The following is a summary of a research project by the authors. For more information please contact Dr Tonelle E. Handley at the University of Newcastle (email:

Authors: Tonelle E. Handley1, Jane Rich2, Terry J. Lewin2,3, Brian J. Kelly2

  1. Centre for Rural and Remote Mental Health, University of Newcastle, Callaghan, NSW Australia
  2. School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
  3. Hunter New England Mental Health, Newcastle, NSW, Australia

Depression affects one in seven Australians at some point in their life and has the third highest burden of all diseases worldwide. Rural communities are affected by a range of factors differently to those who live in cities. A survey of people in rural and remote communities in NSW conducted by Tonelle Handley from the University of Newcastle found that people who were unable to work due to illness or disability were more than three times more likely to develop depression in the future than people who were employed. People who reported having financial difficulties were four times as likely to develop depression by the following survey. And people who smoked cigarettes regularly were three times as likely to develop depression by the following survey. On the other hand, people with strong social support were less likely to develop depression, suggesting that this is an important protective factor.

These findings suggest that rural people with a lower socio-economic status experience more than just financial implications. They are also more likely to develop depression, which in turn increases their vulnerability to a range of further negative outcomes. This includes poorer health behaviours and a higher risk for chronic disease, while they are also less likely to be in a position to afford professional help for these conditions. This emphasises the need to develop broader, community-based support systems for those with financial and employment difficulties, to assist them not only with their immediate financial situation, but also to support them through the associated stress and emotional vulnerability during this time. In doing so, we may prevent a cycle of disadvantage by ensuring that rural people’s immediate finances and employment do not determine their long-term psychological wellbeing and prospects for the future.

Further details about the study can be found at: