The Impact of Rurality on Likelihood of Drunk Driving and Riding With a Driver Under the Influence Among High School Students

Purpose The purpose of this study was to examine the importance of rural location in the likelihood of adolescent drunk driving and riding in a vehicle with a driver under the influence while controlling for a variety of student-, school-, and county-level factors. Methods Data from the 2013 Georgia Student Health Survey (GSHS) II (a statewide assessment of student health in public school students in Georgia) were analyzed using multilevel binary regressions to examine rural-urban differences in prevalence of driving under the influence (11th and 12th graders only; n = 114,907) and riding with a driver under the influence (9th-12th graders; n = 258,610), controlling for school-level race, gender, and income, in addition to county-level education level, unemployment, alcohol use, and smoking. Findings Across geographies, students were twice as likely to report riding with a driver under the influence (10.32%) as driving under the influence (4.16%). While both outcomes were more likely among rural adolescents in unadjusted analyses, in adjusted analyses, rural adolescents were not significantly more likely to drive under the influence (ORadj = 1.19; P = .055), but they were significantly more likely to ride with a driver under the influence (ORadj = 1.18; P = .002). Conclusions Our findings suggest that riding with a driver under the influence rather than driving under the influence may be a more pressing public health issue for adolescents in rural areas. Future research focused on the formative work necessary to build novel, culturally tailored interventions should be conducted to minimize the associated substantial burden of motor vehicle deaths within rural adolescents

Rural/Urban Differences in Drunk Driving and Riding with a Drunk Driver among Students

Purpose: The study examined rural/urban differences in driving under the influence and/or riding in a car driven by someone under the influence among high school students throughout Georgia. Methods: As part of the 2013 Georgia Student Health Survey II, administered annually throughout the public school system in Georgia, students were asked whether they had driven a car while under the influence and whether they had ridden in a car driven by someone else who was under the influence (past 30 days). Responses from 114,907 11th-12th grade students for driving under the influence and 268,610 9th-12th grade students on riding in a car driven by someone under the influence were analyzed using mixed binary linear regressions adjusted for individual, school, and county-level effects. Results: While only 4% of 11th and 12th grade students reported driving under the influence, over 10% of students reported having ridden in a car with a driver who was under the influence. In adjusted analyses, while rural students were not more likely to have driven under the influence, they were 18% more likely to have ridden in a car driven by someone under the influence (ORADJ = 1.18; 95% CI: 1.07-1.31). Conclusions: Driving under the influence and riding with an impaired driver seem to be distinct risk behaviors. Although there were no differences between rural/urban students in prevalence of driving under the influence, rural students were more likely to ride in a car with an impaired driver. Implications for health education and program development will be discussed

Cross-cultural Models of Suicide Risk

Only a handful of empirical investigations have identified culturally salient markers of suicide risk within samples of African American young adults. To address this gap, our study examined the intercorrelations among cultural congruity, defectiveness schemas, and multiple indices of suicide risk for African American (n = 207) and European American (n = 208) students attending a primary White institution. Cultural congruity was negatively associated with reports of interpersonal and behavioral suicide risk for both African and European American students. However, ethnic differences in the magnitude of these relationships emerged. Specifically, as predicted, for African Americans, lower levels of cultural congruity were more strongly related to greater interpersonal factors associated with a desire to die. Finally, the relationships between cultural congruity and multiple indices of suicide risk were partially mediated by defectiveness schemas for both African and European American students, suggesting a useful intervention target for students. These results also have implications for suicide screening, prevention, and intervention strategies directed toward African American students