The highest rates of mental disorder are observed in young adulthood, and in the United States, young adult women suffer from higher rates of major depressive disorder and lower rates of substance use disorder than do young adult men. National estimates in 2010 find that, although rural (non-metropolitan) rates are similar to non-rural (metropolitan) rates nationwide, sex differences in depressive and substance abuse disorders are less apparent in rural America. Whereas non-rural young women show higher rates of depressive disorder than non-rural young men, such rates are comparable for rural young women and men nationwide. Likewise, rural young men abuse alcohol at higher rates than rural young women, but unlike their non-rural counterparts, rural young men are no more likely than rural young women to abuse tobacco, marijuana, or other illicit substances. Within rural contexts, then, it would appear that depressive and substance abuse disorders are more or less equally distributed across sex.