Author Details

Acknowledgement
This research was supported by a grant from the School of Behavioural & Social Sciences & Humanities, University of Ballarat.
 

 Recently, researchers and mental health workers have begun to question the existence of an ideal rural life style (Hoyt, Conger, & Valde, 1997).  Evidence of higher incidence of poorer physical health (Hays & Zouari, 1995; Johnson, 1998), psychiatric illness (Mumford, Saeed, Ahmad, Latif, & Mubbashar, 1997; Wagenfeld, 1982), depression (Beeson & Johnson, 1987; Cheng, Soong, Chong, & Lin, 1995; Hays & Zouari, 1995; Zimbelman, 1987), alcohol dependence and abuse (Lee et al., 1990) and suicide (Dudley, Waters, Kelk, & Howard, 1992; Lohse, 1992; Pritchard, 1992) negates the perception that rural life is free from the stresses of city life.  Indeed, elevated levels of stress have been noted in rural residents (Hays & Zouari, 1995; Johnson, 1998) and have been identified as a significant problem (Jacob, Bourke, & Luloff, 1997).

Much rural research was instigated by the economic downturn in the 1980s, and has examined the direct effects of economic hardship in rural areas.  This research has consistently demonstrated that economic hardship ‘on the farm’ is associated with increased psychological distress and dysfunction (Armstrong & Schulman, 1990; Beeson & Johnson, 1987; Belyea & Lobao,  1990).

In many respects, the farm crisis served to accelerate a continual population decline and many agriculture-dependent businesses were forced to close down (Davidson, 1989; O’Hare, 1988).  The resulting lack of opportunities in rural industry accelerated the exodus of the younger and, in many instances, the more economically viable and educated segment of the population to urban centres.  The migration of youth not only decreased local populations in absolute terms, it also left rural populations disproportionately elderly (Johnson & Beale, 1992).  These changes in size and composition of the population base resulted in the loss of traditional formal support systems such as community organisations, schools and hospitals, into larger, relatively distant regional population centres (Quevillon & Trenerry, 1983; Stewart, McKenry, Rudd, & Gavazzi, 1994; Sullivan, Weinert, & Fulton, 1993).

These economic and demographic changes have fostered conditions that have diminished the effectiveness of traditional community-level buffers and undermined individual defense mechanisms.  Rural residents have reported increasing perceptions of community decline and lowering of work satisfaction, expressed as diminished satisfaction with community life and lessened feelings of cohesion (Naples, 1994; Oberlander, 1990).  These perceptions contribute to expressions of social isolation and hopelessness that are likely to decrease an individual’s sense of control.  Given the key role that these types of psychological resources have in buffering the impact of crises (Mirowsky & Ross, 1989), this situation is likely to translate into increased distress at the individual level.

Perceived stress is a global measure that examines the degree to which non-specific situations in an individual’s life are appraised as stressful (Cohen, Evans, Stokols, & Kranz, 1986).  This appraisal of stress is expected to be sensitive to ongoing life circumstances, to stress resulting from events occurring in lives of friends and relatives, changes in coping resources and to expectations concerning future events.  In assessing stress, it takes into account unidentified stress not listed on life-event and hassle scales (Blankstein & Flett, 1992; Blankstein, Flett, & Koledin, 1991).  With only general beliefs being measured, participants are not provided with a list of experimenter-generated specific life events or chronic strains.  Consequently, results are unlikely to be biased by the event content or by the differential recall of past life experiences.

When reviewing the literature on rural-urban differences in perceived stress, mixed results are evident.  Farm residents living in Manitoba, Canada reported significantly higher chronic fatigue, forgetfulness, loss of temper, concentration difficulties, back pain, and sleep disruptions (all commonly associated with chronic stress) than did non-farmers (Walker & Walker, 1988). In Tunisia, research based on forty-five women living in three distinct environments (rural, mid-size village and the capital city of Tunis), found rural Bedouin women to have greater stress levels and depressive symptoms than the village and/or urban women (Hays & Zouari, 1995).

It should be noted however, that numerous studies have found that physical expression of psychic distress, varies with education, socioeconomic status, age, gender and ethnic groups that discourage the direct expression of emotion (Barsky & Klerman, 1983; Bell, Leroy, & Stephenson, 1982;  Clarke & Jensen, 1997; Dean & Ensel, 1982; Johnson, 1998; Kessler, Price, & Wortman, 1985; Taylor, Henderson, & Jackson, 1991).  Urban-rural differences in stress therefore, may be confounded by other demographic factors (Bell, Leroy, Lin, & Schwab, 1981; Linn, Husaini, Whitten-Stovall, & Broomes, 1989; Mueller, 1981; Neff & Husaini, 1987; Neff, Husaini, & McCorkel, 1980; Romans, Walton, Herbison, & Mullen, 1992).

