This research has two primary goals: to examine the relationship between urban residence and trajectories of depressive symptoms and to investigate whether this relationship differs by social isolation and loneliness.
Method:
Data are from 2006, 2008, 2010, 2012, 2014, and 2016 waves of the Health and Retirement Study (HRS), a nationally representative sample of U.S. adults aged 51+ (n = 3,346 females and 2,441 males). We conduct latent growth curve analysis to predict both baseline and trajectories of depression based on urban or rural residency.
Results:
Residing in urban or rural areas is neither significantly associated with baseline nor the development of late-life depressive symptoms. For females, the relationship between urban residence and baseline depressive symptoms is explained by socioeconomic factors.
Discussion:
Findings of this study serve to better understand how social and geographic contexts shape long-term well-being of older adults.
AbeY.FujiseN.FukunagaR.NakagawaY.IkedaM. (2012). Comparisons of the prevalence of and risk factors for elderly depression between urban and rural populations in Japan. International Psychogeriatrics, 24(8), 1235–1241. https://doi.org/10.1017/s1041610212000099
2.
AdkinsD. E.WangV.DupreM. E.Van den OordE. J.. (2009). Structure and stress: Trajectories of depressive symptoms across adolescence and young adulthood. Social Forces, 88(1), 31–60. https://doi.org/10.1353/sof.0.0238
3.
AltemusM.SarvaiyaN.EppersonC. N. (2014). Sex differences in anxiety and depression clinical perspectives. Frontiers in Neuroendocrinology, 35(3), 320–330. https://doi.org/10.1016/j.yfrne.2014.05.004
4.
AneshenselC. S.WightR. G.Miller-MartinezD.BotticelloA. L.KarlamanglaA. S.SeemanT. E. (2007). Urban neighborhoods and depressive symptoms among older adults. The Journals of Gerontology: Series B, 62(1), S52–S59. https://doi.org/10.1093/geronb/62.1.s52
5.
BergdahlE.AllardP.LundmanB.GustafsonY. (2007). Depression in the oldest old in urban and rural municipalities. Aging & Mental Health, 11(5), 570–578. https://doi.org/10.1080/13607860601086595
6.
BirdittK. S.PolenickC. A.LuongG.CharlesS. T.FingermanK. L. (2020). Daily interpersonal tensions and well-being among older adults: The role of emotion regulation strategies. Psychology and Aging, 35(4), 578–590. https://doi.org/10.1037/pag0000416
7.
CacioppoJ. T.HawkleyL. C.ThistedR. A. (2010). Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and Aging, 25(2), 453–463. https://doi.org/10.1037/a0017216
8.
CacioppoJ. T.HughesM. E.WaiteL. J.HawkleyL. C.ThistedR. A. (2006). Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyses. Psychology and Aging, 21(1), 140–151. https://doi.org/10.1037/0882-7974.21.1.140
9.
CarmichaelC. L.ReisH. T.DubersteinP. R. (2015). In your 20s it’s quantity, in your 30s it’s quality: The prognostic value of social activity across 30 years of adulthood. Psychology and Aging, 30(1), 95–105. https://doi.org/10.1037/pag0000014
10.
CarstensenL. L.FungH. H.CharlesS. T. (2003). Socioemotional selectivity theory and the regulation of emotion in the second half of life. Motivation and Emotion, 27(2), 103–123. https://doi.org/10.1023/A:1024569803230
11.
ChangS. C.WangW.PanA.JonesR. N.KawachiI.OkerekeO. I. (2016). Racial variation in depression risk factors and symptom trajectories among older women. The American Journal of Geriatric Psychiatry, 24(11), 1051–1062. https://doi.org/10.1016/j.jagp.2016.07.008
12.
CuijpersP.VogelzangsN.TwiskJ.KleiboerA.LiJ.PenninxB. W. (2013). Differential mortality rates in major and subthreshold depression: Meta-analysis of studies that measured both. The British Journal of Psychiatry, 202(1), 22–27. https://doi.org/10.1192/bjp.bp.112.112169
13.
de la Torre-LuqueA.de la FuenteJ.PrinaM.Sanchez-NiuboA.HaroJ. M.Ayuso-MateosJ. L. (2019). Long-term trajectories of depressive symptoms in old age: Relationships with sociodemographic and health-related factors. Journal of Affective Disorders, 246, 329–337. https://doi.org/10.1016/j.jad.2018.12.122
14.
