Rural-urban differences in depression prevalence: implications for family medicine.
OBJECTIVE
Rural populations experience more adverse living circumstances than urban populations, but the evidence regarding the prevalence of mental health disorders in rural areas is contradictory. We examined the prevalence of depression in rural versus urban areas.


METHODS
We performed a cross-sectional study using the 1999 National Health Interview Survey (NHIS). In face-to-face interviews, the NHIS administered the Composite International Diagnostic Interview Short Form (CIDI-SF) depression scale to a nationally representative sample of 30,801 adults, ages 18 and over.


RESULTS
An estimated 2.6 million rural adults suffer from depression. The unadjusted prevalence of depression was significantly higher among rural than urban populations (6.1% versus 5.2% ). After adjusting for rural/urban population characteristics, however, the odds of depression did not differ by residence. Depression risk was higher among persons likely to be encountered in a primary care setting: those with fair or poor self-reported health, hypertension, with limitations in daily activities, or whose health status changed during the previous year.


CONCLUSIONS
The prevalence of depression is slightly but significantly higher in residents of rural areas compared to urban areas, possibly due to differing population characteristics.
Probst
Janice C
JC
South Carolina Rural Health Research Center, University of South Carolina, 220 Stoneridge Drive, Columbia, SC 29210, USA. jprobst@gwm.sc.edu
Laditka
Sarah B
SB
Moore
Charity G
CG
Harun
Nusrat
N
Powell
M Paige
MP
Baxley
Elizabeth G
EG
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012423:Rural Health; D014504:Urban Health