In addition to examining perceived stress, researchers have focused on the experience of life events.  After two decades of research, evidence supports the contention that life events are associated with a wide variety of physical and psychiatric disorders, including heart disease, fractures, schizophrenic episodes, anxiety, and depressive reactions (Dohrenwend & Dohrenwend, 1981; Kessler et al., 1985; Selye, 1982; Thoits, 1983).

Life events are discrete and major changes that may be outside of an individual’s control (Selye, 1982).  Events may include, death of a loved one, a life-threatening or incapacitating illness or being unemployed.  It could also be an event heavily influenced by the person to whom it happens, such as in divorce, giving birth or taking an important examination.  Both positive and negative changes, such as marriage and divorce, are considered to be stressful by Holmes and Rahe (1967) because they all demand adjustments by the individual to a new lifestyle or pattern and may consequently affect mental health (Harpham, 1994).

When comparing the experience of life events as a function of residence, epidemiological surveys of samples from the south-eastern United States demonstrated that rural residents report more life events than urban residents (Linn et al., 1989; Neff & Husaini, 1987).  In another study conducted in the United States, adolescents across four rural counties reported experiencing more negative life events (Stewart et al., 1994) than the normative data collected by McCubbin and colleagues (McCubbin, Patterson, Bauman, & Harris, 1985).

Whereas some studies associate the experience of stress with place of residence, more recent studies suggest there is no difference in the types (Thomas & Groer, 1986) and levels of psychological distress in urban and rural communities (Horwell & McLaren, 2000; Hoyt, Odonnell, & Mack, 1995; Zitzow, 1992).  Further, there are some studies (Harpham, 1994; Hays & Zouari, 1995) which suggest that any differences in stress levels, depression and mental disorders, were attributable to poverty and perceived financial status rather than the influence of a specific geographic location.

In summary, people experience stress regardless of their place of residence.  Research has examined the levels of stress and the number of life events experienced by rural and urban residents.  Little research has investigated whether the types of life events experienced differ as a function of residence.  One study, based on a community sample of 420 residents in Montana, indicated greater financial and business stress for rural respondents and greater work and family stress for the urban respondents (Marotz-Baden & Colvin, 1986).

Overall, the review of rural-urban differences in stress failed to show any consistency and comparison was, in any case, difficult due to use of different types of data, definitions and methods.  A weakness of many studies which compared residence is that compositional differences (e.g. age, gender, education) between urban and rural areas are not taken into account.  Participants studied had different ethnic background, age, sex, education, income, occupation, and mobility which may affect mental health more than place of residence.  If urban or rural residence is a risk factor for psychiatric morbidity, that relationship should be observed with statistically controlled compositional differences between urban and rural areas (Crowell, George, Blazer, & Landerman, 1986).

The current study investigated the experience of perceived stress and life events in a community sample of Australian residents.  It was hypothesised that rural residents would report higher levels of perceived stress and more negative life events than urban residents.  It was also expected that the life events reported would differ as a function of residential location, though the paucity of research examining this issue did not allow a precise hypothesis to be formulated.

Method

Participants
A total of 655 community members from the state of Victoria, Australia, participated in the study (22% response rate).  The sample comprised of 58% females (n = 379) and 42 % males (n = 276).  The respondents were divided into four groups by their location of residence: urban (n = 146), regional city (n = 164), regional town (n = 174) and rural (n = 171).  Average age of the sample was 42.71 years (SD = 13.42).  The demographic details for males and females for each of the residential groups can be seen in Table 1.

2.2 Materials
A questionnaire package consisting of a covering letter, a demographic page, the List of Recent Experiences (Headey, Holmstrom, & Wearing, 1984), and the Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983) was used.
The demographics section of the research questionnaire requested information from participants regarding their age, gender, marital status, postcode, and highest level of education achieved.

The List of Recent Experiences (Headey et al., 1984) was used to assess the number and type of life events experienced by the respondents.  It is a self-administered questionnaire containing a list of 44 events (both positive and negative) to which participants respond by checking those events that they have experienced during the past twelve months.  The List of Recent Experiences contains items that can be divided into nine categories: financial and work situation; illness, injury and accident; relationships; recreation; study and schooling; loss and bereavement; friendships; personal and civil assault; and religion.  The reliability of the scale appears satisfactory.  A test-retest reliability of r = .89 has been reported after two weeks (Henderson, Byrne, & Duncun-Jones, 1981).

