The importance of fulfilling unmet needs of rural and urban adolescents with substance abuse

Epidemiology of drug use among biracial/ethnic youth and young adults: results from a U.S. population-based survey

This study estimates the prevalence of cigarette, alcohol, and marijuana use in a nationally representative sample of monoracial/ethnic and biracial/ethnic youth and young adults. The authors consider 16 racial/ethnic categories and used four waves of data from the National Longitudinal Study of Adolescent Health. The analysis sample consists of 20,745 individuals in Wave 1. The primary statistical methodology used in the present study is logistic regression with sample weights. Findings suggest that participants who self-report two races/ethnicities have prevalence rates that are intermediate to those of the two corresponding monoracial/ethnic rates. For example, Black-American Indians reported cigarette smoking rates that were significantly lower than rates reported by American Indians but significantly higher than rates reported by Blacks. Groups with the highest prevalence of cigarette smoking at Wave 1 were American Indian, White-American Indian, White, and Multiracial (people reporting three or more races/ethnicities). Groups with the highest prevalence of alcohol drinking at Wave 1 were White-American Indian, Multiracial, Hispanic, White, and White-Hispanic. Groups with the highest prevalence of marijuana smoking at Wave 1 were Black-Asian and American Indian. The authors found an interaction effect between race/ethnicity and socioeconomic status. Lower-class SES status may serve as a risk factor for biracial/ethnic adolescents while upper-class SES may serve as a protective factor for these youth. In general, biracial/ethnic individuals have prevalence rates that are intermediate to those of the two corresponding monoracial/ethnic rates.

Rural-urban migration patterns and mental health diagnoses of adolescents and young adults in British Columbia, Canada: a case-control study

BACKGROUND

The identification of mental health problems early in life can increase the well-being of children and youth. Several studies have reported that youth who experience mental health disorders are also at a greater risk of developing psychopathological conditions later in life, suggesting that the ability of researchers and clinicians to identify mental health problems early in life may help prevent adult psychopathology. Using large-scale administrative data, this study examined whether permanent settlement and within-province migration patterns may be linked to mental health diagnoses among adolescents (15 to 19 years old), young adults (20 to 30 years old), and adults (30 years old and older) who grew up in rural or urban communities or migrated between types of community (N = 8,502).

METHODS

We conducted a nested case-control study of the impact of rural compared to urban residence and rural-urban provincial migration patterns on diagnosis of mental health. Conditional logistic regression models were run with the following International Classification of Diseases, 9th Revision (ICD-9) mental health diagnoses as the outcomes: neurotic disorders, personality disorder, acute reaction to stress, adjustment reaction, depression, alcohol dependence, and nondependent drug abuse. Analyses were conducted controlling for paternal mental health and sociodemographic characteristics.

RESULTS

Mental health diagnoses were selectively associated with stability and migration patterns. Specifically, adolescents and young adults who were born in and grew up in the same rural community were at lower risk of being diagnosed with acute reaction to stress (OR = 0.740) and depression (OR = 0.881) compared to their matched controls who were not born in and did not grow up in the same rural community. Furthermore, adolescents and young adults migrating between rural communities were at lower risk of being diagnosed with adjustment reaction (OR = 0.571) than those not migrating between rural communities. No differences were found for diagnoses of neurotic disorders, personality disorder, alcohol dependence, and nondependent drug abuse.

CONCLUSIONS

This study provides some compelling evidence of the protective role of rural environments in the development of specific mental health conditions (i.e., depression, adjustment reaction, and acute reaction to stress) among the children of sawmill workers in Western Canada.

A Systematic Review of Recent Literature on Religiosity and Substance Use

This paper contains a systematic review of articles about the relationship between religiosity/spirituality and alcohol and drug use that were published between 1997 and 2006. Summaries of methodological characteristics (e.g., study design, sample size and composition, specific dimensions of religiosity, and substances investigated) and general findings of 105 studies provide an overview of the field. The association between religiosity/spirituality and reduced risk of substance use is well established, but a well defined body of knowledge on this relationship has been slow to emerge. The development of more sophisticated instrumentation to measure religiosity and spirituality, the investigation of samples that include users of major drugs of abuse, and the integration of the study of religion and drug use into the broader literature on religion and health can help the field build upon the considerable work that has been published.

Rural Mexican-American Adolescent Sexual Risk Behavior

CONTEXT

There is a need for community-based, culturally sensitive, cognitive-behavioral interventions to reduce sexual risk behavior among minority adolescents. Studies of adolescent risk and protective behaviors have focused on identifying modifiable psychosocial variables that predict differential outcomes for subsequent intervention efforts. Research has been scarce in studies of rural minority adolescent women.

PURPOSE

To examine the protective and risk behaviors of these rural Mexican-American adolescent women and their relationship to physical or sexual abuse.

METHODS

Mexican-American adolescent women aged 14-19 years were recruited through a rural health clinic and administered a self-report assessment for protective and risk behavior and sexual, physical, and psychological abuse.

FINDINGS

Rural minority adolescent women endured high levels of psychological distress and many risk behaviors yet experienced few protective behaviors. Barriers to health care included access and confidentiality. Physically or sexually abused adolescents endured relatively greater risk and fewer protective behaviors than nonabused.

CONCLUSIONS

Rural Mexican-American adolescent women may benefit from confidential identification and assessment of abuse history and risk and protective behaviors so that appropriate psychological treatment can accompany accessible medical treatment. The prevalence of risk behaviors and abuse among these women presents a need for development of behavioral interventions for risk reduction and promotion of health protective behaviors.