Socioeconomic status, urbanicity and risk behaviors in Mexican youth: an analysis of three cross-sectional surveys

Abstract

BackgroundThe relationship between urbanicity and adolescent health is a critical issue for which little empirical evidence has been reported. Although an association has been suggested, a dichotomous rural versus urban comparison may not succeed in identifying differences between adolescent contexts. This study aims to assess the influence of locality size on risk behaviors in a national sample of young Mexicans living in low-income households, while considering the moderating effect of socioeconomic status (SES).MethodsThis is a secondary analysis of three national surveys of low-income households in Mexico in different settings: rural, semi-urban and urban areas. We analyzed risk behaviors in 15-21-year-olds and their potential relation to urbanicity. The risk behaviors explored were: tobacco and alcohol consumption, sexual initiation and condom use. The adolescents' localities of residence were classified according to the number of inhabitants in each locality. We used a logistical model to identify an association between locality size and risk behaviors, including an interaction term with SES.ResultsThe final sample included 17,974 adolescents from 704 localities in Mexico. Locality size was associated with tobacco and alcohol consumption, showing a similar effect throughout all SES levels: the larger the size of the locality, the lower the risk of consuming tobacco or alcohol compared with rural settings. The effect of locality size on sexual behavior was more complex. The odds of adolescent condom use were higher in larger localities only among adolescents in the lowest SES levels. We found no statically significant association between locality size and sexual initiation.ConclusionsThe results suggest that in this sample of adolescents from low-income areas in Mexico, risk behaviors are related to locality size (number of inhabitants). Furthermore, for condom use, this relation is moderated by SES. Such heterogeneity suggests the need for more detailed analyses of both the effects of urbanicity on behavior, and the responses--which are also heterogeneous--required to address this situation.

Sexual behavior among high school students in Brazil: alcohol consumption and legal and illegal drug use associated with unprotected sex

“…In a survey of adolescents from low-income areas in Mexico, the odds of adolescent condom use were higher in larger urban areas only among adolescents in the lowest SES levels. The results suggest that condom use is related to urbanicity but moderated by SES (29). …”

Desigualdad en indicadores de comportamientos de riesgo en adolescentes en México: análisis de dos encuestas de salud

“…Como se ha documentado en análisis previos, el entorno de residencia tiene una relación relevante con la probabilidad de comportamientos antisociales, que podrían entonces ser parte del proceso de los daños a la salud reportados. 9,16 El análisis presentado señala retos importantes en términos de la atención de comportamientos que comprometen la salud de los adolescentes mexicanos y su bienestar futuro. Las acciones que se han desarrollado a la fecha, si bien documentan resultados positivos muy relevantes, son aún insuficientes para atender estos riesgos y eliminar las brechas entre poblaciones.…”

“…Por otro, el hecho de que el propio entorno de vida representa un factor que puede favorecer la decisión de participar en estos comportamientos. 5,9 Para México, análisis previos han documentado las brechas por nivel socioeconómico para un conjunto de indicadores de cobertura efectiva tanto para 2006 como para 2012. No obstante, se han concentrado en un conjunto acotado de indicadores sin realizar un análisis sobre la significancia de los cambios en el periodo.…”

Examination of the community-specific prevalence of and factors associated with substance use and misuse among Rural and Urban adolescents: a cross-sectional analysis in Bosnia and Herzegovina

“… 8–11 However, the results were not consistent. Some studies found a lower likelihood of smoking, 8 alcohol consumption, 9 or smoking and alcohol consumption 12 among adolescents from rural communities. Other studies, however, found a higher prevalence of SUM in rural youth.…”