I believe clean air and water make a difference. The extent of this difference and its exact effect will need more studies. This is one study. I have observed that I find mental health services much harder to access in this rural setting than the urban area where I accessed them for my job. The insurance gaps in the state would not provide the type of services I once took for granted. The proximity of services in a city will always be a factor in how likely someone will be accessing those services. People in rural areas are the most at risk population in this country. And the air pollution in their older homes can be very bad. Air pollution is not just an outdoor phenomenon.