Adolescent substance use, sexual behavior, and metropolitan status: is "urban" a risk factor?
OBJECTIVE
To determine if urban youth ("metropolitan" status) are at greater risk of engaging in risk behaviors than suburban or rural youth.


METHODS
We analyzed data on substance use and sexual risk behaviors from the national school-based Youth Risk Behavior Survey (YRBS) conducted in 1999, an anonymous questionnaire self-administered by students in grades 9 through 12. The national survey employs a multistage cluster sample to produce a nationally representative sample of high school students. Data were analyzed using SUDAAN software to take into account the sampling model.


RESULTS
In 1999, metropolitan status was not a significant determining factor for involvement in risk behaviors. Of the specific risk factors examined in this analysis, there were no significant differences between rural and suburban youth, and these two groups were combined as "nonurban." In subsequent analysis of urban vs. nonurban youth, no significant differences in risk behaviors were found on bivariate or multivariate analyses.


CONCLUSIONS
This analysis suggests that metropolitan status has little if any association with youth engaging in substance use and sexual risk behaviors. In addition, it appears that urban youth are engaging in these risk behaviors no more frequently than their nonurban counterparts.
Levine
Sara B
SB
Department of Pediatrics, Residency Program in Social Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York, USA.
Coupey
Susan M
SM
D000293:Adolescent; D000294:Adolescent Behavior; D035841:Behavioral Research; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D012424:Rural Population; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D013334:Students / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013383:Suburban Population; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014505:Urban Population