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Rural and urban variation in psychological distress among adults: results of the 2014–2015 Eastern Townships Population Health Survey (ETPHS)

  • Quantitative Research
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Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Objective

A growing number of people live in urban areas. Urbanization has been associated with an increased prevalence of mental disorders, but which mechanisms cause this increase is unknown. Psychological distress is a good indicator of mental health. This study sought to examine the relationship between urbanization and distress among adults in the Eastern Townships (southern region of Quebec, Canada).

Method

In the 2014–2015 Eastern Townships Population Health Survey (N = 10,687 adults living in one of the 96 Eastern Townships communities), distress was measured with the K6 distress scale (≥ 7). Urbanization was estimated by the residential density of the community treated in quintiles. Logistic regression analyses were carried out with adjustments for individual and environmental characteristics.

Results

Women, young people aged 18–24, single parents, those without diplomas, those without a job, those with < $20,000 in income, adults with two or more chronic physical illnesses, adults with bad perceived health, or those living in disadvantaged neighbourhoods exhibited more distress. The unadjusted estimate between density and distress is only significant for the fifth quintile when compared with the first quintile (OR 1.23; 95% CI: 1.06–1.42). The relationship is practically the same after controlling for individual characteristics but decreases considerably after controlling for environmental characteristics (lack of trees, social deprivation, intersection density, vegetation index, and land use mix).

Conclusion

This study was the first to examine an association between urbanization and distress by considering individual and environmental characteristics. The latter seem to explain the relationship between these concepts.

Résumé

Objectif

Un nombre croissant de personnes vivent en milieu urbain. L’urbanisation a été associée à une prévalence accrue de troubles mentaux, mais on ignore par quels mécanismes. La détresse psychologique est un bon indicateur de la santé mentale. Cette étude cherche à examiner le lien entre l’urbanisation et la détresse des adultes en l’Estrie (région dans le sud du Québec, Canada).

Méthode

Dans l’Enquête de santé populationnelle estrienne 2014-2015 (N = 10 687 adultes, résidant dans l’une des 96 communautés estriennes), la détresse a été mesurée avec le Kessler-6 (score ≥7). L’urbanisation a été estimée par la densité résidentielle de la communauté traitée en quintiles. Des analyses de régression logistique ont été réalisées, avec ajustement pour des caractéristiques individuelles et environnementales.

Résultats

Les femmes, les 18-24 ans, les personnes monoparentales, celles ne possédant pas de diplôme, sans emploi, ayant un revenu < 20 000$, ayant deux maladies chroniques ou plus, ayant une mauvaise perception de leur santé, ou vivant dans les quartiers défavorisés présentent plus de détresse. La relation brute entre la densité et la détresse n’est significative que pour la dernière catégorie avec un RC 1,23; IC95% : 1,06–1,42 (Q5 vs Q1). En contrôlant pour les caractéristiques individuelles, la relation demeure pratiquement inchangée, mais diminue davantage après un contrôle pour les caractéristiques environnementales (manque d’arbres, défavorisation sociale, densité d’intersections, indice de végétation et mixité des sols).

Conclusion

Cette étude est la première à examiner une association entre l’urbanisation et la détresse en considérant les caractéristiques individuelles et environnementales. Ces dernières semblent expliquer la relation entre ces concepts.

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Authors and Affiliations

  1. Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada

    Sadaf Matiullah

  2. Department of Community Health Sciences, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada

    Mélissa Généreux & Geneviève Petit

  3. Eastern Townships Public Health Department, Sherbrooke, QC, Canada

    Mélissa Généreux & Geneviève Petit

Authors
  1. Sadaf Matiullah
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  2. Mélissa Généreux
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  3. Geneviève Petit
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Correspondence to Sadaf Matiullah.

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The authors declare that they have no conflict of interest.

Ethics approval and consent to participate

This was a secondary analysis of 2014–2015 ETPHS data, a cross-sectional study led by the Eastern Townships Public Health Department. This study was approved by the research ethics board of the Centre de santé et de services sociaux—Institut universitaire de gériatrie de Sherbrooke (CSSS-IUGS), now known as the CIUSSS de l’Estrie-CHUS (2014-460).

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Matiullah, S., Généreux, M. & Petit, G. Rural and urban variation in psychological distress among adults: results of the 2014–2015 Eastern Townships Population Health Survey (ETPHS). Can J Public Health 112, 253–261 (2021). https://doi.org/10.17269/s41997-020-00403-5

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  • DOI: https://doi.org/10.17269/s41997-020-00403-5

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