TY - JOUR
T1 - Determinants of mental health and well-being within rural and remote communities
AU - Kelly, Brian J.
AU - Lewin, Terry J.
AU - Stain, Helen J.
AU - Coleman, Clare
AU - Fitzgerald, Michael
AU - Perkins, David
AU - Carr, Vaughan J.
AU - Fragar, Lyn
AU - Fuller, Jeffrey
AU - Lyle, David
AU - Beard, John R.
PY - 2011/12
Y1 - 2011/12
N2 - Background: The individual and contextual factors influencing current mental health and well-being within rural communities are poorly understood. Methods: A stratified random sample of adults was drawn from non-metropolitan regions of NSW, Australia. One-quarter (27.7%) of the 2,639 respondents were from remote/very remote regions. An aggregate measure of current well-being was derived from levels of distress and related impairment (Kessler-10 LM), self-reported overall physical and mental health, functioning, satisfaction with relationships, and satisfaction with life. Multivariate methods investigated the contributions to current well-being of demographic/dispositional factors, recent events and social support, individual exposure to rural adversity, and district/neighbourhood level characteristics. Results: Respondents from very remote regions tended to be younger and have lower education. Univariate associations were detected between well being and exposure to rural adversity (greater drought-related worry, lower perceived service and support availability, greater number of years living in the current district). Multivariate analysis (n = 2,462) accounted for 41% of the variance in well-being scores. The major contributing variables were dispositional factors (trait neuroticism, marital status), recent adverse events and indices of social support. However, no additional effects were detected for district-level variables (drought severity, regional socioeconomic categorisation, population change). Similar associations were detected using the K-10 alone as the outcome measure. Conclusions: The chief determinants of current well being were those reflecting individual level attributes and perceptions, rather than district-level rural characteristics. This has implications for strategies to promote well being within rural communities through enhancing community connectedness and combating social isolation in the face of major adversities such as drought.
AB - Background: The individual and contextual factors influencing current mental health and well-being within rural communities are poorly understood. Methods: A stratified random sample of adults was drawn from non-metropolitan regions of NSW, Australia. One-quarter (27.7%) of the 2,639 respondents were from remote/very remote regions. An aggregate measure of current well-being was derived from levels of distress and related impairment (Kessler-10 LM), self-reported overall physical and mental health, functioning, satisfaction with relationships, and satisfaction with life. Multivariate methods investigated the contributions to current well-being of demographic/dispositional factors, recent events and social support, individual exposure to rural adversity, and district/neighbourhood level characteristics. Results: Respondents from very remote regions tended to be younger and have lower education. Univariate associations were detected between well being and exposure to rural adversity (greater drought-related worry, lower perceived service and support availability, greater number of years living in the current district). Multivariate analysis (n = 2,462) accounted for 41% of the variance in well-being scores. The major contributing variables were dispositional factors (trait neuroticism, marital status), recent adverse events and indices of social support. However, no additional effects were detected for district-level variables (drought severity, regional socioeconomic categorisation, population change). Similar associations were detected using the K-10 alone as the outcome measure. Conclusions: The chief determinants of current well being were those reflecting individual level attributes and perceptions, rather than district-level rural characteristics. This has implications for strategies to promote well being within rural communities through enhancing community connectedness and combating social isolation in the face of major adversities such as drought.
KW - Determinants
KW - Epidemiology
KW - Mental disorders
KW - Rural
KW - Well-being
UR - http://www.scopus.com/inward/record.url?scp=83655203439&partnerID=8YFLogxK
U2 - 10.1007/s00127-010-0305-0
DO - 10.1007/s00127-010-0305-0
M3 - Article
C2 - 21046069
AN - SCOPUS:83655203439
SN - 0933-7954
VL - 46
SP - 1331
EP - 1342
JO - Social Psychiatry and Psychiatric Epidemiology
JF - Social Psychiatry and Psychiatric Epidemiology
IS - 12
ER -