Providers' Perceptions of Prevalent Mental and Behavioral Health Problems: Differences and Similarities Across Urban, Rural, and Frontier Areas

Most research exploring possible differences in the prevalence of mental and behavioral health1 (MBH) problems between urban and rural areas has indicated that there are no differences. Unfortunately, most of this research has measured urbanness-ruralness as a 2-level or dichotomous construct only (i.e., an area is either urban or rural), and researchers have used inconsistent (and sometimes conflicting) definitions for what constitutes an "urban" or "rural" area. In this study, urbanness-ruralness is conceptualized as an expanded categorical construct with the addition of a 3rd point: The frontier area. Surveys were completed by 259 MBH professionals across the urban, rural, and frontier counties of a U.S. state in the intermountain west. Survey items asked about a number of issues related to MBH, including what the professionals perceived to be the most-prevalent MBH problems in their areas. Anxiety was perceived to be a significantly more prevalent problem in urban areas, and substance abuse and domestic violence were perceived to be significantly more prevalent problems in frontier areas. These results suggest that when urbanness-ruralness is conceptualized as an expanded categorical construct (rather than simply a dichotomous one), differences in the perceived prevalence of MBH problems may be found.