Area Deprivation Affects Behavioral Problems of Young Adolescents in Mixed Urban and Rural Areas: The TRAILS Study
Received 22 March 2009; accepted 16 June 2009. published online 12 August 2009.
Abstract
Purpose
Behavioral problems occur more frequently among adolescents in deprived areas, but most evidence concerns urbanized areas. Our aim was to assess the impact of area deprivation and urbanization on the occurrence and development of behavioral problems among adolescents in a mixed urban and rural area and to examine the contributory factors.
Methods
We obtained data from the first two waves (n=2,230; mean ages, 11.5 and 13.5 years respectively; response at follow-up, 96.4%) of the TRacking Adolescents' Individual Lives Survey (TRAILS). TRAILS is a prospective study of adolescent mental health in a mixed urban and rural region of the Netherlands. We assessed adolescent behavioral problems using the parent-reported Child Behavior Checklist (CBCL), the adolescent-reported Youth Self-Report (YSR) and the Antisocial Behavior Scale (ABS). Living areas were categorized into tertiles of deprivation. We further collected data on child temperament, perceived rearing style, parental socioeconomic position (education, income and occupation), family composition, and parental mental health history.
Results
At baseline, adolescents living in the most deprived tertile more frequently had elevated behavioral problem scores than those from the least deprived tertile on the CBCL (11.2% against 7.1%), YSR (11.9% against 6.9%), and ASB (11.5% against 7.4%) (all p < .05). Socioeconomic position explained half of the differences due to area deprivation. Other familial and parental characteristics did not significantly contribute to the explanation of observed area differences.
Conclusions
As in highly urbanized areas, behavioral problems occur more frequently among adolescents in deprived mixed rural and urban areas. Urbanization has little effect on these area differences.
aDepartment of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
bDepartment of Sociology, University of Groningen, Groningen, the Netherlands
cDepartment of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
dDepartment of Social Psychiatry, University Medical Center Groningen, Groningen, the Netherlands
eMunicipal Health Service Fryslân, Leeuwarden, the Netherlands
Address correspondence to: Sijmen A. Reijneveld, M.D., Ph.D., University Medical Center Groningen, University of Groningen, Department of Health Sciences, PO Box 196, 9700 AD Groningen, the Netherlands.
ABSTRACT