Substance use continues to be a significant problem among youth in our society. While the stereotypical drug-user is an inner-city adolescent, the Substance Abuse and Mental Health Services Administration (SAMHSA; 2006) suggests that adolescents in rural communities are actually more likely than urban adolescents to use alcohol and illegal drugs. Unfortunately, while a substantial amount of research has looked at the overall population of adolescents and substance use, much of the attention has focused on urban populations. Very little research has looked at adolescents living in rural areas.

Even less attention has been given specifically to minority populations living in rural communities. While African American youth are disproportionately exposed to many factors that are believed to be risk factors for substance use (i.e., poverty, crime, single-parent homes), SAMHSA (2006) found that African American youth use alcohol and illegal drugs less often than Caucasian youth. Although substance use is believed to be less prevalent among African American teenagers, Clark et al. (2008) suggest that “the social and health related consequences of drug use are more serious for African Americans than other ethnic groups” (p. 293). Also, while African American adolescents report lower substance use than Caucasian adolescents, by young adulthood, African Americans have surpassed Caucasians in alcohol and drug use (French et al. 2002). Because of this shift during late adolescence and the serious consequences of substance use among African American youth, it is important that we try to understand the risk and protective factors that are at play with regard to African Americans during adolescence and early adulthood. Once we have identified these factors, we can implement programs that aim to strengthen the protective factors and reduce the effects of the risk factors in an effort to provide support to these adolescents as they grow into young men and women.

The purpose of the current study is to identify the possible risk and protective factors that may be affecting the rates of alcohol and illegal drug use among a population of African American adolescents living in a rural, southern community.

Review of the Current Research

Substance Use Among Adolescents

Results from the 2005 Youth Risk Behavior Surveillance System (Centers for Disease Control and Prevention 2006), based on a national probability sample, indicated that 43 % of adolescents had used alcohol and 20 % had used marijuana. The U.S. Department of Health and Human Services (2000) states that alcohol and illicit drug use are associated with many serious problems affecting our country’s adolescents, including violence, injury, and HIV infection. Other research has linked adolescent drug use with homicide (Boyd et al. 2006) and juvenile delinquency (Jordan and Lewis 2005).

Alcohol is included with illegal drug use in the current study because of the extremely serious consequences of alcohol consumption. In 1995, the annual costs from alcohol abuse were estimated to be $167 billion, and the costs from drug abuse were estimated to be $110 billion (DHHS, 2000). The CDC (2007) estimates that excessive alcohol consumption is related to 4,500 deaths (homicides, motor-vehicle crashes, and suicides) per year among adolescents in the United States. Alcohol and drug use is involved in a significant proportion of assaults, automobile accidents, drownings, and other accidental injuries and deaths (Spirito et al. 1997).

Substance Use Among African Americans Adolescents

The Substance Abuse and Mental Health Services Administration (SAMHSA; 2006) found the prevalence of adolescent reported alcohol use for Caucasians was 19 % and 11 % for African Americans. Reported marijuana use was 8 % for Caucasian adolescents and 7 % for African Americans. While other research has also shown that African American adolescents are less likely to report drug and alcohol use than Caucasian adolescents (French et al. 2002; Johnson 2004; Watt and Rogers 2007), by age 35, African Americans surpass whites in drug and/or alcohol-related problems (French et al. 2002). Wallace (1999a, b) suggests that socioeconomic and cultural differences contribute to the higher levels of substance use in adulthood, but Watt and Rogers (2007) point out that it is still “unclear why Black youth (who suffer the same disadvantages as adults) appear to be protected” (p. 55). Clearly identifying the risk and protective factors that affect African American adolescents and young adults would help us develop more effective strategies for preventing and reducing substance use among these young people.

