Rural–urban differences in the distribution of parent-reported risk factors for substance use among young adolescents Richard Spoth*, Catherine Goldberg, Tricia Neppl, Linda Trudeau, Suhasini Ramisetty-Mikler Institute for Social and Behavioral Research, Iowa State University, ISU Research Park, Building 2, Suite 500, 2625 North Loop Drive, Ames, IA 50010-8296, USA Abstract Purpose: We examined rural –urban differences in cumulative risk for youth substance use. A recent report [National Center on Addiction and Substance Abuse (CASA) 2000] found that the rural – urban distribution of substance use and known risk factors for substance use differed; in many cases rural youth showed higher levels of use, as well as higher levels of risk factors. The current investigation, while not directly examining substance use, further examined rural – urban differences in the distribution of risk factors for youth substance use, based on information from parent reports. Method: Study 1 data were collected from a random sample of Midwestern parents (n = 339) with a young adolescent between the ages of 11 and 13 years. Study 2 data were collected from a second sample of Midwestern parents (n = 593). Results: Analyses of rural – urban comparisons demonstrated higher levels of cumulative risk among rural youth. An evaluation of the sensitivity of the analysis to rural – urban classification schemes indicated that the findings were robust, but that there was some minor variation in rural –urban differences by classification scheme. Implications: Results contribute to an explanation of findings from earlier reports of rural–urban differences in substance use, and suggest directions for future research on rural – urban distributions of youth risk factors. D 2001 Elsevier Science Inc. All rights reserved. Keywords: Adolescent substance use; Cumulative risk; Rural – urban differences 0899-3289/01/$ – see front matter D 2001 Elsevier Science Inc. All rights reserved. PII:S0899-3289(01)00091-8 * Corresponding author. Tel.: +1-515-294-4127; fax: +1-515-294-3613. E-mail address: rlspoth@iastate.edu (R. Spoth). Journal of Substance Abuse 13 (2001) 609 – 623