Debate: Urban versus rural environments - which is better for mental health? The one good thing about a small town….

Urban environments are related to higher prevalences of common mental disorders (addictions, anxieties and mood disorders) in adults. The mechanisms underlying this relationship are less clear. Cities function as a magnet, related to economic and educational opportunities, but are also related to urban stress and low well-being. Urban areas have larger inequalities, and people in deprived areas are at enhanced risk for mental health problems, which have been related both to environmental factors like pollution and to perceptions of the (social) environment, including perceived safety and social support. The interactions of vulnerability factors at different levels of description (e.g., within-person stress vulnerability vs. neighborhood stressors) can be considered a complex system. We here discuss what is known about growing up in an urban versus rural environment, with the aim to identify target points for mental health-related interventions in youth. We summarize this for three broad developmental periods: early life (first 1000 days), childhood, and adolescence into young adulthood, with implications for interventions.