Substance Abuse Among Rural Populations

Despite a media-supported stereotype of high drug use and violence among inner-city minority youth, research is supporting a different conclusion. In 2002, Atav and Spencer studied the health risk behaviors of 2,017 adolescents attending rural, suburban, and urban schools in New York. They found that “a consistent pattern emerged from the analysis of the data with rural students at most risk, followed by suburban and urban adolescents at lower risk” (p. 63). One study (Puskar et al. 2008) looked at 193 high school students in rural Pennsylvania, and found that 49 % drank alcohol, 31 % used pain killers, and 14 % used marijuana. Felton et al. (1996) found alcohol to be the drug of choice among adolescents living in a rural environment, and another study (Bloch et al. 1991), looking at alcohol use among a group of rural 7th–9th graders, found that 62 % had gotten drunk at least once, 20 % got drunk at least once a month, 13 % at least once a week, and 2.6 % at least daily. Overall, it is clear that all of these high-risk behaviors are significant problems in the rural setting (Albrecht et al. 1996; Atav and Spencer 2002).

Risk and Protective Factors Associated with Substance Use

A number of research studies have attempted to identify risk factors that increase the chance of substance abuse among adolescents, as well as protective factors that reduce substance use. Fraser and Terzian (2005) define risk factors as any event, condition, or experience that increases the likelihood that a problem will be formed, maintained, or exacerbated. A protective factor can directly influence the likelihood that a problem will increase, or it can indirectly influence the problem by acting as a buffer against the risk factors.

Having friends who use drugs is probably one of the strongest risk factors for drug use among adolescents (Reinherz et al. 2000). Having friends who pressure the adolescent to use drugs has also been identified as a risk factor (Farrell and White 1998; Hersch 1997), although Wallace and Muroff (2002) suggest that peer pressure to use drugs does not influence African American adolescents as much as other youth. Academic failure has been identified as a risk factor for drug and alcohol use (Bloch et al. 1991; Wallace and Muroff 2002), but again these influences were greater among Caucasian youth than African American youth (Saint-Jean and Crandall 2004; Wallace and Muroff 2002).

Research has also looked at the association between substance use among adolescents and involvement in extra-curricular activities. Borden et al. (2001) found school-based and non-school based extra-curricular activities provided a protective factor against substance use, although peer pressure was identified as the strongest influence on high school students. Hersch (1997) also found extra-curricular activity involvement to be a protective factor.

Other research focused on family factors. One study (Challier et al. 2000) found that the adolescent’s mother being a housewife rather than working outside the home was a protective factor. Another study (Dorius et al. 2004) suggests that an authoritative parenting style may help buffer the influence of peer pressure on adolescents to use drugs. Hersch (1997) found both parental attitudes toward substance use and the amount of time the adolescent spent with adults to be protective factors against substance use.

Method

Study Site

This study utilizes secondary data from a survey conducted by the Family Connections, a group committed to encouraging communication among all human service agencies in order to provide the most effective services to the community. The county surveyed is a rural county in southwest Georgia, with an estimated total population in 2006 of 45,135. The county consists of 61 % Caucasian and 37 % African Americans. Approximately 74 % of the adult population has graduated high school, and 17 % have a college degree. In addition, it is estimated that 17 % of the total population lives below the poverty level, with 25 % of the population under the age of 18 living in poverty (U.S. Census Bureau 2008).

The survey was completed in an effort to identify the prevalence of high risk behaviors among the adolescent population in the county. The survey looks at a broad range of health risk behaviors, including tobacco use, alcohol use, use of illegal drugs, and gang involvement and activities. In addition, it assesses demographic attributes of the adolescent population and extra-curricular activities to help identify possible protective factors.

There are three public middle schools and two public high schools in the county, and all five schools participated in the study. In the 2007–2008 school year, these schools reported a total of 4,815 students. Members of a local voluntary coalition against adolescent drug and alcohol abuse created the survey and distributed it to all of the county’s middle schools and high schools, covering two school systems. Permission forms were developed based on the requirements of the each school system. All teachers were asked to distribute the survey to the students in their classrooms over a 1 week period. Involvement in the project was completely voluntary for both teachers and students. Of the 4,815 total students, 2,668 students completed the survey for a response rate of 55.4 %.

Survey Instrument

The survey included a total of 57 questions. In the three areas of tobacco use, alcohol use, and illegal drug use, students answered questions regarding use, amount, age of initiation, ease of purchasing, parents’ knowledge, family and friends’ use, peer pressure to use, among others. Demographics included age, race, gender, grades in school, and who raises the student. Students also identified their extracurricular activities, who they spend time with in the afternoons after school, as well as the students’ plans after graduating from high school. A copy of the survey instrument is available from the corresponding author.

