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

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      https://www.riss.kr/link?id=A108593773

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      다국어 초록 (Multilingual 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.
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      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 w...

      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.

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      참고문헌 (Reference)

      1 박승진 ; 최혜라 ; 최지혜 ; 김건우 ; 홍진표, "한글판 우울증 선별도구(Patient Health Questionnaire-9, PHQ-9)의 신뢰도와 타당도" 대한불안의학회 6 (6): 119-124, 2010

      2 박경순 ; 박영란 ; 손덕순, "사회적 연결감과 우울의 관계: 도시노인과 농촌노인의 비교" 한국콘텐츠학회 20 (20): 667-677, 2020

      3 Sundquist K, "Urbanisation and incidence of psychosis and depression: follow-up study of 4.4 million women and men in Sweden" 184 : 293-298, 2004

      4 Purtle J, "Urban-rural differences in older adult depression : a systematic review and meta-analysis of comparative studies" 56 : 603-613, 2019

      5 Ranzani OT, "Urban-rural differences in hypertension prevalence in low-income and middle-income countries, 1990-2020 : a systematic review and meta-analysis" 19 : e1004079-, 2022

      6 Hegewald J, "Traffic noise and mental health : a systematic review and meta-analysis" 17 : 6175-, 2020

      7 Vallée J, "The role of daily mobility in mental health inequalities : the interactive influence of activity space and neighbourhood of residence on depression" 73 : 1133-1144, 2011

      8 Wiens K, "The prevalence of major depressive episodes is higher in urban regions of Canada" 62 : 57-61, 2017

      9 Hong JW, "The prevalence of and factors associated with depressive symptoms in the Korean adults : the 2014and 2016 Korea National Health and Nutrition Examination Survey" 56 : 659-670, 2021

      10 Peen J, "The current status of urban-rural differences in psychiatric disorders" 121 : 84-93, 2010

      1 박승진 ; 최혜라 ; 최지혜 ; 김건우 ; 홍진표, "한글판 우울증 선별도구(Patient Health Questionnaire-9, PHQ-9)의 신뢰도와 타당도" 대한불안의학회 6 (6): 119-124, 2010

      2 박경순 ; 박영란 ; 손덕순, "사회적 연결감과 우울의 관계: 도시노인과 농촌노인의 비교" 한국콘텐츠학회 20 (20): 667-677, 2020

      3 Sundquist K, "Urbanisation and incidence of psychosis and depression: follow-up study of 4.4 million women and men in Sweden" 184 : 293-298, 2004

      4 Purtle J, "Urban-rural differences in older adult depression : a systematic review and meta-analysis of comparative studies" 56 : 603-613, 2019

      5 Ranzani OT, "Urban-rural differences in hypertension prevalence in low-income and middle-income countries, 1990-2020 : a systematic review and meta-analysis" 19 : e1004079-, 2022

      6 Hegewald J, "Traffic noise and mental health : a systematic review and meta-analysis" 17 : 6175-, 2020

      7 Vallée J, "The role of daily mobility in mental health inequalities : the interactive influence of activity space and neighbourhood of residence on depression" 73 : 1133-1144, 2011

      8 Wiens K, "The prevalence of major depressive episodes is higher in urban regions of Canada" 62 : 57-61, 2017

      9 Hong JW, "The prevalence of and factors associated with depressive symptoms in the Korean adults : the 2014and 2016 Korea National Health and Nutrition Examination Survey" 56 : 659-670, 2021

      10 Peen J, "The current status of urban-rural differences in psychiatric disorders" 121 : 84-93, 2010

      11 Kroenke K, "The PHQ-9 : validity of a brief depression severity measure" 16 : 606-613, 2001

      12 Kitchen P, "Sense of community belonging and health in Canada : a regional analysis" 107 : 103-126, 2012

      13 Wang JL, "Rural-urban differences in the prevalence of major depression and associated impairment" 39 : 19-25, 2004

      14 Probst JC, "Rural-urban differences in depression prevalence : implications for family medicine" 38 : 653-660, 2006

      15 Ryser L, "Resolving mobility constraints impeding rural seniors’ access to regionalized services" 24 : 328-344, 2012

      16 Orban E, "Residential road traffic noise and high depressive symptoms after five years of follow-up : results from the Heinz Nixdorf Recall study" 124 : 578-585, 2016

