Abstract

Research Article

Rural adolescent health: Issues, behaviors and self-reported awareness

Molly Jacobs*

Published: 22 April, 2020 | Volume 1 - Issue 1 | Pages: 001-017

Purpose: The purpose of the study was to examine the health status of rural adolescents and young adults in the United States through a comprehensive review of detailed health information, behavior and health awareness. The disparity in health awareness between rural and non-rural residents compared and evaluated.

Methods: Rural-Urban Commuting Area (RUCA) codes were combined with respondent-level data from the Longitudinal Survey of Adolescent to Adult Health (Add Health) to classify individuals as rural/non-rural residents. Health characteristics and perceived health awareness was tested for statistically significant differences using ANOVA. Differences in weight perception accuracy was compared for systematic differences controlling for self-selection into rural areas using a two-stage logistic selection model.

Findings: Analysis revealed that rural residents have a higher incidence of major health conditions including epilepsy, high cholesterol, high blood pressure and diabetes. Additionally, they have a higher prevalence of unhealthy behaviors including drinking and drug use. Rural residents are less likely to be insured, but more likely to be overweight or obese. While rural adolescents are more likely to mis-classify their body weight, this misclassification is a result of the higher incidence of overweight rather than the residential location.

Conclusion: The higher prevalence of chronic conditions combined with the income and education levels suggests the rural environment is a unique and potentially challenging context for adolescent health. Improving rural adolescent health will require innovative solutions appropriate for rural environments and changes in individual health literacy. Solutions must be multisectoral, engaging education, economic development, and other community perspectives to establish key drivers for health equity.

Read Full Article HTML DOI: 10.29328/journal.jcmhs.1001001 Cite this Article Read Full Article PDF

References

  1. Parker K, Horowitz JM, Brown A, Fry R, Cohn D, et al. What Unites and Divides Urban, Suburban and Rural Communities. 2018. https://www.pewsocialtrends.org/2018/05/22/what-unites-and-divides-urban-suburban-and-rural-communities/
  2. Rechel B, Džakula A, Duran A,Fattore G,Edwards N, et al. Hospitals in rural or remote areas: An exploratory review of policies in 8 high-income countries. Health Policy. 2015; 120: 758-769. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27312144
  3. Curtis AC, Waters CM, Brindis C. Rural adolescent health: the importance of prevention services in the rural community. J Rural Health. 2011; 27: 60-71. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21204973
  4. Levine SB,Coupey SM. Adolescent substance use, sexual behavior, and metropolitan status: is 'urban' a risk factor? J Adolescent Health. 2003; 32L 350-355. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12729984
  5. Catalano RF, Fagan AA, Gavin LE, Greenberg MT,Irwin CE Jr, et al. Worldwide application of prevention science in adolescent health. Lancet. 2012; 379: 1653-1664. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22538180
  6. Eaton DK, Kann L, Kinchen S, Shanklin S, Flint KH, et al. Youth risk behavior surveillance – United States, 2011. Morbidity and Mortality Weekly Report: Surveillance Summaries. 2012; 61: 1-62. PMid:22673000
  7. Raingruber B. Contemporary health promotion in nursing practice. Burlington, MA: Jones & Bartlett. 2016; PMid:27504500.
  8. Santrock JW. A topical approach to life-span development. New York: McGraw-Hill Education. 2014.
  9. Miller AS. CE FEATURE Adolescent Alcohol and Substance Abuse in Rural Areas: How Telehealth Can Provide Treatment Solutions. J Addic Nurs . 2005; 16: 107-115.
  10. Salois MJ. The built environment and obesity among low-income preschool children. Health Place. 2012; 18: 520–527.
  11. Akinbami LJ, Ogden CL. Childhood overweight prevalence in the United States: The impact of parent‐reported height and weight. Obesity. 2009; 17: 1574–1580. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19629061
  12. Rosenblatt RA, Chen FM, Lishner DM, Doesher MP. WWAMI Rural Health Center. The future of Family Medicine and Implications for Rural Primary Care Physician Supply. Grand Forks, ND. 2010.
  13. Warshaw R. Health Disparities Affect Millions in Rural U.S. Communities. 2017. https://www.aamc.org/news-insights/health-disparities-affect-millions-rural-us-communities
  14. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance. 2011. http://www.cdc.gov/std/stats11/adol.htm
  15. Heckman JJ. Sample Selection Bias as a Specification Error. Econometrica. 1979; 47: 153-161.
  16. Borjas GJ, Sueyoshi GT. A two-stage estimator for probit models with structural group effects. J Econometrics. 1994; 64: 165-182. PubMed:
  17. Frenzen PD. Health insurance coverage in US urban and rural areas. J Rural Health. 1993; 9: 204-214. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10128159
  18. Casey MM, Thiede Call K, Klingner JM. Are rural residents less likely to obtain recommended preventive healthcare services? Am J Prev Med. 2001; 21: 182-188. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11567838
  19. Bennett KJ, Probst JC, Pumkam C. Obesity among working age adults: the role of county-level persistent poverty in rural disparities. Health Place. 2011; 17: 1174-1181. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21665515
  20. Befort CA, Nazir N, Perri MG. Prevalence of obesity among adults from rural and urban areas of the United States: findings from NHANES (2005‐2008). J Rural Health. 2012; 28: 392-397. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23083085
  21. Cronk CE, Sarvela PD. Alcohol, tobacco, and other drug use among rural/small town and urban youth: a secondary analysis of the monitoring the future data set. Ame J Public Health. 1997; 87: 760-764. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9184502
  22. Donnermeyer JF, Scheer SD. An analysis of substance use among adolescents from smaller places. J Rural Health. 2001; 17: 105-113. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11573460
  23. Hartley D. Rural health disparities, population health, and rural culture. Ame J Public Health. 2004; 94: 1675-1678. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15451729
  24. Jilcott SB, Laraia BA, Evenson KR, Ammerman AS. Perceptions of the community food environment and related influences on food choice among midlife women residing in rural and urban areas: a qualitative analysis. Women Health. 2009; 49: 164-180. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19533508
  25. Agency for Healthcare Research and Quality. National Healthcare Quality and Disparities Report chartbook on rural health care. Rockville, MD: Agency for Healthcare Research and Quality. Rockville, MD: AHRQ. 2017.

Figures:

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?