Urban versus Rural Living: Associations with Mental Health, Physical Health, and Psychological Constructs

Urbanization has raised urgent questions about how environmental contexts shape mental and physical health. This review synthesizes findings from 500 studies (1982–2023) on mental health, physical health, brain function, cognition, personality, and epigenetics in urban versus rural settings. In the Global North, urban living is linked to increased risks for mental disorders, particularly schizophrenia, whereas rural living is often associated with better quality of life. In the Global South, urban environments may confer mental health benefits, likely due to improved healthcare and economic opportunities. Urban populations, mostly in the North, show higher rates of obesity and cardiovascular disease, while rural groups face greater mortality risks linked to healthcare disparities. Neuroimaging studies suggest urban upbringing alters stress-related brain circuits. However, causal inferences are limited by cross-sectional designs, inconsistent definitions of “urban” and “rural,” and overrepresentation of Global North populations. Improved classification and global representation are needed to inform equitable and effective health policy.