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Community, Health, and Family

Religious Attendance and Mental Health in Rural and Urban America: Distinguishing Depression from Anxiety Joshua Grove*, Joshua Grove,

Religious participation is consistently associated with better mental health, yet findings vary across outcomes and contexts. Many studies treat mental health as unidimensional, limiting insight into whether associations differ across forms of psychological distress. Using repeated cross-sectional data from the National Wellbeing Survey (2021-2024; N=25,390), I examine religious service attendance and two mental health outcomes – depression and anxiety – across rural and urban contexts. Survey-weighted logistic regression models with identical specifications include demographic, socioeconomic, and social engagement covariates. Results show clear outcome specificity: associations between religious attendance and depression attenuate substantially after covariate adjustment, whereas associations with anxiety remain robust and are consistently stronger in rural contexts. Weekly attendance is associated with an 11.6-percentage-point lower probability of anxiety in rural areas compared to 6.4 points in urban areas. These findings demonstrate that religious attendance relates differently to depression and anxiety and plays a particularly pronounced role in rural mental health, challenging assumptions that treat mental health as a single construct and highlighting the importance of place effects in religion-health research.