While people might associate remote settings with peaceful landscapes and quiet lifestyles, rural residents experience more depression and anxiety than their urban counterparts, a new University of Houston study has found.
The research did not assess why people living in rural areas reported worse psychological well-being and higher levels of neuroticism, but researchers and advocates believe some of the findings align with scarcer mental health resources outside of larger cities — a well-documented national problem that is especially the case in Texas.
“You’re much farther from grocery stores and gyms. You’re much farther from health care services,” said Olivia Atherton, assistant professor of psychology at UH. “You might be getting calm and peace, but you’re also in an environment that’s deprived of other resources that are important for your mental health.”
Atherton, the study’s lead author, said her research team pulled from two major studies that surveyed about 20,000 American adults over the course of 25 years. In Midlife in the United States and the Health and Retirement Study, the respondents answered questions that pointed to the “Big Five” personality traits — extraversion, agreeableness, openness, conscientiousness and neuroticism — as well as their psychological well-being and life satisfaction.
The team found higher reports of depression and anxiety in rural areas, plus a tendency of people there to be less open-minded, less conscientious and more neurotic. But rural Americans had about the same life satisfaction as those in urban settings, researchers wrote in February in the Journal of Psychology.
The study did not find location having any influence on personal changes over time, Atherton said.
“It’s possible that they have lived in these areas for a long time and there’s maybe not any room for these places to affect how their personality changes,” she said. “Or maybe their personalities led them to live in those areas.”
Study author Marquita Wenonah Lewis-Thames said personality differences are under-researched subjects that could have practical affects for health workers who are seeking to solve issues in more far-flung communities.
“You have this idea of coming in and saying, 'Let me help you with your mental health,' and they’re like, 'Who the freak are you? '” said Lewis-Thames, assistant professor at Northwestern University’s Feinberg School of Medicine. ‘That’s supported by lower personality trait levels of openness.’ "
Other health care workers and advocates said the study especially points to issues with mental health access in rural areas.
A 2020 article in the Journal of Clinical and Translational Science detailed how as many as 65 percent of non-metropolitan counties don’t have psychiatrists and more than 60 percent of rural Americans live in areas that have a shortage of mental health providers. And the percentage of rural hospitals that face the threat of closures jumped from 16 percent in 2021 to 26 percent last year, the Chronicle reported.
Greg Hansch, executive director of the National Alliance on Mental Illness Texas, said he has received many calls related to the lack of access to mental health care in rural places. Distance appears to be a large factor, he said.
“There’s more isolation, there’s more loneliness in rural areas,” he said. “There’s less opportunity to build relationships.”
Steve F. Bain, founding director of the Institute for Rural Mental Health Initiatives at Texas A&M Kingsville, said his organization is working to determine how to fund locales with unmet needs. Every community has different demands, but his work has shown that people in rural areas have mental health issues the same as people in urban areas do — they just can’t address them.
“It’s not so much that rural people have more mental health issues,” Bain said. “It’s that they don’t have the accessibility and availability of services.”
samantha.ketterer@houstonchronicle.com