The Perceived Stress Scale (Cohen et al., 1983) assesses the subjective experience of stress.  The 14-item scale measures the cognitive and affective outcomes of all factors that contribute to the experience of stress, including objective environmental events, subjective appraisals, personality factors, coping ability and other resources.  Responses are given on a 4-point Likert scale ranging from never to very often.  The Perceived Stress Scale has been found to have adequate internal and test-retest reliability, with alpha coefficients ranging between r = .84 and r = .86 (Cohen et al., 1983).  In their initial validation research, Cohen et al. (1983) found small to moderate correlations between the Perceived Stress Scale and life events scales (r = .17 to r = .49) and fairly strong correlations with measures of physical symptomatology (r = .52 to r = .70) and depression (r = .65 to r = .76).  In a 2-month prospective study, Cohen et al. (1986) found the Perceived Stress Scale predicted physical and psychological symptoms even after symptoms at Time 1 were removed.

Procedure
Selection of participants followed a stratified random sampling procedure (Shaughnessy & Zechmeister, 1990).  Rather than utilising two groups of participants (rural, metropolitan), the state of Victoria was divided into four strata: urban (the capital city of Melbourne; postcodes 3000-3200); regional cities (Ballarat, Bendigo, and Geelong; population above 50,000); regional towns (population from 7,500 to 50,000); and rural (open country farm and non-farm settings of fewer than 2,500 people) (Dwyer, Barton, & Vogel, 1994).

Randomly selected postcodes for all four strata were generated.  Postcodes were then supplied to the Listbank Company, which generated random mailing lists from Electoral Rolls.  The details of the procedure were as follows.  For the urban region, 30 questionnaire packages were distributed to each of the 25 randomly selected ‘urban’ postcodes.  For the regional cities, 250 questionnaire packages were distributed to the ‘regional city’ postcodes of Ballarat, Bendigo and Geelong.  For the regional towns, all 20 ‘regional town’ postcodes were included.  Out of the twenty towns, 42 questionnaire packages were distributed to the two most populated towns, and 37 questionnaire packages were delivered to each of the remaining eighteen towns.  For the rural region, one postcode was generated per 6,000 residents per shire, and 15 questionnaire packages were distributed to each of the 50 randomly selected postcodes.  A total of 3,000 questionnaire packs were posted to a random sample of Australians- 750 urban, 750 regional cities, 750 regional towns and 750 rural residents. Questionnaire presentations were randomly ordered to counterbalance possible carry-over effects (Shaughnessy & Zechmeister, 1994).

Results
A two-tailed alpha level of .05 was used.  For all statistical tests, Levene’s test for equality of variance showed no significant differences between variances of stress scores, and evaluations of the assumptions of normality, linearity, homogeneity and sphericity were satisfactory (Tabachnick & Fidell, 1996).

Reliability
In order to assess the reliability of the Perceived Stress Scale for this sample, Cronbach correlation coefficients for internal consistency were calculated (Tabachnick & Fidell, 1996). The Cronbach’s alpha coefficient obtained r = .89, which was consistent with Cohen and colleagues (1983), who reported alpha coefficients ranging between r = .84 and r = .86.  Results indicated that the Perceived Stress Scale had adequate internal consistency for this sample.

The internal consistency of the List of Recent Experiences was not calculated, as experiencing a particular life event (e.g. you had a major financial crisis) does not necessarily relate to the experience of another life event (e.g. a child of yours died).

Initial Analyses
The order of presentation for the questionnaires did not appear to influence the participants’ way of response, F (12, 1712.09) = 1.11.

The demographic characteristics of the four residential groups were compared.  Results indicated that the number of males and females in each group were similar, Pearson ?2 (3, N = 655) = 2.96, Cramérs V = .07.  There was no difference in age across the four groups, F(3, 645) = 0.53.  It was evident that participants in the more rural settings (rural and regional town) were more likely to be married, Pearson ?2 (3, N = 655) = 41.05, Cramérs V = .15, and to have left formal education earlier than those in the more urban regions (urban and regional city), Pearson ?2 (3, N = 655) = 39.06, Cramérs V = .14.  As both marital status (Cotton, 1999; Grove & Stoll, 1999; Hope, Power, & Rodgers, 1999; Simon & Marcussen, 1999) and level of education (Clarke & Jensen, 1997; Johnson, 1998; Taylor et al., 1991), have been related to the experience of stress, both of these variables were entered as covariates in the subsequent analyses.
Rural-Regional-Urban Comparisons

