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Researchers Say Rural Youth At Risk

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Rural youth are nearly four times as likely to smoke cigarettes frequently and more likely to drink alcoholic beverages and ride in a car with a driver who has been drinking than their urban counterparts, according to University of California researchers.

These unhealthy behaviors are revealed in “California´s Rural Youth,” a new report on the health and well-being of adolescents ages 12 to 17 in rural California by the 4-H Center for Youth Development at UC Davis.

“The higher rates of smoking among rural youth are of great concern,” said lead author Katherine Heck, UC 4-H Youth Development associate specialist. “In the future, many of these young people will face health problems because of smoking. We found that about 8 percent of rural adolescents smoked cigarettes regularly, and more than half of them began smoking before age 13.” It is illegal for persons under age 18 to purchase cigarettes in California.

Heck and her colleagues also noted significantly more rural youths (39 percent) than urban youths (29 percent) have imbibed alcohol. More than one in four (26 percent) rural California adolescents has ridden with a driver who had been drinking alcohol whereas 17 percent of urban youth have.

“Rural areas often lack public forms of transportation that might be available in urban areas, so drinking and driving may be a greater problem for rural youth,” she reasons.

Despite certain challenges, rural adolescents have bright futures, according to Stephen Russell, director of the 4-H Center for Youth Development. “Most rural youth, 79 percent, said there was a purpose to their lives, and 82 percent reported having goals and plans for the future,” Russell said.

Russell, a UC Cooperative Extension youth development specialist, noted that 65 percent of rural youth reported they had an adult at home who talked with them about their problems, and 77 percent had an adult at home who listens when they have something to say.

“The close relationships rural youth have with their parents and other family members can help reduce adolescents´ risk behaviors,” he said.

The UC researchers also found that about 14 percent of California´s rural youth had no health insurance in 2001, compared with 11 percent of adolescents statewide. Those rural youth who did have insurance were more likely to be insured through public programs such as Medi-Cal or Healthy Families; more than one in four rural adolescents had coverage through Medi-Cal. Fewer than half of rural adolescents had employer-sponsored health insurance.

“Health insurance is critical to receiving adequate preventive care,” Heck said. “Rural youth are at particularly high risk for being uninsured and may not receive needed health care as a result.”

A need for health care may be reflected in the fact that only 45 percent of rural adolescents in California reported that they were in very good or excellent health compared with the 82 percent of adolescents nationally who reported themselves to be in very good or excellent health.

The shortage of healthcare workers in rural areas lowers access to quality health care in rural communities, according to the California State Rural Health Association, a Sacramento-based nonprofit organization that advocates improved health and health care for rural Californians.

“The number of adolescents leaving rural areas after high school is alarming,” says Lauri A. Medeiros-Paoli, CSRHA executive director. The study found almost one-quarter fewer 19-year-olds in rural areas than 17-year-olds, confirming that a large number of adolescents leave rural areas when they finish high school.

“To ensure rural residents receive the care they deserve,” Medeiros-Paoli says, “it is particularly important to encourage our rural youth to seek employment and education in the health professions through local community colleges and other training programs so they do not have to move to larger cities.”

Other key findings of the study:

One in five of California´s rural adolescents was born outside the United States; 46 percent speak a language other than English at home.

Almost half (48 percent) of rural adolescents in California are Latino.

More than 15 percent of California´s rural youth lived in families whose income was below the poverty line in 1999, compared with 18 percent for youth in the state as a whole.

Students in rural areas are less likely to drop out of school than are students in other areas. In the 2001-2002 school year, about 1.5 percent of students in rural schools dropped out of school n less than half the drop-out rate for students who attended schools in urban areas.

“The results of this study will certainly help us fine-tune our 4-H youth development programs for rural youth,” said Carole MacNeil, UC´s statewide director for 4-H Youth Development. “The fourth ‘H´ stands for health, and for many decades we have offered programs that support young people in developing healthy lifestyles, including nutrition education, substance-abuse prevention and other aspects of good health. Research such as this helps us target our programmatic efforts more effectively.”

Rural areas are generally considered to have fewer than 250 people per square mile.

To gather data for the report, Heck collaborated with UC colleagues John A. Borba, 4-H youth development advisor for Kern County; Ramona Carlos, research associate, UC 4-H Center for Youth Development; Ken Churches, 4-H youth development advisor for Calaveras County; Susan Donohue, Expanded Food and Nutrition Education Program advisor for Butte County; and Arlene Hyde Fuller, 4-H program representative for Mendocino County. The report draws from multiple sources of data from state and local levels, including the California Health Interview Survey, the California Healthy Kids Survey and the National Longitudinal Study of Adolescent Health.

To obtain a copy of the report, contact the UC 4-H Center for Youth Development, (530) 754-8433,

Calaveras Enterprise story by Ken R. Churches.

Ken R. Churches, a regular contributor to the Enterprise, is the Calaveras County Farm Advisor, an employee of the University of California Cooperative Extension. His office is in San Andreas.