The impact of urban-rural environments on mental health

Background: The present total population study aimed to investigate whether there is an association between type of living environment (urban versus rural) and anxiety, depression and psychosis in the Scottish population. Methods: Data were obtained from the Scottish Neighbourhood Statistics database on Scottish Index of Multiple Deprivation and Urban-Rural Classifications for 6505 data zones across Scotland. Multiple regression was used to test the association between prescriptions for psychotropic medication for anxiety, depression and psychosis, and type of living environment according to urban-rural classification, controlling for a range of socioeconomic factors. Results: Urban-rural classification significantly predicted poorer mental health both before (β=-.29) and after (β=-.20) controlling for a large number of socio-economic variables, with more urban areas having higher rates of prescription for psychotropic medication for anxiety, depression and psychosis. Limitations: The current study focussed on macro-level variables and did not include individual level data. As such, the study did not include data on individual diagnoses, but instead used drug prescriptions for anxiety, depression and psychosis as a proxy for level of affective disorders within data zones. Conclusion: More urban living environments in Scotland are associated with higher rates of prescription for psychotropic medication for anxiety, depression and psychosis.