The mean number of positive life events reported by the residents in each group can be seen in Table 2.  After controlling for marital status and education level, a two-way multivariate analysis of covariance (MANCOVA) was conducted on the number of positive life events reported by males and females in each of the four residential groups.  Results demonstrated a main effect for gender, F(7, 636) = 2.81.  Univariate analyses indicated that females reported significantly more positive studying/schooling events, F(1,636) = 6.00, positive friendship events, F(1, 636) = 11.69, and positive religious events, F(1, 636) = 4.53.  Results did not evidence a significant main effect for place of residence, F(7, 636) = 1.03, nor an interaction between gender and place of residence, F(21, 1826.80) = 0.63.

A second MANCOVA was conducted to test for differences in the mean number of negative life events reported by males and females in the residential groups.  The means can be seen in Table 3.  Results did not demonstrate a main effect for gender, F(10, 633) = 1.14, place of residence, F(10, 633) = 1.16, nor an interaction between the two factors, F(30, 1858.66) = 1.28.

An ANCOVA was used to test for differences in perceived stress between males and females across the four residential locations.  Mean stress scores are included in Table 4.  Results did not indicate a difference in perceived stress as a function of gender, F(1, 642) = 2.43, place of residence, F(3, 642) = 0.30, or an interaction between the two variables, F(3, 642) = 0.71.

In summary, results did not demonstrate any differences in the experience of stress or life events across the four groups of residents.  Consequently, the four groups of residents were reduced to two groups: Urban (urban and regional city) and Rural (regional town and rural), and the same analyses were repeated.  The two groups of residents did not differ on the number of positive, F(7, 640) = 0.88, or negative life events, F(10, 637) = 0.89, or perceived stress, F(1, 646) = 0.30.  A main effect for gender for the number of positive life events reported was evident, F(7, 640) = 2.82, with females experiencing more positive experiences in the areas of studying/schooling, F(1, 640) = 5.75, friends, F(1, 640) = 12.04, and religion, F(1, 640) = 4.43.  A main effect for gender was not demonstrated for the number of negative life events, F(10, 637) = 1.16, or for perceived stress, F(1, 646) = 2.64.  An interaction between place of residence and gender was not shown for positive life events, F(7, 640) = 0.65, negative life events, F(10, 637) = 0.67, or perceived stress, F(1, 646) = 0.01.

In summary, the reporting of perceived stress and life events does not differ as a function of place of residence, whether gross or finer categorisations according to population are utilised.

Correlations Between Perceived Stress and Life Events
A series of one-tailed Pearson partial correlations, controlling for marital status and education, were conducted to test the relationship between the experience of positive and negative life events and perceived stress.  Initially, these correlations were conducted on the whole sample, then on each of the four residential groups.  The correlations can be seen in Table 5.

It is evident from Table 5 that moderate positive correlations exist between the experience of negative life events and perceived stress.  The strength of the correlations was similar across the four residential groups.  A significant negative relationship between the experience of positive life events and perceived stress was not demonstrated for any group, although the small correlation for the Regional Town residents approached significance, p = .067.

Discussion
The current research investigated the experience of stress as a function of residence. The hypothesis that rural residents would report higher levels of perceived stress and more negative life events than urban residents was not supported.  Further, results did not demonstrate that the nature of the life events experienced differed as a function of residential location.

The results were inconsistent with studies conducted in Canada (Walker & Walker, 1988), Tunisia (Hays & Zouari, 1995), and the United States of America (Linn et al., 1989; Marotz-Baden & Colvin, 1986; Neff & Husaini, 1987; Stewart et al., 1994) which indicated that the experience of stress and life events is elevated in rural areas.  This inconsistency may be due to cultural differences, where residents in different countries are exposed to different sets of environmental influences and belief systems, or perhaps other confounding variables exist.  Other studies, however, suggest that there is no difference in the types (Thomas & Groer, 1986) and levels of psychological distress experienced by rural and urban residents (Horwell & McLaren, 2000; Hoyt et al., 1995; Zitzow, 1992).   A recent Australian study demonstrated no differences in perceived stress (as measured by the Perceived Stress Scale) reported by ambulance officers living and working in rural or urban areas (Horwell & McLaren, 2000).

