Urbanicity and depression reconsidered. The evidence regarding depressive symptomatology

Evidence regarding the recent suggestion of greater prevalence of depressive symptoms in urban than in rural communities is evaluated. National data are reviewed which indicate that, whereas depressive symptoms may be less prevalent in rural than in urban communities, mean depression scores of residents of rural farm areas outside of standard metropolitan statistical areas are almost as high as scores of center city residents. Further data are presented from a study of urban and rural Florida residents which indicate a significantly higher mean number of depressive symptoms in urban than rural areas, though this difference was eliminated by controls for income, education, age, and sex. When persistent depressive symptoms were examined, urban-rural differences were not significant. The implications of the present findings for urban-rural differences in depressive disorder are considered and the need to examine the urbanicity hypothesis on a data base allowing appropriate controls for socioeconomic status-related variables and migration is emphasized.