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Family and Consumer Science

Rural Areas and Depression

Depression is a major epidemic in the United States today, especially in rural areas.  Perhaps individuals in rural areas feel isolated and lonely, face poverty, or maintain mottos of self-reliance.  Whatever the cause, people in rural area suffer major depression, and more alarmingly lack the necessary resources to cope with their disorder.

One article, entitled Rates of depression and anxiety in urban and rural Canada explains the epidemic and prevalence of depression among individuals living in rural regions.  The article compares geographic variability of rates of depression and three anxiety disorders among Canadian communities.

Data from the 2002 Canadian Community Health Survey 1.2 was analyzed.  Significant bivariate urban to rural dissimilarities were discovered for “age, marital status, country of birth, ethnicity, education, household income, income adequacy, employment, home ownership, physical activity, perceived stress, and physical health” (Romans, Cohen, & Forte, 2011, p. 567).

Furthermore, individuals in urban areas described a weaker feeling of belonging to their community and described inferior social support.  The article also explains excess cases of depression within the past 12 months but no changes in the rates of agoraphobia, panic disorder or social phobia spanning the geographical regions.  The study ultimately revealed a lesser prevalence of depression for individuals residing in the most rural environments.

Although depression may not be more numerous in rural areas than urban areas, does not necessarily mean that depression is not an issue in rural regions.  The article entitled Relationships Between Depressive Symptoms and Perceived Social Support, Self-Esteem, & Optimism in a Sample of Rural Adolescents describes the symptoms and feelings of depressed youth living in rural areas.  The article explains, ““Ruralness” has important psychosocial implications, including fewer job opportunities, fewer resources in school, and lower levels of available services such as health care. Rural areas’ lower population densities, in turn, reduce access to specialized health services including mental health care. Poverty is an emerging issue in rural areas, with economic stress, unemployment, and other negative life events that may affect youth self-esteem” (Weber, Puskar, & Ren, 2010, p. 584).

The study used a cross-sectional survey design to evaluate designated socio-demographic variables in teens in three high schools.  In this study the average score was for depression among the teens was 57 on the scale utilized.  Additionally, “levels of perceived support from families were almost identical for boys and girls.  Our results also indicated that girls indicated that they felt they had higher levels of perceived social support from friends than did boys in our sample.  Despite these findings, boys in our sample showed significantly higher levels of self-esteem and optimism than did girls” (Weber, Puskar, & Ren, 2010, p. 586).

Another article, Contributors to suicidality in rural communities: beyond the effects of depression, evaluates issues much deeper than depression alone in rural areas.  This particular article studies contributing factors to suicidal ideation and suicide.  According to the article, “Rural populations experience a higher suicide rate than urban areas despite their comparable prevalence of depression” (Handley, et al., 2012, p. 1).

The study in the article, examined 618 participants in the Australian Rural Mental Health Study.  Participants finished the Composite International Diagnostic Interview, supplying information regarding lifetime suicidal ideation and attempted suicides, affective disorders, anxiety disorders and substance abuse disorders.  Furthermore, “Logistic regression analyses explored the independent contribution of depression and additional diagnoses to suicidality” (Handley, et al., 2012, p. 1).

The results of this study indicated that the criteria for lifetime depressive disorder as met by 28% of the participants; 25% of participants had a history of suicidal ideation.  All in all, 41% of individuals had experienced lifetime suicidal ideation and 34% of individuals with a lifetime attempt of suicide displayed no history of depression.  Suicidal ideas were “predicted by younger age, being currently unmarried, and lifetime anxiety or post-traumatic stress disorder” (Handley, et al., 2012, p. 1).  Additionally, suicide attempts were “predicted by lifetime anxiety and drug use disorders, as well as younger age; being currently married and employed” (Handley, et al., 2012, p. 1).

These three articles discuss depression in rural communities; however, the context of every article is very different.  The first article discusses depression rates in rural areas as compared to depression rates in urban areas, the second article discusses depression symptoms and attitudes in adolescents of rural communities, and the third article discusses suicide and depression in rural areas.

Another difference among the articles is that the first study was conducted in Canada; the second article experiment was conducted in the United States, specifically Pennsylvania; and the last article study was done in New South Wales.  The first and the last articles examined a variety of age groups with depression, whereas the second article merely examined teenagers with depression.

Additional differences exist in the methods by which the experiments were conducted.  The first study was a data comparison study.  The data was collected through Canadian Community Health Surveys.  The second article contained a cross-sectional survey descriptive design.  In this article the experimenters interviewed teenagers in participating and volunteering high schools.  The last study evaluated data from surveys.  The last experiment included “data…obtained from the baseline phase of the Australian Rural Mental Health Study (ARMHS), a longitudinal population-based study exploring determinants of mental health in rural and remote communities, with a focus on the influence of social factors” (Handley, et al., 2012, p. 1).

I think the articles were very informative and interesting.  They evaluate a topic that is lacking relevant information and data.  I was very surprised to see the difference in urban depression and rural depression.  I thought that rural depression would have been much higher than urban depression, seeing as how rural areas are so much more isolated.  However, I’m guessing that the statistics are not completely accurate.  I am from a rural area myself, and I think that many rural individuals hold a “tough” mentality believing that they can work through their own problems and issues, and perhaps failing to  recognize their problems and issues altogether.  Additionally, the lack of treatment available in rural areas may have contributed to the decreased number of depressed individuals.  Perhaps individuals in rural areas are not as well educated about the signs and symptoms of depression, so they would not be able to recognize depression in their own lives.  I believe this is a topic that needs further study.  Perhaps more interviews instead of studies based from reported survey material would be helpful and more accurate.

References

Handley, T. E., Inder, K. J., Kay-Lambkin, F. J., Stain, H. J., Fitzgerald, M., Lewin, T. J., . . . Kelly, B. J. (2012). Contributors to suicidality in rural communities: beyond the effects of depression. BMC Psychiatry, 105-114.

Romans, S., Cohen, M., & Forte, T. (2011). Rates of depression and anxiety in urban and rural Canada. Social Psychiatry & Psychiatric Epidemiology, 567-575.

Weber, S., Puskar, K. R., & Ren, D. (2010). Relationships Between Depressive Symptoms and Perceived Social Support, Self-Esteem, & Optimism in a Sample of Rural Adolescents. Issues in Mental Health Nursing, 584-588.