UCSF

ABSTRACT

HEALTH AND ITS CONTEXTUAL DETERMINANTS OF RURAL ADOLESCENTS IN CALIFORNIA

Alexa Colgrove Curtis

Background: Adolescence is a critical developmental period, providing the foundation for both opportunity and risk in adult life. The sociocultural context of the rural community presents unique challenges for rural adolescent health. Patterns of connectedness between the adolescent and the social environment have demonstrated mitigation of risk behaviors in previous studies.

Purpose: To describe the health of rural adolescents, 12 to 17 years, in California and to explore the relationship between health behaviors and connectedness to the social context among middle adolescents, ages 14 to 17 years, in the rural community.

Method: A secondary data analysis of the 2005 and 2003 Adolescent California Health Interview Survey (CHIS) was conducted in an ethnically and economically diverse sample of 663 and 492, respectively. The 2005 CHIS survey was used to examine the rural adolescent health in California. The 2003 CHIS survey was used to examine the influence of social connectedness on health behaviors.

Results: A majority of rural adolescents in California report good to excellent health however significant risk behaviors exist including impaired fitness and nutrition, sexual health risks, substance use, depression, and intra-personal violence. The most influential connectedness factor demonstrating reduced health risk is the home environment, in particular an adult within in the home who "believes the adolescent will be a success". Although the majority of rural adolescents can identify a usual source of care, few are certain they can access confidential services. Many adolescents, particularly minority and low income youth, rely upon community health services.

Conclusions: Adolescence is a critical developmental period and adolescents are a potentially vulnerable population. Health risks exist within the rural adolescent population at least equivalent to urban and suburban settings but rural adolescents may be particularly vulnerable related to limited resources to support positive development. Connnectedness to social contexts are important for the health of middle adolescents in the rural community. Further research is required examining health and health behaviors, and relationship to social connectedness in rural adolescents. Research that adequately samples high risk rural adolescents is particularly needed.