title: Rural-urban differences in stigma against depression and agreement with health professionals about treatment.
abstract: OBJECTIVE
  To determine if levels of personal stigma towards depression and agreement with health professionals about treatment differ between rural-urban populations.
  
  
  METHODS
  Data from a telephone survey conducted in Alberta (n = 3047, response rate = 75.2%) was analyzed. Participants responded to a case vignette describing a depressed individual and questionnaires assessing attitudes towards treatments, and personal stigma against depression. The relation between rural-urban status and agreement with health professionals about treatment was assessed using logistic regression. Stigma scores in relation to rural-urban status were analyzed using multivariate linear regression.
  
  
  RESULTS
  Urban respondents were more likely than rural participants to agree with health professionals about depression treatments. This was found overall, and in women. After adjustment for income and education, rural-urban status was no longer significant. Urban participants had lower stigma scores in overall analysis. After adjustment for income and education, stigma scores remained higher among rural men. Education was associated with lower stigma scores among both men and women in fully adjusted models. The ability to recognize depression was associated with lower stigma scores.
  
  
  CONCLUSIONS
  Differences exist in rural-urban population about treatments for depression and stigma towards depression. The rural-urban differences in stigma and agreement with health professionals about treatment may be largely explained by educational levels.
authors.affiliation: Mental Health Center for Research and Education, Department of Psychiatry, Faculty of Medicine, University of Calgary, Room 4D69, 4th Floor, TRW Building, 3280 Hospital Drive NW, Calgary Alberta, Canada T2N 4Z6. arjjones@ucalgary.ca
authors.forename: Arden R
authors.initials: AR
authors.lastname: Jones
authors.forename: Trevor M
authors.initials: TM
authors.lastname: Cook
authors.forename: Jianli
authors.initials: J
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000416:Alberta; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003863:Depression / Q000523:psychology / Q000628:therapy; D003866:Depressive Disorder; D004522:Educational Status; D005260:Female; D006282:Health Personnel; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D044382:Population Groups; D011639:Public Opinion; D012424:Rural Population / Q000706:statistics & numerical data; D012931:Social Environment; D057545:Social Stigma; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult