Urban-rural differentials: a spatial analysis of Alabama students' recent alcohol use and marijuana use.

Background And Objectives: This study of Alabama public school students sought urban-rural differences in social and spatial mechanisms connecting structural factors to recent use of alcohol and marijuana.

Methods: Its dataset comprised a state-sponsored 2002 need-assessment survey of Alabama students; Alabama education department data; U. S. Census data; and alcohol-outlet locations listed by Alabama's Alcoholic Beverage Control Board. It measured structural-disadvantage factors (population disadvantages, community instability, alcohol-outlet density), social-organization factors (protective role of community, protective role of school), and recent-use factors. Using Geographic Information Systems (GIS), it generated maps of school catchment areas (SCAs)-the units of analysis for the study-that outline spatial patterns (across areas deemed urban or rural) of students' recent use of alcohol and marijuana.

Results: In the final sample of 370 SCAs, significant urban-versus-rural differences were observed for certain structural factors and in how these factors were associated with substance use. These differences aside, spatial analysis weighing the SCAs' particular geographic characteristics suggested location's importance, showing that a school playing a strong protective role significantly reduced not just its own students' recent substance use, but that of students in neighboring SCAs as well.

Conclusions And Scientific Significance: The findings show students' recent use of alcohol and marijuana are associated with characteristics of the environment. (Am J Addict 2013; 22:188-196).