EntwisleB.FaustK.RindfussR. R.KanedaT. (2007). Networks and contexts: Variation in the structure of social ties. American Journal of Sociology, 112(5), 1495–1533. https://doi.org//10.1086/511803
15.
FabozziF. J.FocardiS. M.RachevS. T.ArshanapalliB. G. (2014). The basics of financial econometrics: Tools, concepts, and asset management applications. Wiley. https://doi.org/10.1002/9781118856406
FranckL.MolyneuxN.ParkinsonL. (2016). Systematic review of interventions addressing social isolation and depression in aged care clients. Quality of Life Research, 25(6), 1395–1407. https://doi.org/10.1007/s11136-015-1197-y
18.
FriedmanB.ConwellY.DelavanR. L. (2007). Correlates of late-life major depression: A comparison of urban and rural primary care patients. The American Journal of Geriatric Psychiatry, 15(1), 28–41. https://doi.org/10.1097/01.JGP.0000224732.74767.ad
19.
GeL.YapC. W.OngR.HengB. H. (2017). Social isolation, loneliness and their relationships with depressive symptoms: A population-based study. PLOS ONE, 12(8), Article e0182145. https://doi.org/10.1371/journal.pone.0182145
20.
HainesV. A.BeggsJ. J.HurlbertJ. S. (2008). Contextualizing Health outcomes: Do effects of network structure differ for women and men?Sex Roles, 59(3–4), 164–175. https://doi.org/10.1007/s11199-008-9441-3
21.
Henning-SmithC.MoscoviceI.KozhimannilK. (2019). Differences in social isolation and its relationship to health by rurality. The Journal of Rural Health, 35(4), 540–549.
22.
HuY.LiP.MartikainenP. (2019). Rural-urban disparities in age trajectories of depression caseness in later life: The China Health and Retirement Longitudinal Study. PLOS ONE, 14(4), Article 0215907. https://doi.org/10.1371/journal.pone.0215907
23.
JamesC. V.MoonesingheR.Wilson-FrederickS. M.HallJ. E.Penman-AguilarA.BouyeK. (2017). Racial/ethnic health disparities among rural adults—United States, 2012–2015. MMWR Surveillance Summaries, 66(23), 1–9. https://doi.org/10.15585/mmwr.ss6623a1
24.
LiangJ.XuX.QuiñonesA. R.BennettJ. M.YeW. (2011). Multiple trajectories of depressive symptoms in middle and late life: Racial/ethnic variations. Psychology and Aging, 26(4), 761–777. https://doi.org/10.1037/a0023945
25.
LorantV.DeliègeD.EatonW.RobertA.PhilippotP.AnsseauM. (2003). Socioeconomic inequalities in depression: A meta-analysis. American Journal of Epidemiology, 157(2), 98–112. https://doi.org/10.1093/aje/kwf182
26.
McLaughlinD.VagenasD.PachanaN. A.BegumN.DobsonA. (2010). Gender differences in social network size and satisfaction in adults in their 70s. Journal of Health Psychology, 15(5), 671–679. https://doi.org/10.1177/1359105310368177
27.
Mechakra-TahiriS.ZunzuneguiM. V.PrévilleM.DubéM. (2009). Social relationships and depression among people 65 years and over living in rural and urban areas of Quebec. International Journal of Geriatric Psychiatry, 24(11), 1226–1236. https://doi.org/10.1002/gps.2250
28.
MenecV. H.NewallN. E.MackenzieC. S.ShooshtariS.NowickiS. (2019). Examining individual and geographic factors associated with social isolation and loneliness using Canadian Longitudinal Study on Aging (CLSA) data. PLOS ONE, 14(2), Article e0211143. https://doi.org/10.1371/journal.pone.0211143
29.
MurchlandA. R.EngC. W.CaseyJ. A.TorresJ. M.MayedaE. R. (2019). Inequalities in elevated depressive symptoms in middle-aged and older adults by rural childhood residence: The important role of education. International Journal of Geriatric Psychiatry, 34(11), 1633–1641. https://doi.org/10.1002/gps.5176
ParkS.SmithJ.DunkleR. E.Ingersoll-DaytonB.AntonucciT. C. (2019). Health and social–Physical environment profiles among older adults living alone: Associations with depressive symptoms. The Journals of Gerontology: Series B, 74(4), 675–684. https://doi.org/10.1093/geronb/gbx003
32.
