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Explaining behavioral health differences in urban and rural sexual minority adolescents
dc.contributor.authorGoldbach, Jeremy T.
dc.contributor.authorParra, Luis A.
dc.contributor.authorO’Brien, Rory P.
dc.contributor.authorRhoades, Harmony
dc.contributor.authorSchrager, Sheree M.
dc.date.accessioned2023-01-11T16:27:51Z
dc.date.available2024-02-11 11:27:50en
dc.date.available2023-01-11T16:27:51Z
dc.date.issued2023-01
dc.identifier.citationGoldbach, Jeremy T.; Parra, Luis A.; O’Brien, Rory P.; Rhoades, Harmony; Schrager, Sheree M. (2023). "Explaining behavioral health differences in urban and rural sexual minority adolescents." The Journal of Rural Health 39(1): 262-271.
dc.identifier.issn0890-765X
dc.identifier.issn1748-0361
dc.identifier.urihttps://hdl.handle.net/2027.42/175524
dc.description.abstractPurposeExperiences of sexuality-based discrimination (ie, minority stressors) against youth who identify as nonheterosexual (ie, sexual minority) have been associated with increased symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD) for sexual minority adolescents (SMA; ages 14-17). However, little is known about the experiences of SMA living in rural communities across the United States. Thus, the present study sought to examine differences in mental health patterns between urban and rural dwelling SMA, and to see whether these differences are, at least in part, explained by experiences of lifetime minority stress.MethodsA nationwide sample of SMA residing in the United States (N = 2,558; aged 14-17, M = 15.90 years, SD = 0.98) was recruited through purposive social media and respondent-driven sampling methods to complete a cross-sectional survey online. Measures included those of minority stress, urbanicity, and symptoms of anxiety, depression, and PTSD. Parallel multiple mediation (PMM) analysis was employed to test whether urbanicity was associated with anxiety, depressive, and PTSD symptoms through reported lifetime minority stress.FindingsOn average, SMA living in rural areas significantly reported more lifetime minority stress, depressive, and PTSD symptoms than SMA living in urban settings. Results from our PMM analysis indicated that heightened experiences of lifetime minority stress indirectly linked the effects of living in rural areas on anxiety (b = –0.288, 95% CI = [–0.491, –0.085]), depressive (b = –0.158, 95% CI = [–0.270, –0.047), and PTSD symptoms PTSD (b = –0.349, 95% CI = [–0.596, –0.105]). The model accounted for 16.8%, 18%, and 24.1% of the variability in anxiety symptoms, depressive symptoms, and PTSD symptoms, respectively.ConclusionsSMA in our study who reside in rural areas reported elevated minority stress, depressive, and PTSD symptoms as compared to their urban dwelling peers. Our study found that lifetime experiences of minority stress fully mediated the relationship between urbanicity and both depressive and PTSD symptoms, and partially mediated the relationship between urbanicity and anxiety. These findings highlight the need to increase support for rural youth who are growing into adulthood and may find continuing challenges in their family, peer, and community relationships.
dc.publisherWiley Periodicals, Inc.
dc.publisherGLSEN
dc.subject.otherurbanicity
dc.subject.otheradolescent
dc.subject.otherLGBT
dc.subject.otherbehavioral health
dc.titleExplaining behavioral health differences in urban and rural sexual minority adolescents
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelPublic Health
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/175524/1/jrh12706_am.pdf
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/175524/2/jrh12706.pdf
dc.identifier.doi10.1111/jrh.12706
dc.identifier.sourceThe Journal of Rural Health
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dc.working.doiNOen
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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