Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study

Abstract

Background: International data suggest that living in a rural area is associated with an increased risk of perinatal mental illness. This study tested the association between rurality and risk for two mental illnesses prevalent in perinatal women-depression and anxiety. Methods: Using a cross-sectional design, antenatal and postnatal women were approached by healthcare professionals and through other networks in a county in Northern England (UK). After providing informed consent, women completed a questionnaire where they indicated their postcode (used to determine rural-urban status) and completed three outcome measures: the Edinburgh Postnatal Depression Scale (EPDS), the Whooley questions (depression measure), and the Generalised Anxiety Disorder 2-item (GAD-2). Logistic regression models were developed, both unadjusted and adjusted for potential confounders, including socioeconomic status, social support and perinatal stage. Results: Two hundred ninety-five participants provided valid data. Women in rural areas (n = 130) were mostly comparable to their urban counterparts (n = 165). Risk for depression and/or anxiety was found to be higher in the rural group across all models: unadjusted OR 1.67 (0.42) 95% CI 1.03 to 2.72, p = .038. This difference though indicative did not reach statistical significance after adjusting for socioeconomic status and perinatal stage (OR 1.57 (0.40), 95% CI 0.95 to 2.58, p = .078), and for social support (OR 1.65 (0.46), 95% CI 0.96 to 2.84, p = .070). Conclusions: Data suggested that women in rural areas were at higher risk of depression and anxiety than their urban counterparts. Further work should be undertaken to corroborate these findings and investigate the underlying factors. This will help inform future interventions and the allocation of perinatal services to where they are most needed.

Perinatal Women’s Views of Pharmacist-Delivered Perinatal Depression Screening: A Qualitative Study

“…Specifically, pharmacists can support existing perinatal mental health providers in effectively identifying, caring and referring at-risk women. Although some evidence suggests that there is a higher prevalence of antenatal depression in urban populations with no significant difference in postnatal depression prevalence between urban and rural populations in Australia [ 60 ], evidence from the United States and United Kingdom has demonstrated an increased risk of developing PND in rural populations [ 61 , 62 ]. With 1 in 5 women still not screened for PND [ 7 ], this study affirms that women see the value of pharmacists screening, especially when 20% of women do not receive help for PND [ 6 ].…”

Impact of perinatal maternal depression on child development

“…[ 31 ] It may be noted that living in rural areas has been associated with an increased risk of perinatal mental illness. [ 32 ] The prevalence rate was low in Indian studies that used the Beck Depression Inventory Scale (BDI) to assess AD. [ 33 34 ] The prevalence rate found in our study (28.7%) is close to the one reported for Southeast Asian women (22.6%) in a recent meta-analysis study that used pooled samples, but it is higher than the country average (17.74%) reported in the same study.…”

Risk Preference, Health Risk Perception, and Environmental Exposure Nexus: Evidence from Rural Women as Pig Breeders, China

“…Additionally, women in China residing in deprived rural areas have low health risk perceptions, putting their health conditions incredibly at worst for a long time ( Li et al, 2020). Although some scholars have discussed rural women's cognitive health (Ginja et al, 2020), nutritional status (Perkins et al, 2019), pregnant women's health rights (Bussink-Voorend et al, 2020), and food insecurity issues (Sinclair et al, 2019), as well as cooking fuels impacting women's health (Imran & Ozcatalbas, 2020) in the existing studies. But as far as rural women breeders' environmental exposure is concerned, to our knowledge, no research is conducted before, which must be addressed on a prior basis.…”