Psychological distress in rural Australia: regional variation and the role of family functioning and social support
Date
2014-12
Authors
Butterworth, Peter John
Handley, Tonelle E.
Lewin, Terry J.
Reddy, Prasuna
Kelly, Brian J.
Journal Title
Journal ISSN
Volume Title
Publisher
Springer Verlag
Abstract
AIM Regional variation in the prevalence of mental disorders and particularly variation in the role of risk and
protective factors has received limited research attention.
This study investigates variation in the prevalence of
significant psychological distress across regions, and
quantifies the relative impact of family functioning and
social support. SUBJECT AND METHOD Multilevel analysis of data from the longitudinal Australian Rural Mental Health Study, comprising a stratified random sample from non-metropolitan New South Wales. Distress was assessed using the Kessler-10. The analysis considered clustering within
households and across geographic regions based on Local
Government Areas and collapsed to represent residence in
inner regional, outer regional, remote and very remote
locations. RESULTS There was limited clustering of psychological distress within areas (0.4 %). However, the household accounted for almost 45 % of the variance in psychological distress, and the salience of the household was greater in more remote regions (33.1 % in inner regional to 60.5 % in very remote areas). Family functioning and perceived social support were associated with increased risk of psychological distress, but explained only a modest amount of variance in mental health at household level. After controlling for individual and family/social covariates, 34.5 % of the remaining variance in psychological distress was observed at the household
level. CONCLUSION The findings suggest that individuals in remote locations are more reliant on their family/confidants for their mental health than those in more populated areas. Future research will consider whether this simply reflects differences in the accessibility of formal health services or broader social and cultural differences.
Description
Keywords
rural health, psychological distress, epidemiology, regional variation, household factors, multilevel analysis
Citation
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Source
Journal of Public Health
Type
Journal article