Depression and poverty among rural women: A relationship of social causation or social selection?

Context and Purpose: Depression among rural women is a major public health concern. The purpose of this study was to test the competing theories of social causation and social selection to assess the relationship between depression and economic status for a sample of rural, low-income women in the United States. Methods: Structural equation modeling was used to analyze data from Rural Families Speak, a US Department of Agriculture-funded multi-state, longitudinal study of rural low-income families (N = 413). Findings: Results indicated that the social causation theory yielded a better approximation of the relationship between economic status and depression (RMSEA = 0.50 for a model based on this theory) than the social selection theory (RMSEA = 0.067). Conclusions: The association between lesser economic status and depressive symptoms is pressing in rural areas, given the high prevalence of both depression and poverty. These findings further emphasize the need for improved mental health services in this vulnerable population.