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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2006.107771v1 98/7/1271    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hillemeier, M. M. Articles by Dyer, A.-M. Search for Related Content PubMed PubMed Citation Articles by Hillemeier, M. M. Articles by Dyer, A.-M. Related Collections Community Health Access to Care Mental Health Rural Health Socioeconomic Factors Women's Health

Marianne M. Hillemeier, PhD, MPH, Carol S. Weisman, PhD, Gary A. Chase, PhD and Anne-Marie Dyer, MS

Marianne M. Hillemeier is with the Department of Health Policy and Administration, Pennsylvania State University, University Park. Carol S. Weisman, Gary A. Chase, and Anne-Marie Dyer are with the Department of Public Health Sciences, Pennsylvania State College of Medicine, Hershey.

Correspondence: Requests for reprints should be sent to Marianne M. Hillemeier, PhD, MPH, Department of Health Policy and Administration, Pennsylvania State University, 604 Ford Building, University Park, PA 16802 (e-mail: mmh18{at}psu.edu).

Objectives. We sought to examine variables associated with mental health among rural women of reproductive age, with particular attention given to rural area type and farm residence.

Methods. We analyzed data from the Central Pennsylvania Women’s Health Study, which included a random-digit-dialed survey of women aged 18 to 45 years. Hierarchical multiple linear and logistic regression models were estimated to predict 3 mental health outcomes: score on a mental health measure, depressive symptoms, and diagnosed depression or anxiety.

Results. Mental health outcomes were associated with different factors. Farm residence was associated with higher mental health score, and the most isolated rural residence was associated with less diagnosed depression or anxiety. Elevated psychosocial stress was consistently significant across all models. A key stress modifier, self-esteem, was also consistently significant across models. Other variables associated with 2 of the outcomes were intimate partner violence exposure and affectionate social support.

Conclusions. Farm residence may be protective of general mental health for women of reproductive age, and residence in isolated rural areas may decrease access to mental health screening and treatment, resulting in fewer diagnoses of depression or anxiety.