Participants

Of the 2,668 total students who completed the survey, 42 % (1,043) were African American, 53 % (1,311) were Caucasian, and 5 % (135) were from other racial categories. For the purposes of this study, only the African American students were considered. Among the African American students, 45 % (n = 466) were male and 55 % (n = 574) were female, and the average age was 14.7 years (SD = 1.98). These students reported their academic grades as follows: 11 % (n = 106) receive mostly A’s; 45 % (n = 418) receive mostly B’s; 38 % (n = 353) receive mostly C’s; 2 % (n = 17) receive mostly D’s; and 4 % (n = 41) receive mostly F’s. A majority of the students are being raised either by both parents (50 %, n = 527), one parent (41 %, n = 423), or other family members (6 %, n = 61). The remaining students are being raised by non-family members (1 %, n = 10) or have ‘other’ living arrangements (2 %, n = 17).

Data Analysis

All statistical analyses were completed using the computer package Statistical Package for the Social Sciences (SPSS). In order to identify possible risk and protective factors for African American adolescents, we compared those students who reported alcohol or illegal drug use to those students who reported that they did not use alcohol or illegal drugs. We compared the groups on variables that have been identified in earlier research as possible risk and protective factors. Chi-square analyses were used to identify possible differences between the groups.

Research Questions

The current study attempts to answer the following research question: For African American students living in a rural, southern community, are certain values of the following characteristics associated with alcohol or illegal drug use:

  1. 1.

    Gender;

  2. 2.

    Age;

  3. 3.

    Family members’ and friends’ use of alcohol and illegal drugs;

  4. 4.

    Parental attitudes toward alcohol and illegal drugs;

  5. 5.

    Parents talk to adolescents about dangers of alcohol and drug use;

  6. 6.

    Adolescents’ perception of risk;

  7. 7.

    Peer pressure to use alcohol and illegal drugs;

  8. 8.

    Who does student spend time with after school (parents, friends, alone);

  9. 9.

    Extra-curricular activity involvement (church, sports, band, drama, music);

  10. 10.

    Grades in school;

  11. 11.

    Post-high school graduation plans (college, technical school, work, military, other); and

  12. 12.

    Person(s) responsible for raising the adolescent (both parents, one parent, other family member, non-family member, other).

Any characteristic found to be associated with substance use will be identified as a possible risk factor (associated with more substance use) or protective factor (associated with less substance use) for this sample of adolescents.

Results

Of the 1,043 African American students, 16.8 % (n = 167) reported using alcohol, 6.6 % (n = 67) reported using illegal drugs, 18 % (n = 191) reported using alcohol or illegal drugs or both, and 82 % (n = 852) reported no substance use. While it is not the focus of this study, it is interesting to note that the African American adolescents reported less alcohol use (X 2 = 11.03, df = 1, p = .001) than the Caucasian students. There was not, however, a statistically significant difference between African American and Caucasian students on illegal drug use (X 2 = 1.05, df = 1, p = .306).

Personal/Family Characteristics

Somewhat surprisingly, being male is not a risk factor for substance use among African American adolescents. Males were no more likely than females to use alcohol (X 2 = .163, df = 1, p = .687) or illegal drugs (X 2 = 3.59, df = 1, p = .058). Age is a risk factor for substance use among African American adolescents. Higher ages (15 and older) were associated with increased drug (X 2 = 13.8, df = 1, p < .001) and alcohol use (X 2 = 48.59, df = 1, p < .001). Adolescents being raised by non-family members are significantly more likely to use illegal drugs (X 2 = 22.31, df = 4, p < .001) than youth being raised by two parents, single parent, or other family members, although this was not significant with respect to alcohol use (X 2 = 9.08, df = 4, p = .059).

