Changes in Depression Levels for US Rural Communities Before and After the Start of the COVID-19 Pandemic

The objective of this research is to identify whether there were statistically significant changes in depression severity for rural residents in the United States before the COVID-19 pandemic and after its start in 2020. This study uses paired-sample t tests to differentiate between depression levels, measured by the Patient Health Questionnaire-9, before the pandemic and after its start for a sample of rural residents (n = 324), as well as a subsample of women (n = 224) and Black clients (n = 55). Results indicate that the average Patient Health Questionnaire-9 decreased from 11.86 to 11.77 for the total sample and from 12 to 11.99 for the subsample of women, whereas the subsample of Black residents increased from 10.58 to 11.27 for prepandemic versus postpandemic levels, though the differences are not statistically significant. Given the urban/rural differences in coping with challenges stemming from the COVID-19 pandemic, the United States cannot have a one-size-fits-all pandemic response policy.