Mental health: how living in the city and country compare
<p>Is it better to live in a city or in the countryside? While urban dwellers may benefit from more employment opportunities, better access to public services alongside cultural activities and entertainment, people who live in rural areas often argue they have a better sense of community and greater access to nature.</p>
<p>A number of studies have sought to determine whether city or country is better for mental health by drawing on national survey data from the <a href="https://www.understandingsociety.ac.uk/">UK Household Longitudinal Study</a> (UKHLS). This is a national survey which has followed approximately 40,000 UK households since 2009. Each year, data is collected on a range of social, economic and behavioural factors.</p>
<p>This is what some of these studies have found when it comes to mental health and where you live:</p>
<h2>Physical activity</h2>
<p>Research has shown that physical activity can reduce <a href="https://www.sciencedirect.com/science/article/pii/S0749379719302466?casa_token=_QxDT_feTekAAAAA:Sd_9jfW0ukJY1fUCkUx43sTEGHkNBiwqViPI4-HfSx-LngPhuxBjGMRQrokDmpYlZIwzR7wDzA">anxiety</a> and <a href="https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2018.17111194">depression</a>, alongside <a href="https://www.tandfonline.com/doi/abs/10.1080/00223980.2018.1470487">improving mood</a> and <a href="https://academic.oup.com/tbm/article-abstract/10/5/1098/5921063?login=true">wellbeing</a>. Indeed, UK health guidelines recommend physical activity for the <a href="https://www.nice.org.uk/guidance/ng222">treatment of depression</a> and <a href="https://www.gov.uk/government/publications/physical-activity-guidelines-adults-and-older-adults/physical-activity-for-adults-and-older-adults-19-and-over-text-of-the-infographic">improved quality of life</a>.</p>
<p>One easy way of getting more physical activity in your life is through active travel – such as cycling or walking on your way to work or running errands.</p>
<p>So how does urban or rural dwelling impact on this? According to UKHLS research which looked at data from 35,295 people in the UK, urban residents were 64% more likely than rural residents to <a href="https://link.springer.com/article/10.1007/s00038-014-0578-2">engage frequently in active travel</a>. This is likely because there are more active travel opportunities in urban environments where there are shorter distances between facilities, shops, offices and homes.</p>
<p>Research shows that the more active travel a person does, the better their <a href="https://www.sciencedirect.com/science/article/pii/S2214140520300487">mental health</a>. In fact, the mental health benefits of active travel may be <a href="https://pubmed.ncbi.nlm.nih.gov/28153647">just as good</a> as physical activity for leisure. So, based on this measure, people living in the city may have better mental health overall.</p>
<p>But while urban life may offer more opportunities for active travel compared to living in the countryside, that doesn’t mean there aren’t still many ways to incorporate physical activity into your daily life for mental health benefits wherever you live.</p>
<h2>Access to green space</h2>
<p>Access to green space (such as parks) is believed to support many aspects of <a href="https://www.nature.com/articles/s41598-019-44097-3">health and wellbeing</a> – including your <a href="https://www.tandfonline.com/doi/abs/10.1080/09638237.2020.1755027?journalCode=ijmh20">mental health</a>.</p>
<p>To investigate whether nearby green space was related to mental wellbeing, data from the 2009-2010 UKHLS study was combined with data on the proportion of green space within different areas of England. The analysis found the amount of local green space did not actually <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4401-x">predict mental wellbeing</a>.</p>
<p>What this suggests is that while green space may be important for mental wellbeing, having it nearby doesn’t necessarily mean people will engage with it. As such, we can’t assume rural living is inherently more beneficial just because nature is more accessible.</p>
<p>This aligns with the findings of a 2021 study, which showed that living near green space <a href="https://www.nature.com/articles/s41598-021-87675-0#Sec2">did not improve mental health outcomes</a>. However, the analysis did find that the more frequently a person visited green spaces, the better their mental wellbeing. <a href="https://www.tandfonline.com/doi/full/10.1080/17439760.2016.1221126">Meaningful engagement with green spaces</a> (such as taking photographs) may also be more important for reaping the mental health benefits of nature.</p>
<p>As such, urban living may be just as good as rural dwelling when it comes to the mental health benefits of green space.</p>
<h2>Air quality</h2>
<p>Numerous studies have found links between high levels of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447209/">air pollution</a> and <a href="https://www.kcl.ac.uk/news/exposure-to-air-pollution-linked-with-increased-mental-health-service-use-new-study-finds">poorer mental health</a>. A <a href="https://www.sciencedirect.com/science/article/pii/S0161813X22001668?via%253Dihub">review of 111 studies</a> even suggests that polluted air may cause changes in the brain regions that control emotions. This may increase the risk of developing anxiety and depression compared to those who breathe cleaner air.</p>
<p>To investigate the impact of air pollution on mental health, researchers combined data on air pollution from the UK Department for Environment, Food and Rural Affairs with UKHLS survey data, alongside data from the British Household Panel Survey (which looked at 10,000 UK households and ran from 1991 to 2009). This allowed them to analyse data from the years 1991-2014.</p>
<p>The analysis found that people who were exposed to higher levels of air pollution reported lower levels of <a href="https://www.understandingsociety.ac.uk/research/publications/524260">life satisfaction</a>. The study indicated that the negative effect of air pollution on life satisfaction can be equivalent to major life events, such as divorce.</p>
<p>In general, urban areas have between <a href="https://www.thelancet.com/pdfs/journals/lanplh/PIIS2542-5196(21)00255-2.pdf">two to four times the levels of air pollution</a> than rural areas, suggesting people who live in cities may be more likely to experience worse mental health as a result. However, the agricultural industry also generates <a href="https://uk-air.defra.gov.uk/assets/documents/reports/aqeg/2800829_Agricultural_emissions_vfinal2.pdf">high levels of air pollution</a> meaning some rural dwellers in certain settings may also be at risk.</p>
<h2>Regional variation in wellbeing</h2>
<p>Of course, these are just a few of the factors that affect a person’s day to day mental health – and it appears neither city nor country living is significantly better than the other when it comes to your mental health.</p>
<p>Indeed, research has found that the <a href="https://www.tandfonline.com/doi/full/10.1080/00343404.2019.1645953?needAccess=true">region of the country</a> you live in may be more important when it comes to your mental health than whether you live in the city or the countryside. There are many factors that may explain this effect, including the cost of living in certain areas, alongside local politics and a person’s economic status.</p>
<p>Where we live is clearly very important when it comes to our mental health. But the place that works best for your mental health will depend largely on broader social and economic factors as well as which aspects of your lifestyle are most important to you.</p>
<p><em><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Image credit: Shutterstock</span></em></p>
<p><em>This article originally appeared on <a href="https://theconversation.com/mental-health-how-living-in-the-city-and-country-compare-200402" target="_blank" rel="noopener">The Conversation</a></em><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">.</span></p>
