Alcohol Use among Rural Middle School Students: Adolescents, Parents, Teachers, and Community Leaders' Perceptions

By de Haan, Laura; Boljevac, Tina | Journal of School Health, February 2009 | Go to article overview

Alcohol Use among Rural Middle School Students: Adolescents, Parents, Teachers, and Community Leaders' Perceptions


de Haan, Laura, Boljevac, Tina, Journal of School Health


Over 14 million children and adolescents, comprising 20% of US children, live in rural areas. Although the rural economy has changed significantly over the past 50 years (ie, less reliance on farming, aging demographics, smaller family size), many policy makers rely on "outdated yet still popular images of rural family life." (1(p1) Rural adolescents face fewer curricular choices, structured school activities, fewer job prospects, and geographic isolation. (2) These factors may be why risk behaviors among adolescents living in rural areas are accelerating concurrently and, in many cases, faster than national levels. (3) One important risk behavior is alcohol use. When examining alcohol use among rural and urban adolescents, studies have found either few differences (4) or increased rural adolescent consumption, (3) with adolescents living in the Midwest and Northern Plains the most likely to consume alcohol. (5) Rural adolescents were also considerably more likely to drink and drive. (6) One study of rural high school students found that 75% had reported lifetime alcohol use. (7)

One factor predicting long-term negative outcomes is age of onset. Early alcohol use has been found to significantly predict higher levels of use later in adolescence and adulthood. (4,8-11) Drinking during the preadolescent years (aged 10-12 years) was strongly associated with later alcohol misuse in a national sample of adolescents. (12) The correlation between early and later use persisted until young adulthood, even if alcohol use was reduced at some time during adolescence. (13) Thus, understanding early adolescent use in rural areas is particularly important.

Few studies have focused on both adolescent and adult community norms, that is, attitudes regarding adolescent alcohol use. Parental norms have been related to adolescent alcohol use both in late childhood and in early adolescence. (14,15) Adolescents who perceived their parents' views toward alcohol as negative started drinking later and were less influenced by peer norms. (16) Adolescent perceptions of friends' and peer drinking were also significantly related to actual use. (17,18)

One alcohol-related norm is the estimation of perceived use by both adolescents and adults. Students in middle/high school and college overestimated the alcohol consumption levels of both their friends and the general student body, (19) but parents of both younger and older adolescents were more likely to underestimate their children's drinking. (20,21) In a rural study, both adolescents and adults overestimated community adolescent alcohol use, but middle school adolescents were more restrictive about drinking acceptability than older adolescents. (22) Less is known about the attitudes of other community leaders or how these norms relate to actual adolescent alcohol use in rural communities.

This article focuses on alcohol-related attitudes and behaviors of rural middle school students, parents, teachers, and other community leaders in 22 rural communities in the Upper Midwest. Three research questions are explored: (1) Which factors distinguish between adolescents who have tried alcohol, or have been drunk, from those who have not? (2) Are there differences in attitudes among community parents, teachers, and other community leaders in relation to adolescent alcohol use? and (3) Are these attitudes related to actual use?

METHODS

Four states were selected from the 1999 National Household Survey on Drug Abuse (23) and scored among the highest nationally in adolescent (aged 12-17 years) binge drinking: North Dakota (the highest nationally), South Dakota, Wyoming, and Wisconsin. Because these states are in the Upper Midwest and have predominately Caucasian populations, findings may have limited generalizability to other racial and ethnic groups.

Selection of Communities

Census data were used to determine towns meeting necessary criteria in terms of population and distance from urban areas. …

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