The prevalence of psychological distress and relationships with social fragmentation and isolation: a geospatial study and survey in rural Australia

Purpose There is limited data on the effects of social isolation on rural mental health. The aim of this study was to describe the prevalence of psychological distress in a rural area of Australia while exploring the association between psychological distress and social isolation at the individual and area level. Methods An online cross-sectional survey of 408 adult volunteers was conducted across rural south-eastern New South Wales from October 2019 to April 2020. The Kessler 10 was used to measure psychological distress, while area-level social fragmentation was assessed using the family (ANSFI fam ) and mobility (ANSFI mob ) components of the Australian Neighbourhood Social Fragmentation Index. The number of different occupations of people known socially was used to assess individual-level social isolation. Spatial analysis was performed to identify any spatial autocorrelation. Results The prevalence of high psychological distress in the sample was 29%. Using logistic regression models, there was little evidence of a relationship between high psychological distress and ANSFI fam (odds ratio (OR)=0.98, 95% confidence interval (CI)=0.93–1.03), or ANSFI mob (OR=1.04, 95%CI=0.99–1.09). High psychological distress also did not appear to be associated with number of occupations known socially (OR=1.00, 95%CI=0.99–1.00). There was no significant spatial autocorrelation of psychological distress or social fragmentation at the postal area level. Conclusion The results suggest that social fragmentation or isolation may not have a significant effect on psychological distress in a rural setting. Nevertheless, further investigation of the effects of social isolation on mental health in rural areas is warranted.