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Abstract: Adolescence is a critical period for the onset of mental health challenges. This project investigates the relationship between living environment (rural, suburban, urban) and depression symptomatology in Black and White adolescents aged 12–18 (n=4,463), using data from the 1994-1995 Wave I of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Depression was measured using an index from the Center for Epidemiologic Studies Depression Scale (CES-D).
Key findings include:
- Rural adolescents exhibited significantly higher mean depression index scores (DIS) compared to suburban peers (p < .001), a relationship that persisted after controlling for race, therapy attendance, and insurance type.
- Black adolescents had significantly higher DIS across all environments compared to White adolescents (p < .001), highlighting racial disparities in mental health outcomes.
- Attending therapy was associated with higher DIS (p < .001), possibly reflecting care-seeking during crises rather than preventive intervention. Adolescents with private insurance or no insurance had lower DIS compared to those with government insurance (p < .001).
While rural living was associated with elevated depression symptomatology, these findings should be interpreted cautiously due to potential confounders, including geographic variation, access to healthcare, and sample composition. These results suggest a need for targeted mental health interventions addressing the unique challenges faced by rural and Black adolescents.