Urban-Rural Differences in the Prevalence of Depressive Symptoms in Korean Adults

Abstract

This study aimed to investigate the prevalence of depression among Koreans living in urban and rural areas, stratified by socioeconomic status. The study included 216,765 participants from the 2017 Korean Community Health Survey. Depressive symptoms were assessed using the PHQ-9, with a score of 10 or higher indicating depressive symptoms. Residences with the words Eup and Myeon in their addresses were categorized as rural areas, and residences with Dong in their addresses as urban areas. Socioeconomic status was evaluated by household income and education level. A Poisson regression analysis with sampling weights was conducted and adjusted for demographic, lifestyle, socioeconomic status, and comorbidity. The adjusted prevalence rate of depressive symptoms was 3.33% (95% CI, 3.21-3.45) in urban areas and 2.59% (95% CI, 2.43-2.74) in rural areas. The prevalence of depressive symptoms in urban areas was 1.29 times (95% CI, 1.20-1.38) higher than in rural areas. The prevalence rate ratio for depressive symptoms in urban areas compared to rural areas sorted by monthly incomes was 1.39 (95% CI, 1.28-1.51) for less than 2 million won, 1.22 (95% CI, 1.06-1.41) for 2 to 3.99 million won, and 1.09 (95% CI, 0.90-1.32) for more than 4 million won, and the urban-rural difference was more evident in lower household income subjects (p for interaction=0.033). However, urban-rural differences did not differ according to sex, age, or education level. In conclusion, we found urban-rural differences in depressive symptoms in a representative sample of Koreans, and revealed that these differences may vary according to income level. These results suggest that mental health policy must consider the health disparities according to residence and income.

The Impact of Physical Activity on Depressive Symptoms among Urban and Rural Older Adults: Empirical Study Based on the 2018 CHARLS Database

“…However, the relationship between residence and depressive symptoms is inconclusive in international epidemiology. For instance, a national study conducted in Korea reported that the prevalence of depressive symptoms was 1.29 times greater in urban settings than in rural ones [30]. Similar findings have been observed in Nordic regions, where among older adults, residing in urban areas is associated with higher odds of suffering from psychological distress [31,32].…”

Regional differences in the effects of healthy aging on depressive symptoms: a Korean longitudinal study of aging (2006–2020)

“…Differences in depressive symptoms among individuals from urban and rural areas have been an interesting research topic. Previous studies investigating the prevalence of depressive symptoms in urban and rural areas have reported inconsistent results ( 15 , 28 , 45 ). China Family Panel Studies examined 8,025, 7,808, and 4,887 older adults aged 60 years and above in 2016,2018, and 2020 and found that rural residents had a higher prevalence of depressive symptoms than urban residents ( 46 ).…”

“…Purtle et al ( 48 ) attributed the regional differences in depressive symptoms to urbanization, wherein urbanization increased the risk of mental health problems. Several studies have reported that urbanization is associated with the prevalence of depressive symptoms ( 45 , 49 ). Urban residents are more likely to have lower social support ( 49 ), and be exposed to stressors related to urban environments, including artificial light at night, neighborhood crime, traffic congestion, and noise ( 48 ).…”

“…Park et al ( 54 ) reported that older adults in urban areas had a mean score of 10.07 for depression, compared to a mean score of 5.82 of their rural peers. Further, in the nationwide Korean Community Health Survey, Jeong et al ( 45 ) reported that the prevalence of depressive symptoms was 3.33% in urban areas and 2.59% in rural areas. Therefore, the findings of this study represent the health disparities between urban and rural areas.…”

“…symptoms in urban and rural areas have reported inconsistent results(15,28,45). China Family Panel Studies examined 8,025, 7,808, and 4,887 older adults aged 60 years and above in 2016,2018,…”