{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:22:09Z","timestamp":1792758129785,"version":"4.5.0"},"reference-count":71,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["Catalyst Grant (50240)"],"award-info":[{"award-number":["Catalyst Grant (50240)"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,9,30]]},"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Previous studies on depression in rural areas have yielded conflicting results. Features of rural areas may be conducive or detrimental to mental health. Our objective for this study was to determine if there are rural\u2013urban disparities in depressive symptoms between those living in rural and urban areas of Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a cross-sectional analysis of a prospective cohort study, which is as representative as possible of the Canadian population\u2014the Tracking Cohort of the Canadian Longitudinal Study on Aging. For this cohort, data were collected from 2010 to 2014. Data were analysed and results were obtained in 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>21 241 adults aged 45\u201385.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Rurality was grouped as urban (n=11 772); peri-urban (n=2637); mixed (n=2125; postal codes with both rural and urban areas); and rural (n=4707). Depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression. We considered age, sex, education, marital status and disease states as potential confounding factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The adjusted beta coefficient was \u22120.24 (95% CI \u22120.42 to \u22120.07; p=0.01) for rural participants, \u22120.17 (95% CI \u22120.40 to 0.05; p=0.14) for peri-urban participants and \u22120.30 (95% CI \u22120.54 to \u22120.05; p=0.02) for participants in mixed regions, relative to urban regions. Risk factors associated with depressive symptoms were similar in rural and urban regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The small differences in depressive symptoms among those living in rural and urban regions are unlikely to be relevant at a clinical or population level. The findings do suggest some possible approaches to reducing depressive symptoms in both rural and urban populations. Future research is needed in other settings and on change in depressive symptoms over time.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-048090","type":"journal-article","created":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T11:56:46Z","timestamp":1638532606000},"page":"e048090","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Depressive symptoms in adults in rural and urban regions of Canada: a cross-sectional analysis of the Canadian Longitudinal Study on Aging"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8827-8220","authenticated-orcid":false,"given":"Philip D","family":"St John","sequence":"first","affiliation":[{"name":"Geriatric Medicine, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Menec","sequence":"additional","affiliation":[{"name":"Community Medicine, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0624-8264","authenticated-orcid":false,"given":"Robert","family":"Tate","sequence":"additional","affiliation":[{"name":"Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy E","family":"Newall","sequence":"additional","affiliation":[{"name":"Psychology, Brandon University, Brandon, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Cloutier","sequence":"additional","affiliation":[{"name":"Department of Geography and Institute on Aging and Lifelong Health, University of Victoria, Victoria, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6159-4322","authenticated-orcid":false,"given":"Megan","family":"O'Connell","sequence":"additional","affiliation":[{"name":"Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,12,3]]},"reference":[{"key":"2025121220383523000_11.12.e048090.1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370605100204"},{"key":"2025121220383523000_11.12.e048090.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-004-0833-6"},{"key":"2025121220383523000_11.12.e048090.3","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0447.2002.10078.x"},{"key":"2025121220383523000_11.12.e048090.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.03.020"},{"key":"2025121220383523000_11.12.e048090.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(01)00413-X"},{"key":"2025121220383523000_11.12.e048090.6","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.112.112169"},{"key":"2025121220383523000_11.12.e048090.7","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.13030325"},{"key":"2025121220383523000_11.12.e048090.8","doi-asserted-by":"publisher","DOI":"10.1080\/13607860902774493"},{"key":"2025121220383523000_11.12.e048090.9","doi-asserted-by":"publisher","DOI":"10.1086\/217913"},{"key":"2025121220383523000_11.12.e048090.10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.0008-3658.2005.00077.x","article-title":"The greying of resource communities in northern British Columbia: implications for health care delivery in already-underserviced communities","volume":"49","author":"Hanlon","year":"2005","journal-title":"The Canadian Geographer\/Le G?ographe canadien"},{"key":"2025121220383523000_11.12.e048090.11","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1017\/S0144686X13000627","article-title":"How \u2018age-friendly\u2019 are rural communities and what community characteristics are related to age-friendliness? 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