Psychological distress in young Australian women by area of residence: findings from the Australian Longitudinal Study on Women's Health

Background: The association between psychological distress and area of residence has been extensively discussed and debated. However, the focus has been largely on men and area of residence is often dichotomised to urban and rural. The aim of this study is to examine the association between psychological distress and area of residence in young Australian women using a broader geographical measure. Methods: Data were from 8961 women aged 19-26 in the 1989-95 cohort of the Australian Longitudinal Study on Women's Health in 2015. The association between area of residence (measured by the Modified Monash Model) and psychological distress (measured by the K10), adjusted for demographic factors, indicators of socioeconomic position and health behaviour characteristics, was analysed using logistic regression. Results: Women in regional centres had lower odds of high to very high psychological distress compared with women in metropolitan areas (adjusted odds ratio 0.73 (95% confidence interval 0.60-0.89)). Women living in large rural towns, medium rural towns and small rural towns/remote/very remote communities had similar levels of psychological distress as women living in metropolitan areas. Limitations: ALSWH uses self-report questionnaires which may introduce potential self-report bias. The small sample size in areas outside of metropolitan areas resulted in the need to collapse small rural towns, remote communities and very remote communities into one category. Conclusions: The subtle regional differences in levels of psychological distress in young women in Australia highlights the importance of the link between health and where people live and suggests further work is required to understand the regional differences and encourage location specific mental health services.