      17 Sarkar C, "Residential greenness and prevalence of major depressive disorders : a cross-sectional, observational, associational study of 94 879 adult UK Biobank participants" 2 : e162-73, 2018

      18 Qin W, "Relative deprivation, depression and quality of life among adults in Shandong Province, China : a conditional process analysis based on social support" 312 : 136-143, 2022

      19 Romans S, "Rates of depression and anxiety in urban and rural Canada" 46 : 567-575, 2011

      20 신철민 ; 김윤정 ; 박수연 ; 윤서영 ; 고영훈 ; 김용구 ; 김승현 ; 전상원 ; 한창수, "Prevalence and Associated Factors of Depression in General Population of Korea: Results from the Korea National Health and Nutrition Examination Survey, 2014" 대한의학회 32 (32): 1861-1869, 2017

      21 Roe J, "Oxford Research Encyclopedia of Environmental Science" Oxford University Press 2016

      22 Helbich M, "Outdoor light at night, air pollution and depressive symptoms : a cross-sectional study in the Netherlands" 744 : 140914-, 2020

      23 Seung Eun Lee ; Miyeon Yeon ; Chul-Woung Kim ; Tae-Ho Yoon ; Dongjin Kim ; Jihee Choi, "Neighborhood Deprivation and Unmet Health Care Needs: A Multilevel Analysis of Older Individuals in South Korea" 질병관리청 10 (10): 295-306, 2019

      24 Thoits PA, "Mechanisms linking social ties and support to physical and mental health" 52 : 145-161, 2011

      25 Belanche D, "Local place identity : a comparison between residents of rural and urban communities" 82 : 242-252, 2021

      26 Kim JM, "Lifetime urban/rural residence, social support and late-life depression in Korea" 19 : 843-851, 2004

      27 Koivumaa-Honkanen H, "Life satisfaction and depression in a 15-year follow-up of healthy adults" 39 : 994-999, 2004

      28 Yang Wha Kang ; 고윤실 ; 김유진 ; 성경미 ; 김효진 ; 최형윤 ; 성창현 ; 정은경, "Korea Community Health Survey Data Profiles" 질병관리청 6 (6): 211-217, 2015

      29 GBD 2019 Mental Disorders Collaborators, "Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019" 9 : 137-150, 2022

      30 Rugel EJ, "Exposure to natural space, sense of community belonging, and adverse mental health outcomes across an urban region" 171 : 365-377, 2019

      31 Menec VH, "Examining the relationship between communities’‘age-friendliness’ and life satisfaction and self-perceived health in rural Manitoba, Canada" 14 : 2594-, 2014

      32 van Os J, "Does the urban environment cause psychosis?" 184 : 287-288, 2004

      33 Kanamori M, "Differences in depressive symptoms by rurality in Japan : a cross-sectional multilevel study using different aggregation units of municipalities and neighborhoods(JAGES)" 20 : 42-, 2021

      34 이규영 ; 함옥경 ; 이보경 ; 김안젤라, "Differences in Factors Associated with Depressive Symptoms between Urban and Rural Female Adolescents in Korea" 한국간호과학회 48 (48): 475-484, 2018

      35 Lee TH, "Depressive symptoms of house-poor persons : Korean panel data evidence" 62 : 569-577, 2016

      36 St John PD, "Depressive symptoms in adults in rural and urban regions of Canada : a cross-sectional analysis of the Canadian longitudinal study on aging" 11 : e048090-, 2021

      37 Remes O, "Biological, psychological, and social determinants of depression : a review of recent literature" 11 : 1633-, 2021

      38 Breslau J, "Are mental disorders more common in urban than rural areas of the United States?" 56 : 50-55, 2014

      39 Kim AR, "Analysis of factors affecting depression in older adults in South Korea" 18 : 9887-, 2021

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