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Although blacks and Hispanics were more likely than whites to use parochial mental health treatment, accounting for use of this type of unconventional treatment did not explain the racial disparity in treatment-seeking behavior.

Substance misuse policies and practices that consider the sociocultural contexts of stress and coping are recommended.

In adolescence, vital sources of support come from family relationships; however, research that considers the health‐related impact of ties to both parents and siblings is sparse, and the utility of such ties among at‐risk teens is not well understood. Here we use two waves of panel data from the population of 8th and 12th grade students in a geographically isolated, rural, northeastern U.S. county to assess whether socioeconomic status (SES) moderates the effects of parental and sibling attachments on three indicators of adolescent health: obesity, depression, and problem substance use. Our findings indicate that, net of stressful life events, prior health, and sociodemographic controls, increases in parental and sibling attachment correspond with reduced odds of obesity for low‐SES adolescents, reduced odds of depression for high‐SES adolescents, and reduced odds of problem substance use for low‐SES adolescents. Results suggest also that sibling and maternal ties are more influential than paternal ties, at least with regard to the outcomes considered. Overall, the findings highlight the value of strong family ties for the physical, psychological, and behavioral health of socioeconomically strained rural teens, and reveal the explanatory potential of both sibling and parental ties for adolescent health.

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