ProbstJ. C.LaditkaS. B.MooreC. G.HarunN.PowellM. P.BaxleyE. G. (2006). Rural-urban differences in depression prevalence: Implications for family medicine. Family Medicine. Family Medicine, 38(9), 653–660.
33.
PurtleJ.NelsonK. L.YangY.LangellierB.StankovI.RouxA. V. D. (2019). Urban–rural differences in older adult depression: A systematic review and meta-analysis of comparative studies. American Journal of Preventive Medicine, 50(4), 603–613. https://doi.org/10.1016/j.amepre.2018.11.008
34.
ShankarA.McMunnA.BanksJ.SteptoeA. (2011). Loneliness, social isolation, and behavioral and biological health indicators in older adults. Health Psychology, 30(4), 377–385. https://doi.org/10.1037/a0022826
35.
SinghG. K.SiahpushM. (2014). Widening rural–urban disparities in all-cause mortality and mortality from major causes of death in the USA, 1969–2009. Journal of Urban Health, 91(2), 272–292. https://doi.org/10.1007/s11524-013-9847-2
36.
SmithJ.FisherG.RyanL.ClarkeP.HouseJ.WeirD. (2013). Psychosocial and lifestyle questionnaire. Survey Research Center, Institute for Social Research.
37.
JohnP. D.StBlandfordA. A.StrainL. A. (2006). Depressive symptoms among older adults in urban and rural areas. International Journal of Geriatric Psychiatry, 21(12), 1175–1180. https://doi.org/10.1002/gps.1637
38.
StockdaleS. E.WellsK. B.TangL.BelinT. R.ZhangL.SherbourneC. D. (2007). The importance of social context: Neighborhood stressors, stress-buffering mechanisms, and alcohol, drug, and mental health disorders. Social Science & Medicine, 65(9), 1867–1881. https://doi.org/10.1016/j.socscimed.2007.05.045
39.
TiikkainenP.HeikkinenR. L. (2005). Associations between loneliness, depressive symptoms and perceived togetherness in older people. Aging & Mental Health, 9(6), 526–534. https://doi.org/10.1080/13607860500193138
40.
ValléeJ.CadotE.RoustitC.ParizotI.ChauvinP. (2011). The role of daily mobility in mental health inequalities: The interactive influence of activity space and neighbourhood of residence on depression. Social Science & Medicine, 73(8), 1133–1144. https://doi.org/10.1016/j.socscimed.2011.08.009
41.
Van DamN. T.EarleywineM. (2011). Validation of the Center for Epidemiologic Studies Depression Scale—Revised (CESD-R): Pragmatic depression assessment in the general population. Psychiatry Research, 186(1), 128–132. https://doi.org/10.1016/j.psychres.2010.08.018
42.
WaltersK.BreezeE.WilkinsonP.PriceG. M.BulpittC. J.FletcherA. (2004). Local area deprivation and urban–rural differences in anxiety and depression among people older than 75 years in Britain. American Journal of Public Health, 94(10), 1768–1774. https://doi.org/10.2105/ajph.94.10.1768
43.
WangJ. L. (2004). Rural–urban differences in the prevalence of major depression and associated impairment. Social Psychiatry and Psychiatric Epidemiology, 39(1), 19–25. https://doi.org/10.1007/s00127-004-0698-8
44.
WarnerC. B.RobertsA. R.JeanblancA. B.AdamsK. B. (2019). Coping resources, loneliness, and depressive symptoms of older women with chronic illness. Journal of Applied Gerontology, 38(3), 295–322. https://doi.org/10.1177/0733464816687218
45.
XuX.LiangJ.BennettJ. M.QuiñonesA. R.WenY. (2010). Ethnic differences in the dynamics of depressive symptoms in middle-aged and older Americans. Journal of Aging and Health, 22(5), 631–652. https://doi.org/10.1177/0898264310370851
46.
YangY. (2007). Is old age depressing? Growth trajectories and cohort variations in late-life depression. Journal of Health and Social Behavior, 48(1), 16–32. https://doi.org/10.1177/002214650704800102
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