Rural Adolescent Health: The Importance of Prevention Services in the Rural Community


  • Alexa C. Curtis RN, FNP, PhD,

    1. Division of Nursing, California State University, Sacramento, California
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  • Catherine M. Waters RN, PhD,

    1. Department of Community Health Systems, School of Nursing, University of California, San Francisco, California
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  • Claire Brindis DrPH

    1. Department of Pediatrics, Division of Adolescent Medicine; Department of Obstetrics, Gynecology and Reproductive Health Sciences; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California; National Adolescent Health Information and Innovation Center, and Policy Information and Analysis Center for Adolescence and Young Adulthood, University of California, San Francisco, California
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  • This research was supported in part by grants from the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services (U45MC 00002 and U45MC 00023). For further information, contact: Alexa C. Curtis, RN, FNP, PhD, Division of Nursing, California State University, Solano Hall 5012, 6000 J Street, Sacramento, CA 95819-6096; e-mail:


Context: Adolescence is a pivotal developmental period for the establishment of positive health and health practices. However, developmentally propelled risk behaviors coinciding with barriers to health services may increase the propensity for untoward health outcomes in adolescence. In addition, the sociocultural context of the rural environment can present challenges to the health of adolescents. Limited data on rural adolescent health, particularly among population subgroups, hinder the ability to adequately advocate for adolescent health prevention services.

Methods: A secondary analysis of the 2005 California Health Interview Survey Adolescent questionnaire was conducted. Selected survey items corresponding to the Healthy Youth 2010 objectives were analyzed for 663 adolescents aged 12-17 residing in rural regions of California. Adolescent subgroup analysis included race/ethnicity, age, and poverty level.

Findings: Adolescent health issues of particular concern in this study include sexual health, substance use, mental health, and risk factors for obesity. Predictably, risk behaviors increase with the age of the adolescent. Minority and poor youth demonstrate the greatest vulnerability to untoward health outcomes.

Conclusion: Significant risk behaviors and health concerns exist among the rural adolescent population, particularly among poor and minority youth, arguing for the creation and preservation of prevention services for youth in the rural community. Future research using alternative sampling methodologies may be necessary to adequately represent the higher-risk adolescent in the rural community. More data are needed on vulnerable adolescent populations in the rural community in order to adequately advocate for prevention services.