Abstract
Studies from around the globe have found that urbanicity is associated with greater risk for certain psychiatric disorders, though the association has been less evident in the United States. We analyzed data collected in 2019 from the RAND American Life Panel (n = 2554), which were representative of the general adult population of the United States. Using multivariable logistic regression, we examined the associations between environment of birthplace (large urban, small urban, suburban, rural) and psychiatric disorders, adjusting for sociodemographic characteristics. We found that being born in a large urban area was associated with greater odds of having any psychiatric disorder when compared with being born in a rural area. However, when looking at specific disorders, we found that being born in a large urban area was only significantly associated greater odds of anxiety disorder and post-traumatic stress disorder (PTSD), but was not associated with bipolar disorder, major depressive disorder, attention deficit/hyperactivity disorder, or alcohol/substance use disorder. Being born in a small urban area was marginally associated with anxiety disorder. Future studies should examine why urban birthplace has only been associated with anxiety disorders and PTSD in the United States, and why urbanicity is associated with mood disorders in other parts of the world but not in the United States.
Highlights
Over the past century, the United States has become increasingly urbanized, which may have contributed to the development of mental health problems for population
A meta-analysis found that psychiatric disorders were more prevalent in urban areas when compared with rural areas, though this was not the case for substance use disorders [7]
1.40 times odds of having any psychiatric disorder when compared with being born in a rural area
Summary
The United States has become increasingly urbanized, which may have contributed to the development of mental health problems for population. Urbanization has been linked to several mental health problems, attributed to social disparities (see [1]), violence exposure [3], adversities and traumas [4], pollution [5], and absence of natural environments or green spaces [6]. A meta-analysis found that psychiatric disorders ( mood and anxiety disorders) were more prevalent in urban areas when compared with rural areas, though this was not the case for substance use disorders [7]. In the United States, the association between urban living and psychiatric disorders has been unclear. One study that used data from the National Comorbidity Survey Replication (NCS-R) showed that while drug abuse was more common among people currently residing in urban areas when compared with people residing in non-urban (i.e., suburban or rural) areas, rurality was not associated
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