Unintentional Injury, Psychological Distress and Depressive Symptoms: Is There an Association for Rural Australians?

Authors

  • Lyn Fragar MPH,

    1.  Australian Centre for Agricultural Health and Safety, University of Sydney, Moree, NSW, Australia
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  • Kerry J. Inder PhD,

    1.  Centre for Brain and Mental Health Research, University of Newcastle and Hunter New England Health, Newcastle, NSW, Australia
    2.  Hunter Medical Research Institute, Newcastle, NSW, Australia
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  • Brian J. Kelly PhD,

    1.  Centre for Brain and Mental Health Research, University of Newcastle and Hunter New England Health, Newcastle, NSW, Australia
    2.  Hunter Medical Research Institute, Newcastle, NSW, Australia
    3.  Centre for Rural and Remote Mental Health, University of Newcastle, Orange, NSW, Australia
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  • Clare Coleman PhD,

    1.  Centre for Rural and Remote Mental Health, University of Newcastle, Orange, NSW, Australia
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  • David Perkins PhD,

    1.  Department of Rural Health, Broken Hill, University of Sydney, Australia
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  • Terry J. Lewin BCom

    1.  Centre for Brain and Mental Health Research, University of Newcastle and Hunter New England Health, Newcastle, NSW, Australia
    2.  Schizophrenia Research Institute, Sydney, NSW, Australia
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  • Funding: The ARMHS study was funded by the National Health and Medical Research Council (Project Grant #401241), and it was also supported by a Research Capacity Building Grant to the Australian Rural Health Research Collaboration.

  • Disclosures: The authors have no conflicts of interest to disclose.

  • For further information, contact: Lyn Fragar, MPH, AO Research Leader, Australian Centre for Agricultural Health and Safety, University of Sydney, PO Box 256, Moree NSW 2400, Australia; e-mail: lynette.fragar@sydney.edu.au.

  • Acknowledgments: We wish to acknowledge the support of Area Directors of Mental Health Services during the course of this phase of the study: Dr Russell Roberts, Richard Buss, Judy Kennedy, Dr Dinesh Arya, and particularly acknowledge the research site coordinators in each site: Jan Sidford, John Ogle (Broken Hill), Trim Munro, Amy Strachan (Moree), Louise Holdsworth, Kath O’Driscoll (Lismore), Cheryl Bennett, Jannelle Bowler (Orange), along with Fleur Hourihan, Dr Gina Sartore, Denika Novello, and the team of CIDI interviewers.

Abstract

Purpose: To investigate the association between unintentional injury and mental health in Australian rural communities.

Methods: Using cross-sectional baseline data for a longitudinal study from randomly selected adults in nonmetropolitan Australia, we fitted logistic regression models for the outcomes of domestic or public setting injury and injury in high-risk settings, using prior depression and demographic factors. OR and 99% CI were reported and also calculated for current mental health including psychological distress, depressive symptoms and risky alcohol consumption, comparing those injured with those not.

Findings: Of 2,639 participants who completed the injury component, 364 (13.8%) reported injury requiring treatment from a doctor or a hospitalization in the previous 12 months. Of those requiring treatment or hospitalization, 147 (40.4%) reported being injured in a domestic or public setting and 207 (56.9%) in a high-risk setting. The most common types and mechanisms of injury were sprains and strains, and falls, trips and slips, respectively. Preinjury depression was independently associated with unintentional injury in a domestic or public setting. Being injured in this setting was associated with double the odds of experiencing current depressive symptoms. The likelihood of a high-risk setting injury was significantly associated with male gender. High-risk setting injury was associated with current psychological distress and higher levels of alcohol usage.

Conclusions: This study supports the hypothesis that pre-existing depression is associated with unintentional injury in a rural sample and indicates the important role of prior depression in management of injury, given the high rate of injury in rural communities. Mechanisms by which prior depression increases likelihood of unintentional injury will be further investigated using longitudinal data.

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