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Collective resources or local social inequalities? Examining the social determinants of mental health in rural areas

Riva, M.; Bambra, C.; Curtis, S.E.; Gauvin, L.

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Authors

M. Riva

C. Bambra

L. Gauvin



Abstract

Background: In England, although some studies report better health among rural populations, few have examined social inequalities in health within rural areas and how they compare to inequalities observed in urban settings. The objectives of this study are to examine (i) whether living in rural, in more affluent and in more socially cohesive areas is associated with better mental health; and (ii) whether being in employment is more protective for mental health in rural than in urban areas. Methods: Data on common mental disorders (CMD) and socio-demographic characteristics of 12 962 adults are from the Health Survey for England. Individuals resided in 892 areas categorized as urban or rural. Area deprivation is measured using the employment deprivation domain from the 2004 Index of Multiple Deprivation. Area social cohesion is derived from individuals’ perceptions using ecometric procedures. Data are analysed using multilevel logistic models. Results: Living in rural areas is significantly associated with lower risk of reporting CMD [odds ratio (OR): 0.81; 95% confidence interval (CI): 0.71–0.92], independently of individuals’ characteristics, and of area deprivation and social cohesion. The mental health advantage of being in employment is more important in rural areas (OR: 0.74; 95% CI: 0.58–0.95) than in urban settings. Conclusion: Living in rural areas is associated with better overall mental health. Yet inequalities in mental health between people in the workforce and those who are not are more important in rural settings. More studies are needed to understand the patterning of social inequalities in health in rural communities.

Journal Article Type Article
Publication Date Apr 1, 2011
Deposit Date May 2, 2010
Publicly Available Date Jul 8, 2011
Journal European Journal of Public Health
Print ISSN 1101-1262
Electronic ISSN 1464-360X
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 21
Issue 2
Pages 197-203
DOI https://doi.org/10.1093/eurpub/ckq064
Keywords Employment, Mental health, Rural health, Small-area analysis.
Public URL https://durham-repository.worktribe.com/output/1520906

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Copyright Statement
This is a pre-copy-editing author-produced PDF of an article accepted for publication in European journal of public health following peer review. The definitive publisher-authenticated version Riva, M. and Bambra, C. and Curtis, S.E. and Gauvin, L. (2011) 'Collective resources or local social inequalities ? examining the social determinants of mental health in rural areas.', European journal of public health., 21 (2). pp. 197-203 is available online at: http://eurpub.oxfordjournals.org/content/21/2/197






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