Youth who have family members who use alcohol are more likely to use alcohol (X 2 = 30.82, df = 1, p < .001), and youth who have family members who use illegal drugs are more likely to use drugs (X 2 = 40.82, df = 1, p < .001). Adolescents who have parents who talk to them about the dangers of using alcohol are less likely to use alcohol (X 2 = 23.22, df = 1, p < .001), and when parents disapprove of alcohol use, the adolescents are less likely to use alcohol (X 2 = 50.14, df = 1, p < .001). Youth who have parents who talk to them about the dangers of illegal drugs are less likely to use (X 2 = 10.5, df = 1, p = .001) as are youth whose parents disapprove of drug use (X 2 = 35.03, df = 1, p < .001). Finally, adolescents who perceive alcohol use as a risky or potentially harmful behavior are less likely to drink (X 2 = 37.51, df = 1, p < .001), and youth who perceive drug use as a risky or potentially harmful behavior are less likely to use drugs (X 2 = 66.51, df = 1, p < .001). See Table 1 for further details of these findings.

Table 1 Possible risk/protective factors: personal/family related characteristics
Full size table

School/Friend Related Characteristics

Peer pressure did not appear to be a significant risk factor. Youth who reported alcohol use were not significantly more likely to report experiencing pressure from their peers to use alcohol (X 2 = .603, df = 1, p = .438), and youth who reported illegal drug use were not more likely to report peer pressure to use drugs (X 2 = .007, df = 1, p = .932). Adolescents who have friends who use alcohol, on the other hand, are significantly more likely to use alcohol (X 2 = 233.9, df = 1, p < .001), and youth who have friends who use illegal drugs are more likely to use illegal drugs (X 2 = 100.15, df = 1, p < .001).

Extra-curricular activities do not appear to produce a protective factor against substance use. There was no difference between youth who use and do not use alcohol in participation in extra-curricular church (X 2 = 1.02, df = 1, p = .314), sports (X 2 = 1.12, df = 1, p = .29), drama (X 2 = .444, df = 1, p = .505), music (X 2 = .048, df = 1, p = .826) or band activities (X 2 = 1.76, df = 1, p = .185). Likewise, there was no difference between youth who use and do not use illegal drugs in participation in extra-curricular sports (X 2 = .656, df = 1, p = .418), drama (X 2 = .457, df = 1, p = .499), music (X 2 = 1.17, df = 1, p = .28) or band activities (X 2 = 2.08, df = 1, p = .149). There was, however, a greater chance that youth would refrain from illegal drug use when involved in extra-curricular church activities (X 2 = 4.57, df = 1, p = .032).

While most extra-curricular activities do not seem to affect substance use, with whom the youth spends time after school may be important. Those students who spend their weekday afternoons with a parent are less likely to use alcohol (X 2 = 12.74, df = 1, p < .001) and illegal drugs (X 2 = 30.17, df = 1, p < .001), while students who spend their afternoons with friends are more likely to use alcohol (X 2 = 8.96, df = 1, p = .003) and illegal drugs (X 2 = 7.6, df = 1, p = .006). Students who spend their afternoons alone were not more or less likely to use alcohol (X 2 = 2.7, df = 1, p = .101) or illegal drugs (X 2 = 1.83, df = 1, p = .177).

Surprisingly, grades in school were not associated with alcohol use (X 2 = 6.94, df = 4, p = .139) or illegal drug use (X 2 = 4.1, df = 4, p = .393). Plans after high school did, however, show significant differences. Those students planning to enter the military or who selected “other” to describe their plans were more likely to use alcohol (X 2 = 11.68, df = 4, p = .02) and illegal drugs (X 2 = 33.84, df = 4, p < .001) than those students planning to work, attend college, or attend technical school. See Table 2 for further details of these findings.

Table 2 Possible risk/protective factors: school/friend related characteristics
Full size table

Discussion

To summarize the findings, the following characteristics are associated with greater alcohol and illegal drug use among rural African American youth, and have been identified as possible risk factors (factors apply to both alcohol and illegal drug use unless otherwise noted):

  • Being an older adolescent (15 years of age or older);

  • Being raised by non-family members (illegal drug use only);

  • Spending afternoons after school with friends;

  • Having friends who use alcohol or illegal drugs;

  • Having family members who use alcohol or illegal drugs; and

  • Having plans to enter military after high school.

The following characteristics were associated with less alcohol and illegal drug use, and have been identified as possible protective factors:

  • Being raised by parent(s) or other family members (illegal drug use only);

  • Spending afternoons after school with parents;

  • Having parents who talk to youth about dangers of drug and alcohol use;

  • Having parents who disapprove of their child using drugs or alcohol;

  • Being involved in extra-curricular church-related activities (illegal drug use only); and

  • Having plans to work or attend college or technical school after high school.

