Depressive symptoms in rural West Virginia: Labor market and health services correlates

The prevalence and socioeconomic correlates of depressive symptoms in rural West Virginia were assessed. A random-digit-dialed telephone interview was administered to a community-dwelling sample of adults, ages 18 to 64, residing in the 40 rural counties of the Appalachian State of West Virginia. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Overall rates of depressive symptoms were substantially higher than in the nation as a whole. Gender differences were lower than expected due to a high rate of depressive symptoms among men. Depressive symptoms were inversely associated with higher socioeconomic position. One-third of those who described themselves in "good mental health" reported depressive symptoms. About half who reported depressive symptoms had never seen a mental health professional or a physician for mental health problems. Efforts to increase awareness and access to mental health services are needed to promote the mental health of rural West Virginian populations.