The role of community assets in adolescent substance use across rural and urban contexts.
 
 Mikaela Rojas, MPH, Natasha De Silva, MPH, Xiao Zhang, MPHc, Nazar Madaski, MPHc, Jennifer Unger, Myriam Forster
 
Introduction: There is considerable evidence that living in rural areas can increase risk for negative health outcomes. Strong community connectedness, that may be more easily forged in more densely populated urban settings, can have substantial health benefits. To assess these relationships, we investigate the associations between community assets (i.e., religious groups, sports programs, opportunities to serve others in the community, etc.), urbanicity, and adolescent substance use (alcohol, cannabis, and nicotine).
 
Methods: Data are baseline survey responses (N=2,360) of high school students, linked to geospatial indices of urbanicity (RUCA), participating in a multisite school-based study. GLMs tested the hypothesized associations between community assets and adolescents’ substance use (alcohol, cannabis, and nicotine), adjusting for age, sex, state, and ethnicity. We also explored whether the community assets-substance use relationship varied across levels of urbanicity.
 
Results: The sample was 52% female and was on average 16 (SD=2.0) years old. Approximately 31% of participants identified as Non-Hispanic White, followed by African American (29%), Hispanic (24%), Multi-Ethnic (9%), and Asian (7%). Nearly 1 in 4 (23%) adolescents reported alcohol use, 16% reported cannabis use, and 9% used nicotine. Compared to youth with low community assets, adolescents with robust community assets reported lower risk for alcohol use (AOR: 0.54, 95% CI:0.42-0.70) and cannabis (AOR: 0.42, 95% CI:0.42-0.76) use, but not nicotine use. However, youth with robust community assets living in rural settings had lower risk of alcohol and cannabis use than youth with robust community assets living in urban settings (p<0.01).
 
Discussion: Our results highlight that robust community assets play an essential role in adolescent health behaviors, especially for youth living in rural communities. Investing in rural community programs (i.e., recreational activities, faith-based groups) that encourage connections between young people and with adults not only facilitates social bonds but may be a promising substance use prevention approach