This Is AuburnElectronic Theses and Dissertations

Relationships Between Physical and Mental Health in Rural, Low-Income Adolescents




Feiss, Robyn

Type of Degree

PhD Dissertation



Restriction Status


Restriction Type


Date Available



Studies have consistently reported that environment (i.e., rural vs. urban) and socioeconomic status (SES) are moderating factors of physical health (i.e., obesity and/or physical activity) and mental health (i.e., stress, anxiety, and depressive symptoms) in adolescents and adults. Additionally, relationships between physical and mental health have been shown in adolescents; however, research has not addressed these relationships in those from low-income or rural backgrounds. The present program of research aims to: (1) characterize physical and mental health in rural, low SES adolescents, (2) investigate the relationships between physical and mental health in this population, and (3) investigate longitudinal changes in mental and physical health. We hypothesized that (1) elevated rates of obesity, stress, anxiety, and depressive symptoms would be observed and would be influenced by sex, (2) body composition and self-esteem/body image would be related to anxiety, depression, and stress and that these relationships would be influenced by sex, and (3) longitudinal increases in stress, anxiety symptoms, depressive symptoms, and obesity would be observed. To address these aims, students in 10th and 11th grade at Title I schools in the rural, southeastern U.S. participated in a wellness fair program, during which mental health measures (i.e., stress, depression, anxiety), self-esteem, body image, physical health characteristics (i.e., physical activity level, body fat percentage, BMI, blood pressure, resting heart rate, number of sports), and physical fitness measures (i.e., push-ups, curl-ups, PACER) were collected. Relationships were assessed using stepwise linear models and Pearson correlations. Due to logistical issues, longitudinal analyses were not able to be evaluated. The first hypothesis was supported. The rates of obesity, anxiety, and depressive symptoms observed were higher than previous state- and national-level estimates, and females exhibited increased anxiety, depressive, and stress symptoms compared to males. Additionally, males reported greater physical activity and sport participation than females. The second hypothesis was partially supported. As expected, bivariate correlations demonstrated positive relationships between body composition and mental health symptoms and negative relationships between body image and mental health and body composition. However, linear analyses with physical activity, sport participation, and demographics (sex and race) as factors, showed that physical activity was negatively related to anxiety symptoms in females and depressive symptoms in female athletes. These analyses also demonstrated that sport participation was associated with lower depressive and psychological stress symptoms, but only among Caucasian/White adolescents. Additionally, these analyses revealed positive influences of physical activity and sport participation on physical fitness. These studies suggest that efforts must be made towards reducing both mental and physical health burdens among rural, low-income adolescents. The relationships observed between body composition, body image, and mental health suggest that mental health programs may benefit from the discussion of these topics. In particular, school-based programs that integrate physical and mental health education may be important to reduce these health burdens.