A healthy move? gender, psychological distress and wellbeing among rural ‘stayers’ and ‘movers’

BackgroundWomen consistently report worse mental health than men and while inequalities in work and family are highlighted as an underlying factor, inequalities can vary between contexts. The present study expands on the literature by including a geographic dimension and exploring the importance of rural-urban migration.ObjectiveThe aim was to compare mental health among men and women who remained in rural areas (stayers) and those who had moved to larger cities (movers) and to explore the importance of psychosocial work environment, family situation and work-family conflict. In line with the dual-factor mental health model, two outcomes were analyzed.MethodsBased on a survey of 2022 targeting individuals raised in small towns/rural municipalities in Sweden (n = 1743), OLS regressions were conducted to study variation in psychological distress and mental wellbeing between male and female stayers and movers aged 30-50. The job demand-control-support (JDCS) model, the respondents' family situation and perceived work-family conflict were analyzed as mechanisms.ResultsOverall, female movers had the worst mental health and male movers the best. Female stayers reported more psychological distress than male stayers, but not lower mental wellbeing than any other group. The JCDS model explained the gender difference among stayers, while work-family conflict largely explained female movers' disadvantage.ConclusionsRural-urban migration implied better mental health for men but not for women, due to higher work-family conflict. The study points to the importance of considering the interplay between work, family and place and applying a broad perspective on mental health.