An APA Practice Directorate report to Congress calls for more research and services for this underserved population. But for people who live in rural America, life stress and mental health problems are just as prevalent as for city dwellers, APA's Practice Directorate recently told Congress. And in particular, APA said in a report delivered to a congressional briefing, for the 30 percent of U.S. women who live in rural areas, problems are often exacerbated by poverty, isolation, a lack of education and economic opportunities and inadequate access to health care, including mental health care. In presenting the report's overview of current knowledge on the issues, Katherine Nordal, PhD, chair of the APA Committee on Rural Health, and Pamela Mulder, PhD, lead author of the report, indicated that more services should be provided and more research should be conducted on this often invisible group, and that women in rural areas need help in building resources in their own communities. The poverty rate in nonmetropolitan areas is 15.9 percent as compared with 13.2 percent in cities.
Rural women are more likely to have unpaid employment in family businesses.
Two recent studies of rural primary-care settings found depressive symptoms in 40 percent and 41 percent of rural women screened, as compared with the 13 percent to 20 percent in urban women. Incidence of rape and spousal abuse in rural areas is equal to that in cities, but in the country perpetrators may use the isolation to continue the abuse without interference from other people. Local services for women, when they exist, may be hampered by the lack of confidentiality and by the woman's family's acquaintance with the providers themselves. Rural women are more likely than their urban counterparts to have a number a health problems, including diabetes, cancer, heart disease, stroke and lung disease. Fetal, infant and maternal mortality are higher in rural areas.