Some characteristics that have been associated with drug and alcohol in previous research that were not associated in the current study include:

  • Being male;

  • Peer pressure to use alcohol or illegal drugs;

  • Grades in school; and

  • Involvement in extra-curricular activities.

The characteristic most strongly associated with both alcohol and illegal drug use was having friends who use. This does not mean, however, that having friends who use drugs and alcohol causes adolescents to use these substances. Adolescents who use drugs and alcohols would naturally tend to have friends who also use. This study has shown an association only. Determining a causal relationship would require a much more sophisticated research study. It is, however, useful to know what characteristics are associated with greater substance use. These characteristics represent possible risk and protective factors and can help us identify students who may be at risk for drug and alcohol use.

The data from the current study supports previous research in several areas, including age, friend and family substance use, and parental involvement and attitudes. As discussed earlier, while grades and peer pressure have shown to be possible risk factors among adolescents, these influences are generally weaker among African American students. The current study found that neither of these characteristics is associated with substance use among these African American adolescents.

In other areas, the current study disagreed with findings of previous research. Except for the possible protective factor of church activities on illegal drug use, extra-curricular activity involvement does not appear to offer any protective factor. With whom the student spends time after school seems to be a more influential characteristic.

Limitations

The findings in this study are confounded by several limitations. First, results from this study cannot be generalized to the broader adolescent population, because (1) random sampling was not used; (2) data were collected on adolescents from only one rural county in the United States; and (3) only students currently enrolled in public high schools and middle schools were surveyed, excluding students in private schools, alternative schools, and those adolescents who are not attending school at all. In 1998, the state of Georgia had the lowest graduation rate of any state in the country at 54 %, significantly below the national graduation rate of 71 % (Greene 2002). Therefore, there may be a significant population of adolescents who are not attending school who could benefit from prevention programs that are usually only provided in the school setting.

A significant threat to the internal validity of the study is that a self-report survey instrument was used to gather the data. Students completed the instrument in class in front of their teachers and peers, therefore it is possible that students could have under or over-reported risky behaviors. As with any self-report instrument, there is no way to determine the validity of the students’ responses on the survey.

Future Directions

Substance use is a significant problem among African American adolescents, and the consequences of alcohol and drug use during adolescence are considerable. In order to prevent substance use among adolescents, it is important to first identify the risk factors that are associated with use, as well as the protective factors that may buffer the effects of the risk factors. Hawkins et al. (2004) suggest that before we can develop a successful prevention program in a community, we must identify the most elevated risk factors and the most depressed protective factors for substance use in that particular community. Preventive interventions can then be selected to address these specific weaknesses.

It is important that human services workers do not stereotype drug and alcohol use as inner-city problems, thus depriving rural communities of much needed funding and efforts toward prevention of these serious problems. Simansky (2008) states, “The prevalence of substance abuse among rural adolescents has equaled or surpassed rates in urban youth, but rural substance abusers go untreated at rates twice that of urban populations” (p. 8412). While urban adolescent populations need to continue to be served, it is imperative that attention be paid to every community in the country if we want to have a positive effect on our country’s adolescent population.

The current study helps to identify possible risk and protective factors that may be affecting drug and alcohol use among one group of rural African American adolescents. There is clearly a need for longitudinal research that can focus specifically on African American youth as they move through adolescence into young adulthood. It would be invaluable to discover challenges faced by African American young adults that may increase their risk for problem behaviors, such as alcohol and drug use. Longitudinal data would also help identify the protective factors that provide a buffer against drug and alcohol use during adolescence and into young adulthood.

Farmer et al. (2004) state that the focus of drug and alcohol prevention “involves supporting the positive factors while simultaneously working to ameliorate the risk” (p. 58). If these risk and protective factors can be identified, then drug and alcohol prevention programs can be developed that target a community’s strengths and weaknesses. The goal of our treatment and prevention efforts must be to help our youth move through adolescence and young adulthood without the burden of the destructive effects of drug and alcohol use. This may be particularly important in rural communities where there may be significant gaps in health and mental health care services.