Rurality and mental health: the role of accessibility.
OBJECTIVE
The absence of an agreed definition of "rural" limits the utility of existing research into a possible relationship between rurality of residence and mental health. The present study investigates the bipolar dimension accessibility/remoteness as a possible correlate of mental health.


METHODS
A continuous area of non-metropolitan Australia was selected to provide a range of scores on the Accessibility/Remoteness Index of Australia (ARIA). A questionnaire measuring demographics, the five-factor model of personality and three aspects of mental health (distress, disability and wellbeing) was mailed to 20 000 adults selected randomly from electoral rolls.


RESULTS
Responses were received from 7615 individuals (response rate = 40.5%; 57.1% female). ARIA was not associated with either distress or disability measures, but a small negative association was found between accessibility and two measures of wellbeing. Individuals residing in locales with better access to services and opportunities for interaction reported higher levels of satisfaction with life (SWL) and positive affect (PA). Adjusting statistically for a range of demographic and personality correlates did not alter the effect of ARIA on SWL. The effect on PA remained significant after adjusting for demographics, but not once personality correlates entered the model.


CONCLUSIONS
By sampling across a single proposed parameter of rurality, a novel profile of correlations was identified. In accord with existing data, accessibility was not associated with distress or disability. In contrast, accessibility was positively associated with the wellbeing aspect of mental health. Further attention to the measurement of rural place and the exploration of accessibility as a parameter with mental health relevance, is warranted.
Murray
Greg
G
School of Social and Behavioural Sciences, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia.
Judd
Fiona
F
Jackson
Henry
H
Fraser
Caitlin
C
Komiti
Angela
A
Hodgins
Gene
G
Pattison
Pip
P
Humphreys
John
J
Robins
Garry
G
D001315:Australia / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000600:supply & distribution*; D008875:Middle Aged; D019035:Rural Health Services / Q000600:supply & distribution*; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires