Rural–urban disparities in knowledge, behaviors, and mental health during COVID-19 pandemic

Mar 31, 2021Medicine

Differences between rural and urban communities in COVID-19 knowledge, actions, and mental health

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Abstract

The average anxiety score among urban residents was 9.15, while rural residents recorded an average score of 8.69.

Urban residents reported higher levels of depression, with an average score of 11.25 compared to 10.57 in rural areas.
Significant differences in anxiety and depression levels were found between urban and rural participants (P < .01).
Urban residents demonstrated greater knowledge about COVID-19 transmission, prevention, symptoms, treatment, and prognosis compared to rural residents (P < .01).
Information access differed: urban residents primarily used digital platforms, while rural residents relied more on community interactions (P < .01).
Positive behaviors related to COVID-19 were associated with factors such as being female, aged 18-65, and having knowledge of transmission and symptoms in urban areas.
In rural areas, factors like being married and screening for mask-wearing were positively associated with acceptable conduct.

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To examine the knowledge level, behaviors, and psychological status of the Chinese population during the COVID-19 pandemic, and to explore the differences between urban and rural areas.We carried out a cross-sectional survey of the knowledge, behaviors related to COVID-19, and mental health in a probability sample of 3001 community residents in 30 provinces or districts across China from February 16-23, 2020. Convenience sampling and a snowball sampling were adopted. We used (GAD), the 9-item (PHQ-9), and knowledge and behaviors questionnaire of community residents regarding COVID-19 designed by us to investigate the psychological status, disease-related knowledge, and the behavior of Chinese urban and rural residents during the pandemic.The average score of anxiety and depression among urban residents was 9.15 and 11.25, respectively, while the figures in rural areas were 8.69 and 10.57, respectively. There was a statistically significant difference in the levels of anxiety (P < .01) and depression (P < .01). Urban participants reported significantly higher levels of knowledge regarding COVID-19 in all aspects (transmission, prevention measures, symptoms of infection, treatment, and prognosis) (P < .01), compared to their rural counterparts. While a majority of respondents in urban areas obtained knowledge through WeChat, other apps, and the Internet (P < .01), residents in rural areas accessed information through interactions with the community (P < .01). Urban residents fared well in exchanging knowledge about COVID-19 and advising others to take preventive measures (P < .01), but fared poorly in advising people to visit a hospital if they displayed symptoms of the disease, compared to rural residents (P < .01). Regression analysis with behavior showed that being female (OR = 2.106, 95%CI = 1.259-3.522), aged 18 ≤ age < 65 (OR = 4.059, 95%CI = 2.166-7.607), being satisfied with the precautions taken by the community (OR = 2.594, 95%CI = 1.485-4.530), disinfecting public facilities in the community (OR = 2.342, 95%CI = 1.206-4.547), having knowledge of transmission modes (OR = 3.987, 95%CI: 2.039, 7.798), symptoms (OR = 2.045, 95%CI = 1.054-4.003), and outcomes (OR = 2.740, 95%CI = 1.513-4.962) of COVID-19, and not having anxiety symptoms (OR = 2.578, 95%CI = 1.127-5.901) were positively associated with affirmative behavior in urban areas. Being married (OR = 4.960, 95%CI = 2.608-9.434), being satisfied with the precautions taken by the community (OR = 2.484, 95%CI = 1.315-4.691), screening to ensure face mask wearing before entering the community (OR = 8.809, 95%CI = 2.649-19.294), and having knowledge about precautions (OR = 4.886, 95%CI = 2.604-9.167) and outcomes (OR = 2.657, 95%CI = 1.309-5.391) were positively associated with acceptable conduct in rural areas.The status of anxiety and depression among urban residents was more severe compared to those living in rural areas. There was a difference in being positively associated with constructive behaviors between rural and urban areas.

Key numbers

9.15

Average Anxiety Score (Urban)

Average anxiety score during COVID-19 pandemic.

11.25

Average Depression Score (Urban)

Average depression score during COVID-19 pandemic.

90.9%

Knowledge Acquisition via Digital Platforms (Urban)

Percentage of urban residents acquiring knowledge through WeChat and apps.

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Rural–urban disparities in knowledge, behaviors, and mental health during COVID-19 pandemic

Abstract

Key numbers

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