ANN ARBOR—”Location, location, location” is key in determining a home’s value, but the phrase is equally important regarding the mental health for women living in rural areas, according to a new University of Michigan study.

Addie Weaver, a researcher at the U-M School of Social Work, and colleagues examined how the interaction of rural and urban residency and race/ethnicity affected lifetime and 12-month major depressive and mood disorders.

They found that non-Hispanic white women who live in rural areas have significantly higher rates of lifetime and 12-month major depressive disorder and mood disorder than African-American women who live in rural areas, and significantly higher rates of 12-month major depressive disorder and mood disorder compared to white women who live in urban areas.

Rural African-American women, however, have lower odds of meeting criteria for both lifetime and 12-month major depressive disorder and mood disorder than urban African-American women.

The researchers used data from the National Survey of American Life, a nationally representative household survey that sampled African-American, Caribbean black and white adults. The Program for Research on Black Americans at the U-M Institute for Social Research conducted the survey. Study participants included about 1,800 African-American and non-Hispanic white women who live in southern states.

Overall, non-Hispanic white women, compared with African-American women, have a significantly higher lifetime prevalence of mood disorder (21.8 percent vs. 13.6 percent, respectively) and lifetime major depressive disorder (21.3 percent vs. 10.1 percent, respectively), regardless of where they live. White women also have higher rates of 12-month major depressive disorder compared with African-American women (8.8 percent vs. 5.5 percent, respectively).

African-American women residing in rural areas have a significantly lower prevalence of lifetime (4.2 percent) and 12-month major depressive disorder (1.5 percent) than urban African-American women (10.4 percent and 5.3 percent, respectively). Conversely, non-Hispanic white women living in rural areas have a significantly higher prevalence of 12-month major depressive disorder (10.3 percent) compared to urban white women (3.7 percent).

The study did not examine which aspects of rural life puts white women at risk for depression. Researchers believe rural women have increasingly more responsibilities for housework, child care and, in some instances, labor force. These can create additional stress.

African-American women, however, may have developed resources and coping strategies to deal with stressful situations, such as social networks and religious participation, Weaver said.

“Many of these coping resources are deeply entrenched within African-American culture in the rural South and may inform why rural residence is associated with lower rates of depression and mood disorders among African-American women,” she said.

The findings may contribute to future research, especially as it relates to mental health among African-Americans.

“Given the substantial barriers to mental health treatment in rural America, these results shed light on important subgroup differences, and may help inform mental health interventions and strategies to increase access to care,” Weaver said.

Her study co-authors included Joseph Himle, Robert Joseph Taylor, Niki Matusko and Jamie Abelson.

The findings appear in the current issue of JAMA Psychiatry.

More information:

• Study: Urban vs Rural Residence and the Prevalence of Depression and Mood Disorder Among African American Women and Non-Hispanic White Women