An Integrative Review of Literature Regarding Health Concerns of Rural Dwelling Adolescents

Those living in rural areas face particular risks to health and well-being as they are more likely to be poor, have no health insurance, and have less access to health care. Many obstacles exist in achieving optimal rural health outcomes. Many of the health related issues experienced by adolescents are preventable and are often related to risky behavior such as substance use and abuse, smoking, and unprotected sex. The purpose of this review is to define the current primary health concerns of rural dwelling adolescents worldwide. Based on current research, the primary health related problems of rural adolescents were identified as risky sexual behaviors, mental health issues, violence and bullying, substance and alcohol use, and overweight and obesity. These problems are exacerbated by diminished access to care, peer influences, and parental influences. This integrative review also illustrates many dimensions of health disparities exist in rural areas. When addressing diversity in care models, it is important to consider the rural setting as well as race or ethnicity, sex, and socioeconomic status in designing curriculum and interventions. Globally, evidence based findings are needed to inform curriculum and respond to the health needs of rural adolescents. Health Concerns of Rural Dwelling Adolescents Vol. 9, Issue 1 (2014) 2 Programs and rural initiatives for adolescents can decrease the prevalence of established health problems and lower health care expenditures across life spans. Those living in rural areas face particular risks to health and well-being (United States [U.S.] Department of Health and Human Services [HHS], 2011). Rural dwellers are more likely than their urban counterparts to be poor, have no health insurance, and have less access to health care (Gamm, Hutchinson, Dabney, & Dorsey, 2003; Ziller, Anderson, & Coburn, 2010). Rural health concerns continue to draw attention from policy makers, clinicians and researchers. Healthy People 2020 re-emphasized the 2010 goal to address the health needs among rural U.S. populations (Bolin & Gamm, 2003; HHS, Healthy People 2020, 2011). Nonetheless, many obstacles exist in achieving optimal rural health outcomes. The purpose of this article is to synthesize findings from an integrative literature review on the current state of rural health needs for adolescents. Adolescence is typically considered to occur between the ages of 13 and 19 years (American Academy of Child and Adolescent Psychiatry, 2008). During these years, adolescents become more independent and autonomous and often make decisions with lifetime implications for their health. Many of the health related issues experienced by adolescents are preventable and are often related to risky behavior by adolescents (Shannon & Broussard, 2011). Risky behaviors such as substance use and abuse, smoking, and unprotected sex have been targeted as leading health indicators for adolescent health in the Healthy People 2020 initiative (HHS, Healthy People 2020, 2011). Adolescents living in rural areas may be at greater risk for poor health outcomes than their urban and suburban counterparts (Curtis, Waters, & Brindis, 2011). An integrative review was undertaken to determine the most common health concerns of rural dwelling adolescents as a path to develop evidence-based curriculum and interventions that are likely to promote health in rural youth at risk.