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Residence type influences risk for depression, mood disorder

Analysis of U.S. National Survey data indicated that residence location — rural vs. urban — affects the prevalence of major depressive disorder and mood disorders among black and non-Hispanic white women.

“Although major depressive disorder is one of the most common mental illnesses in the United States, depression prevalence among both African Americans and rural residents is understudied,” study researcher Addie Weaver, PhD, of the University of Michigan, and colleagues wrote. “The mental health of African Americans living in rural communities has largely been ignored, which is of concern because African Americans and rural residents are more likely than their non-Hispanic white and urban counterparts to experience circumstances and conditions that may increase risk for depression.”

Addie Weaver

To identify associations between urbanicity, race/ethnicity and lifetime and 12-month diagnoses of major depressive disorder (MDD) or mood disorders among women, researchers assessed data from the U.S. National Survey of American Life for 1,462 black women and 341 non-Hispanic white women. Survey data was collected between February 2001 and June 2003.

Non-Hispanic white women had a significantly higher lifetime prevalence of MDD (21.3% vs. 10.1%; P < .001) and mood disorder (21.8% vs. 13.6%; P = .004) vs. black women.

White women also had a significantly higher 12-month (8.8% vs. 5.5%; P = .05) prevalence of MDD vs. black women.

Among black women, those who lived in rural areas had lower rates of lifetime MDD (4.2%) vs. those who lived in urban areas (10.9%) or suburban areas (13.6%) and non-Hispanic white women across urbanicity levels (P < .001). Researchers found similar associations for 12-month MDD (P < .001) and for lifetime (P = .01) and 12-month (P = .003) mood disorder.

Among non-Hispanic white women, those who lived in rural areas had higher rates of 12-month MDD (12.3% vs. 6%) and mood disorder (12.3% vs. 6.3%) vs. those who lived in urban areas.

Overall, black women living in rural areas had significantly lower odds for lifetime (OR = 0.39; 95% CI, 0.23-0.65) and 12-month (OR = 0.29; 95% CI, 0.18-0.46) MDD compared with black women living in urban areas.

However, the relationship between urbanicity and race/ethnicity showed that non-Hispanic white women living in rural areas had significantly higher odds for lifetime (OR = 2.76; 95% CI, 1.22-6.24) and 12-month (OR = 9.48; 95% CI, 4.65-19.34) MDD vs. black women living in rural areas.

“Our findings indicate important urbanicity and race/ethnicity differences in MDD and mood disorder among women in this sample,” Weaver and colleagues wrote. “Our results suggest that while rural residence is associated with lower prevalence of MDD and mood disorder among African American women, it is a risk factor for non-Hispanic white women.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.