Marital status, feeling depressed and self-rated health in rural female primary care patients

To determine whether marital status and self-assessed mental health are independent risk factors for poor self-rated overall health among female primary care patients. We conducted a cross-sectional survey of family medicine patients treated in a clinic in rural Minnesota. Complete responses were obtained from 723 women. Self-ratings of mental health, demographics and symptoms were used to predict self-rated overall health. Women who were single, divorced or otherwise not married, or widowed had lower odds of good self-rated overall health (OR = 0.39, P = 0.004) compared with married women. Women who were 65 years of age and over (OR = 0.31, P = 0.017), women who rated themselves as depressed (OR = 0.54, P = 0.029), and women who reported more physical symptoms (OR = 0.78, P = 0.000) also were less likely to have good health, compared with younger women, women who did not feel depressed, and women with fewer physical symptoms, respectively. Education was not independently related to health in this sample. Worry was related to health in the univariate analysis but not after controlling for self-assessed depression. In order to improve overall health among rural women seen in primary care settings, special attention may need to be directed at women who are single, are older, report more physical symptoms, and feel depressed. Programmes should include self-help materials, support groups and counselling services addressing social isolation, employment and financial hardship.