Rural-urban variations in psychological distress: findings from the Behavioral Risk Factor Surveillance System, 2007

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Abstract.

Objectives:

To describe rural and urban differences in the prevalence and correlates of psychological distress in the United States.

Methods:

We analyzed 2007 Behavioral Risk Factor Surveillance System (BRFSS) data from 62,913 respondents residing in 94 counties in 24 states, and District of Columbia that administered the Kessler-6 (K6) psychological distress questionnaire and met the BRFSS weighting criterion. Using the Rural Urban Classification Codes (RUCC), 94 counties fell into four groups (two metropolitan and two non-metropolitan) out of the nine-part RUCC scheme; these levels were collapsed into two distinct categories of urban and rural.

Results:

Unadjusted estimates indicate that urban county residents have a 22 % higher likelihood of having either MPD or SPD than rural residence (odds ratio [OR]: 1.22, 95 % confidence interval [CI]: 1.09–1.36). This association was slightly attenuated after adjusting for sociodemographic characteristics 17 % higher (OR: 1.17, 95 % CI: 1.04–1.31).

Conclusion:

This is the first study to our knowledge reporting rural and urban prevalence of psychological distress derived from population-based, county-level data for 94 counties in the United States.

Submitted: 19 September 2008; revised: 21 January 2009; accepted: 22 January 2009