Environmental and Societal Determinants of Mental Health in Hyderabad, Sindh: Exploring the Urban-Rural Disparities
DOI:
https://doi.org/10.66021/pakmcr1113Keywords:
Mental Health, Urban-Rural Disparities, Environmental Determinants, Societal Determinants, Help-Seeking Behavior.Abstract
Background: Mental health disorders are a growing public health concern globally, with environmental and societal factors playing a crucial role in their distribution. Urban and rural populations experience these determinants differently, leading to disparities in prevalence, risk factors, and access to care.
Objectives: To investigate and compare the environmental and societal determinants of mental health disorders among urban and rural populations, and to explore their help-seeking behaviors and barriers to care.
Methodology: A comparative cross-sectional study was conducted among 369 adults using a multistage cluster sampling technique in both urban and rural settings from September to February 2026. Data were collected through a structured questionnaire, which included demographic, environmental, societal, and mental health variables. Standardized tools (PHQ-9 and GAD-7) were used to assess depression and anxiety. Data were analyzed using SPSS-29 to identify patterns and associations, with a significance level set at p ≤ 0.05.
Results: Over half of the respondents (55.3%) reported worsening mental health in the past five years. The prevalence of depression was 26.6% mild, 25.2% moderate, and 10.0% severe, while anxiety prevalence was 27.6% mild, 32.0% moderate, and 21.7% severe. Urban residents showed higher mean depression and anxiety scores compared to rural residents. Environmental stressors such as constant air and noise pollution were reported by 45% of participants, while 39.3% perceived their neighborhoods as unsafe with poor infrastructure. Financial insecurity (36%) and lack of social support (24.7%) were the most common social stressors. Awareness of mental health services was low (27.6%), with cost (25.5%) and stigma (23.6%) as major barriers. Only 22% of respondents had sought professional help, reflecting a significant treatment gap.
Conclusion: Environmental and societal factors significantly shape mental health outcomes across urban and rural populations, suggesting the need for context-specific, integrated interventions to reduce disparities and improve access to care.
