Adolescent substance use, sexual behavior, and metropolitan status: is “urban” a risk factor?

doi:10.1016/S1054-139X(03)00016-8

Journal of Adolescent Health

Volume 32, Issue 5, May 2003, Pages 350-355

https://doi.org/10.1016/S1054-139X(03)00016-8 Get rights and content

Abstract

Purpose

To determine if urban youth (“metropolitan” status) are at greater risk of engaging in risk behaviors than suburban or rural youth.

Methods

We analyzed data on substance use and sexual risk behaviors from the national school-based Youth Risk Behavior Survey (YRBS) conducted in 1999, an anonymous questionnaire self-administered by students in grades 9 through 12. The national survey employs a multistage cluster sample to produce a nationally representative sample of high school students. Data were analyzed using SUDAAN software to take into account the sampling model.

Results

In 1999, metropolitan status was not a significant determining factor for involvement in risk behaviors. Of the specific risk factors examined in this analysis, there were no significant differences between rural and suburban youth, and these two groups were combined as “nonurban.” In subsequent analysis of urban vs. nonurban youth, no significant differences in risk behaviors were found on bivariate or multivariate analyses.

Conclusions

This analysis suggests that metropolitan status has little if any association with youth engaging in substance use and sexual risk behaviors. In addition, it appears that urban youth are engaging in these risk behaviors no more frequently than their nonurban counterparts.

Section snippets

Procedure

The YRBS uses a three-stage cluster sample design to produce a nationally representative sample of high school students. The survey methodology has been described in detail elsewhere [6]. For the 1999 national survey, 15,349 questionnaires were completed in 144 schools, giving a school response rate of 77% and a student response rate of 86%. A weighting factor was applied to each student to adjust for nonresponse and the varying probabilities of selection [6].

Survey procedures were designed to

Results

The data set was divided into three groups: urban, rural, and suburban. Differences in demographic variables among the three metropolitan subgroups were analyzed using Chi-square calculations (Table 1). There were no significant differences among the groups on the basis of gender and grade, however the urban group had significantly more minority respondents than either the rural (p = .02) or the suburban (p = .008) groups. The rural and suburban groups did not differ significantly from each

Discussion

No significant differences were found among urban, suburban, and rural youth with regard to substance use or sexual risk behaviors when accounting for race/ethnicity. These results are surprising for a number of reasons. First, the focus in the literature on urban youth suggests that this is a particularly at-risk population [1]. Second, the findings of the CDC report on urban–rural health disparities suggest that suburban teens (those living in the fringe counties of large metropolitan areas)

Limitations

This is one of very few analyses that specifically examine the association between metropolitan status and youth risk behaviors. In addition, the findings differ from similar studies using other datasets 3, 4, 5. Several factors may have contributed to these differences. The YRBS is not designed for the purpose of examining metropolitan status as a key demographic variable. In addition, the dichotomous recoding of variables may also have masked significant differences among the groups. It is

Conclusions

Considering the paucity of previously published work in this area and the noted limitations of this analysis, it is important for there to be more research on the similarities and differences among youth risk behaviors in different metropolitan/non-metro areas. This is not merely an academic enterprise: our research findings on at-risk youth can influence public policy and funding for public health programs. Our work suggests that the risk behaviors of urban and nonurban youth are more similar

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Original articleAdolescent substance use, sexual behavior, and metropolitan status: is “urban” a risk factor?

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Procedure

Results

Discussion

Limitations

Conclusions

Integrative research review of risk behaviors among adolescents in rural, suburban, and urban areas

J Adolesc Health

Urban and Rural Health Chartbook. Health, United States, 2001

No Place to HideSubstance Abuse in Mid-Size Cities and Rural America

Alcohol, tobacco, and other drug use among rural/small town and urban youthA secondary analysis of the Monitoring the Future Data Set

Am J Public Health

Contrasting levels of adolescent drug use between adjacent urban and rural communities in Scotland

Addiction

Original article
Adolescent substance use, sexual behavior, and metropolitan status: is “urban” a risk factor?