Literature suggests that it is possible that rural residents may have under reported their experiences of stress (Buckwalter, Smith, Zevenburgen, & Russel, 1991; Coward, DeWeaver, Schmidt, & Jackson, 1983).  In particular, events they perceive to be minor by nature, as well as those seen as risking privacy and confidentiality, may remain unreported (Nease, 1993).  Thus, rural residents may potentially be at risk for higher experiences of stress than reported in the study.

Review of rural-urban differences in stress, particularly in America, failed to show any consistency, and could be attributed to differences in operational definitions.  Most studies lack a consistent definition of "rural".  In many studies, rural is simply defined as non-metropolitan (Hays & Zouari, 1995; Plunkett, Henry, & Knaub, 1999), in others, the experience of farmers are taken as representative of the entire rural population (Johnson, 1998; Marotz-Baden & Colvin, 1986; Mumford et al., 1997).  With different studies using different population bases to represent "rural", conflicting results will continue to be demonstrated.

The gender differences in the reporting of life events warrant some attention.  The results of this study indicated that females experienced more positive life events, specifically in the areas of schooling/study, friendships, and religion, than males.  Limited data is available on gender differences in positive life events, although one study indicated that females do experience more positive life events than males (Cohen, McGowan, Fooskas, & Rose, 1984).  More research has focused on gender and negative life events, with mixed results being reported.  For example, a study investigating the frequency of stressful life events among male and female athletes demonstrated no difference (Baldwin, Harris, & Chambliss, 1997).  Another study showed that males experience more stressful life changes than females (Sowa & Lustman, 1984).  Other research has indicated that females face more negative life events and social conditions than males (Nolen-Hoeksema, 1994).  A study investigating types of life events in married couples demonstrated that males were more likely to experience negative work and financial events, whereas females were more likely to experience negative family events (Conger, Lorenz, Elder, Simons, & Ge, 1993).  Though not investigated in this study, previous research has also shown that the impact of life events on psychological well-being is greater for females than males (French, Gekoski, & Knox, 1995).  Thus, on the basis of such research, it would have been reasonable to expect gender differences on the negative life events.  The results of the current study, however, indicated no gender differences.  The inconsistent results demonstrated by previous research suggest that sample characteristics may be responsible for the diverse results.  Clear gender differences in the experience of life events appear not to exist.

The current research also demonstrated that the experience of negative life events was significantly related to perceived stress.  This is consistent with previous research that has shown that it is negative life events, and not positive life events, that are related to negative outcomes, including poor psychological well-being (Iwasaki & Smale, 1998), depression (Dixon & Reid, 2000), illness (Sarason, Sarason, Potter, & Antoni, 1985), and injuries (Patterson, Smith, Everett, & Ptacek, 1998).  Research has demonstrated that positive life events impact negatively on health only in participants with low self-esteem (Brown & McGill, 1989).  Conversely, in participants with high self-esteem, positive life events were associated with better health.  The correlations between perceived stress and negative life events were similar across the four residential groups, suggesting that negative life events are not an explanation for poorer health in rural residents.

The results of this study must be considered in light of some limitations.  Stress is a situation-based variable that changes over time, and therefore results may not be interpreted in absolute terms.  Using retrospective self-report instruments may also limit the depth and accuracy of findings.  The cross-sectional design of the study, as well as the relatively low participation rate, should also be regarded as limitations of the current study.  Further, the current study did not assess the length of time participants had resided in their current location.  Future research should include length of residency as a variable.

Future research may benefit from including other measures of the stress process, including cognitive appraisal and coping.  The ways in which one interprets their encounters with the environment and subsequently copes with such encounters may vary in residents from different population bases (Amato, 1993; Heckman, Somlai, Kalichman, Franzoi & Kelly, 1998; Lin & Rogerson, 1995; Wenger, 1995; Wood & Parham, 1990).

In summary, the present study makes several potential contributions to the rural-urban stress literature.  The data offer little support to suggestions that rural groups are more at risk for experiencing stress than urban groups, or vice versa.  The study refutes the American stereotypes regarding the environmental stresses of rural residence.  The cross-sectional design of the study, combined with using statistical techniques to control for the demographic variables of martial status and education, makes it less likely that the results were due to household selection and respondent factors.

There clearly is a need to establish whether or not the rural experience is different.  Mental health professionals can be of most assistance to their clientele when they do not accept blindly the common stereotypes about rural life and its advantages and disadvantages.  The issue is concerned with a search for variables which differentiate rural from metropolitan life and which may have relevance for psychological practice in differentially populated areas.

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