Cutler Institute for Health and Social Policy

Population Health and Health Policy

Adolescent Alcohol Use in Rural Areas: What are the Issues?

1/1/2008 - 1/31/2009
John Gale
Principal Investigator: 
David Hartley, Ph.D., M.H.A.

Previous research has shown that rural adolescents are more likely to use alcohol than those in urban areas adolescents and that the more rural the area, the higher the use. Moreover, current knowledge suggests that risk and protective factors may operate differently for rural adolescents. Methods: This study will use five years of NSDUH pooled data to examine the underlying factors that account for urban-rural and intra-rural differences in adolescent alcohol use and how this knowledge may be used to develop targeted alcohol prevention and intervention programs for rural youth. The specific research questions we wish to address are: <li>What are the prevalence and use patterns of adolescent alcohol (e.g. rates of past month use, age of first use, binge and heavy drinking and driving under the influence) across the urban-rural continuum? Do prevalence rates and use patterns vary by age, gender, ethnicity/race, and geographic region?
<li>What is relationship of developmental, individual, and environmental factors on adolescent alcohol use across the urban rural continuum?
<li>What is the relationship and relative importance of, key protective and risk factors in explaining intra-rural variations in adolescent alcohol use? Do these factors vary by age, gender, ethnicity, and geographic region?
<li>How may this information inform the development of prevention and early intervention strategies targeting rural areas and populations?

Start Date: 
Tue, 2008-01-01
End Date: 
Sat, 2009-01-31
Legacy Muskie ID: 
5 848

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Dr. Ziller to speak on Rural Implementation and Impact of Medicaid Expansions

The impact of the ACA Medicaid expansion on health care coverage and access in rural areas is largely unknown and will depend on the different state policy contexts in which the expansions are implemented and on existing system capacity. Understanding how many rural residents are likely to become newly eligible for Medicaid under the ACA, as well as their characteristics and health status, will provide important information to aid policymakers in structuring outreach and enrollment strategies and ensuring that the healthcare infrastructure and delivery systems in rural areas can address the needs of these individuals.

On March 18th, Dr. Ziller, Deputy Director of the Maine Rural Health Research Center at the University of Southern Maine, will present via a SHARE webinar, nationally representative information identifying rural-urban differences among low-income non-elderly adults (18 to 65) in the following areas:

  • Medicaid eligibility, pre-ACA
  • Medicaid participation, pre-ACA
  • New Medicaid eligibility in 2014

Dr. Ziller will also analyze the characteristics associated with any rural-urban differences in the above areas. Characteristics to be considered include age, gender, employment, education, income, Census region, health status, current relationship to primary care provider, primary care supply, and FQHC availability.

This webinar is based on Dr. Ziller's research under a State Health Access Reform Evaluation (SHARE) grant to inform federal and state implementation of the ACA Medicaid expansion by estimating the size and characteristics of the rural population likely to be newly eligible.
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