modeling. London: Sage.
Stansfeld, S. A., North, F. M., White, I., et al (1995) Work characteristics and psychiatric disorder in civil servants in London. Journal of Epidemiology and Community Health, 49, 4853.
Sundquist, K., Frank, G. & Sundquist, J. (2004) Urbanisation and incidence of psychosis and depression. Follow-up study of 4.4 million women and men in Sweden. British Journal of Psychiatry, 184, 293298.
Taylor, M. F., Brice, J., Buck, N., et al (1999) British Household Panel Survey User Manual Volume A: Introduction, Technical Report and Appendices. Colchester: University of Essex.
van Os, J. (2004) Does the urban environment cause psychosis? British Journal of Psychiatry, 184, 287288.
Vollebergh, W. A. M., Iedema, J., Bijl, R. V., et al (2001) The structure and stability of common mental disorders. Archives of General Psychiatry, 58, 597603.
Wainwright, N. W. J. & Surtees, P. G. (2003) Places, people, and their physical and mental functional health. Journal of Epidemiology and Community Health, 58, 333339.
Wainwright, N. W. J. & Surtees, P. G. (2004) Area and individual circumstances and mood disorder prevalence. British Journal of Psychiatry, 185, 227232.
Wallace, M. & Denham, C. (1996) ONS Classification of London and Health Authorities of Great Britain. London: Stationery Office.
Wandersman, A. & Nation, M. (1998) Urban neighborhoods and mental health. American Psychologist, 53, 647656.
Wang, J. L. (2004) Rural-urban differences in the prevalence of depression and associated impairment. Social Psychiatry and Psychiatric Epidemiology, 39, 1925.
Weich, S. & Lewis, G. (1998) Poverty, unemployment and common mental disorders: population-based cohort study. BMJ, 317, 115119.
Weich, S., Lewis, G. & Jenkins, S. P. (2001) Income inequality and the prevalence of common mental disorders in Britain. British Journal of Psychiatry, 178, 222227.
Weich, S., Blanchard, M., Prince, M., et al (2002) Mental health and the built environment: a cross-sectional survey of individual and contextual risk factors for depression. British Journal of Psychiatry, 180, 428433.
Weich, S., Holt, G., Twigg, L., et al (2003a) Geographical variance in the prevalence of common mental disorders in Britain: a multilevel investigation. American Journal of Epidemiology, 157, 730737.
Weich, S., Twigg, L., Holt, G., et al (2003b) Contextual risk factors for the common mental disorders in Britain: a multilevel investigation of the effects of place. Journal of Epidemiology and Community Health, 57, 616621.
Weich, S., Twigg, L., Lewis, G., et al (2005) Geographical variation in rates of common mental disorders in Britain: prospective cohort study. British Journal of Psychiatry, 187, 2934.
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Rural/non-rural differences in rates of common mental disorders in Britain: Prospective multilevel cohort study

  • Scott Weich (a1), Liz Twigg (a2) and Glyn Lewis (a3)
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