Is the Countryside Now More Toxic Than the City?

The roles seem to have reversed.

Posted Apr 21, 2016

For years it was “the toxic city, the healthy countryside.” No more. The roles seem to have been reversed.

The city as Sodom was a familiar image: the place where young women from the countryside were molested by their domestic employers and where gin mills spilled their sordid human contents into the gutters. The countryside, with its sweaty muscled farmers and rosy-cheeked housewives clad in gingham, counted as a place of purity where the soul could repose far from the madding crowd.

This ideology remains sheet-anchored today in parts of US politics, where New York “lifestyles” are scorned and god-fearing parishoners assemble every Sunday morning.

And sure, why not. Rural Arkansas is different from Times Square. But it’s not necessarily purer. These are the findings from two major recent statistical studies.

By almost every measure of mental health, the countryside now does worse than the big city, and the amount of pathology increases as you go from metropolis to suburb to small town. This reverses completely generations of sociological findings about the city as the man-cave of Mammon and social dissolution.

This particular finding was released in 2014, on the basis of national survey data. But nobody knew about it because it came from a research institute in North Dakota.  Where’s that? And the media showed little interest.

An equally interesting finding, however, broke last week: For young people, rates of opioid use in the past year were twice as high among rural teens and young adults as in the nation as a whole. The study found that, “About 8 percent of rural youth aged 12 to 19 and 9.5 percent of those aged 20-29 had used opioids in the previous year.”  (See also Psychiatric News, April 1, 2016)

This is really eye-opening. The two studies together mean that drug abuse as well as serious mental illnesses are now centering in small towns and the countryside.

What is going on here? There are two possible explanations. One is that, after graduating from high school, the bright and highly motivated kids in small towns move to the big city, to school and jobs, because they know that’s where the future lies. The marginal and disaffiliated remain at home, easy prey for a drug culture that now seems ubiquitous in many small communities.

The second explanation is that there is some toxic factor in rural and small-town life itself that makes people mentally ill, or turns them towards drugs. This is what we used to believe about the city: the nameless toxin in urban life that destroyed human bonds and turned people into money-grubbers. You don’t hear that so much anymore.

Now, what we learn about is the monotony of small-town life and how soul-destroying the endless sameness and routine can be. In an age where everyone is plugged into social media, leading a life where nothing happens can be toxic. You’ve got nothing to message about, and your urban friends’ Facebook pages are jammed with interesting news of clubbing and funky fashion.

This is such a sudden and astonishing reversal, it’s impossible to say right now if it will hold. Young families will flee the sky-high housing prices of the central cities for suburban and rural settings where the kids won’t grow up in a tower and they can have a dog. 

The adult bookstores won’t be returning to Times Square. But other social pathologies may lie in wait for the metropolis: riots, cynical, corrupt police, all kinds of things may yet go wrong.

But right now the cities are winning, and if you are fantasizing about some kind of bucolic escape from “the pressures of urban life,” forget it.


Rural Health Reform Policy Research Center, The 2014 Update of the Rural-Urban Chartbook 2014. University of North Dakota Center for Rural Health

Rural Opioid Abuse: Prevalence and User Characteristics