Rural resilience or big city wellness? Preliminary insights from the European Social Survey

Abstract

This study, analyzing 42,319 respondents across 28 EU countries, examines the impact of residential settings along the urban-rural continuum on physical health, mental health, and healthcare access.

We reveal a complex health paradox: rural residents show better mental wellbeing and lower cardiovascular risk but face a greater burden of musculoskeletal disorders and 18% less access to specialist care. Urban populations have better specialist access but report elevated mental health challenges and sedentary lifestyle risks. Universal issues, including general overweight/obesity (mean BMI 25–30) and consistent healthcare avoidance (~20%), demand population-wide interventions. Findings highlight the need for health-oriented urban planning that balances service accessibility with nature integration, and suggest targeted interventions like telemedicine for rural specialist gaps and mental health programs for urban settings.