County-Level Determinants of Mental Health, 2002–2008


Poor mental health is a concern in the US and world-wide. In this study we examine the effects of socioeconomic and environmental variables on the number of days of poor mental health reported across US counties. The results suggest that educational attainment, employment opportunities including self-employment, and social capital have important benefits in terms of community mental health. Other socio-demographic variables also tend to have predicted effects, as does the amount of sunshine in January, which is our control for Seasonal Affective Disorder. The general conclusion of the study is that living in a non-metro county and adjacent to a metro core, is associated with greater happiness. Mental health days also increase considerably due to natural disasters and they are affected by regional climate variability. For policymakers concerned about reducing the average number of poor mental health days across the nation, our results suggest that reducing poverty is a more powerful strategy than reducing income inequality.

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Fig. 1


  1. 1.

    One empirical difference is that happiness measures range from high to low subjective well-being, whereas poor mental health is truncated in that it ignores extremes at the other end of the scale (i.e., happiness or bliss).

  2. 2.

    Whether this effect is positive or negative is an empirical question. For some commuters this time is spent transitioning between work and home life, and vice versa, and therefore not necessarily stressful.

  3. 3.

    In supplemental specification tests not reported here, we also used an ethnic fractionalization measure (Alesina et al. 1999; Montalvo and Reynal-Querol 2005), which was not statistically significant.

  4. 4.

    The peak age for poor mental health days calculated from the OLS coefficients is 32 years, which is lower than the peak year reported in most studies (i.e., a common value is 44 years). The coefficients on age (linear, quadratic) were jointly insignificant, however.


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This study was supported in part by U.S. Department of Agriculture, National Institute of Food and Agriculture Grant No. 2012-70002-19385. The usual disclaimer applies. The authors thank Scott Loveridge, Rob Lyerla and Dee Owens for stimulating discussion, but are solely responsible for the content and any opinions expressed.

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Correspondence to Stephan J. Goetz.



See Tables 3, 4, 5 and 6.

Table 4 Description of 2003 rural–urban continuum codes, including number of counties and average population
Table 5 The NOAA Climate regions
Table 6 Data source for each variable

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Goetz, S.J., Davlasheridze, M. & Han, Y. County-Level Determinants of Mental Health, 2002–2008. Soc Indic Res 124, 657–670 (2015) doi:10.1007/s11205-014-0792-6

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  • Mental health
  • Social capital
  • Inequality
  • Disasters