Depressive symptoms in adults in rural and urban regions of Canada: a cross-sectional analysis of the Canadian Longitudinal Study on Aging.
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ABSTRACT: Objectives
Previous studies on depression in rural areas have yielded conflicting results. Features of rural areas may be conducive or detrimental to mental health. Our objective for this study was to determine if there are rural-urban disparities in depressive symptoms between those living in rural and urban areas of Canada.Design
We conducted a cross-sectional analysis of a prospective cohort study, which is as representative as possible of the Canadian population-the Tracking Cohort of the Canadian Longitudinal Study on Aging. For this cohort, data were collected from 2010 to 2014. Data were analysed and results were obtained in 2020.Participants
21 241 adults aged 45-85.Measures
Rurality was grouped as urban (n=11 772); peri-urban (n=2637); mixed (n=2125; postal codes with both rural and urban areas); and rural (n=4707). Depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression. We considered age, sex, education, marital status and disease states as potential confounding factors.Results
The adjusted beta coefficient was -0.24 (95% CI -0.42 to -0.07; p=0.01) for rural participants, -0.17 (95% CI -0.40 to 0.05; p=0.14) for peri-urban participants and -0.30 (95% CI -0.54 to -0.05; p=0.02) for participants in mixed regions, relative to urban regions. Risk factors associated with depressive symptoms were similar in rural and urban regions.Conclusions
The small differences in depressive symptoms among those living in rural and urban regions are unlikely to be relevant at a clinical or population level. The findings do suggest some possible approaches to reducing depressive symptoms in both rural and urban populations. Future research is needed in other settings and on change in depressive symptoms over time.
SUBMITTER: St John PD
PROVIDER: S-EPMC8647394 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe relationship between social support and hypertension is poorly understood in women and men. We investigated whether multiple measures of social support are linked to blood pressure levels differentially by gender.MethodsCross-sectional study of 28,779 middle-age and older-age adults (45-85 years) in the baseline Canadian Longitudinal Study on Aging comprehensive cohort. Stratified multivariable regression models estimated the role and relative contribution of 4 types of support to blood pressure in women and men.ResultsThe highest levels of perceived availability of informational, tangible, emotional, and belonging support were significantly associated with the lowest mean level of systolic blood pressure (SBP) but not diastolic blood pressure, independent of known confounders and other support types. However, associations were small, and their directions were more consistent in women. The lowest levels of informational support, relative to the highest, were associated with higher odds of hypertension in women (odds ratio [OR] = 1.20 [95% confidence interval {CI}: 1.06, 1.36]), more so than in men (OR = 1.16 [95% CI: 1.03, 1.32]). The lowest levels of emotional support were similarly associated with the odds of hypertension (OR = 1.08 [95% CI: 1.00, 1.17] in women and OR = 1.08 [95% CI: 1.00, 1.15] in men), relative to the highest. Larger differences in mean SBP in women, compared with men, were seen for informational support (2.43 and 1.18 mm Hg, respectively) and emotional support (1.60 and 0.74 mm Hg, respectively). Findings were unaltered by sensitivity analyses.ConclusionsInformational and emotional support were inversely associated with SBP, more so in women than men. Further longitudinal investigation is warranted, as results suggest that specific supports may help prevent hypertension and lower cardiovascular risk, especially in women.
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