Metropolitan and nonmetropolitan adolescents: differences in demographic and health characteristics.

The demographic and health characteristics of metropolitan and nonmetropolitan adolescents are examined based on a nationally representative sample of 15,181 randomly selected adolescents from the 1984 National Health Interview Survey. One third of all adolescents reside in nonmetropolitan areas of the United States. Nonmetropolitan youth differed from their metropolitan counterparts in race, population concentration in the South, poverty status, family composition, education of household head, and marital status. While the health status of metropolitan and nonmetropolitan youth were similar, their patterns of health services utilization and health insurance coverage were not. Nonmetropolitan adolescents made fewer physician visits and were more apt to delay seeking physician care than metropolitan youth. Adolescents in nonmetropolitan areas were also 39 percent more likely to be hospitalized and 30 percent more likely than metropolitan youth to be without any form of health insurance protection. Despite higher rates of poverty among nonmetropolitan adolescents, they were 20 percent less likely to be publicly insured. The delivery and financing implications of these distinct metropolitan and nonmetropolitan demographic and health characteristics are discussed.