National Center for Education in Maternal and Child Health

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July 5, 2002

1. Report Documents Rural Child Poverty in America

2. Early Head Start Research and Evaluation Project Issues Final Report to Congress

3. Article Examines Rural Families' Childrearing Expenditures

4. Study Compares Rural Elementary Students', Parents', and Teachers' Perceptions of Bullying

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1. REPORT DOCUMENTS RURAL CHILD POVERTY IN AMERICA

Through research, statistics, and the voices of young people, America's Forgotten Children: Child Poverty in Rural America documents the facts and faces of rural poverty and recommends solutions with a call to action to create real and lasting change. Produced by Save the Children to raise national awareness about the problem of child poverty in rural areas and to offer suggestions for improving the lives of the children who live there, the report is divided into three sections: (1) "The Challenges of Rural Child Poverty," (2) "The Voices of Rural Children and Youth," and (3) "Call to Action." Save the Children recommends that public-private partnerships form a national coalition to lead the way at the federal, regional, and local levels by (1) building human capital, (2) creating new community institutions, (3) strengthening the economic self-sufficiency of families, and (4) increasing resources to eliminate rural poverty. The executive summary, links to the complete report, and information on joining the national campaign are available at http://www.savethechildren.org/afc/afc_exec_summary.shtml.

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2. EARLY HEAD START RESEARCH AND EVALUATION PROJECT ISSUES FINAL REPORT TO CONGRESS

Making a Difference in the Lives of Infants and Toddlers and Their Families: The Impacts of Early Head Start presents complete findings from a 7-year national evaluation of Early Head Start. This final report to Congress was prepared by Mathematica Policy Research, Inc., under contract with the Administration for Children and Families. For this evaluation, Mathematica staff worked with a consortium of local researchers and program directors to conduct a comprehensive implementation study and a random assignment impact study at 17 Early Head Start sites. The executive summary provides an overview of the study and findings. The full report is presented in three volumes. Volume I provides a detailed description of the methodology and results, volume II contains methodological appendixes, and volume III presents brief reports of 21 studies conducted by members of the Early Head Start Research Consortium at the local sites. Information about the Early Head Start Research and Evaluation Project, including the project overview, the executive summary, and the full report, is available at http://www.mathematica-mpr.com/3rdLevel/ehstoc.htm.

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3. ARTICLE EXAMINES RURAL FAMILIES' CHILDREARING EXPENDITURES

"States developing guidelines for child support and foster care payments . . . need to keep in mind the difference in childrearing expense between rural and urban areas," states the author of an article published in the Spring 2002 issue of Rural America. Since 1960, the U.S. Department of Agriculture (USDA) has provided annual estimates of family expenditures on children in both urban and rural areas. This article examines recently calculated childrearing expenditures based on 1990-92 Consumer Expenditure Survey data updated to 2000 dollars using the Consumer Price Index.

Childrearing expenditures are direct parental expenditures made on children ages 18 and under for seven major budgetary components: housing, food, transportation, clothing, health care, child care/education, and miscellaneous goods and services. For this study, the four urban regions (Northeast, South, Midwest, and West) were combined into a single overall urban average. Rural areas were defined as places of fewer than 2,500 people outside a Metropolitan Statistical Area; such areas span the entire country.

Analysis shows that

• Childrearing expenditures are lower in rural areas than in urban areas for families in similar income groups;
• The gap in childrearing expenditures (in percentage terms) between rural and urban families declines as household income rises;
• Housing- and food-related childrearing expenditures represent a smaller dollar amount for rural families than for urban families, while transportation- and health-related childrearing expenditures are higher in rural areas than in urban areas;
• Childrearing expenditures by budgetary component differ among lower-, middle-, and higher-income rural families;
• For families in both rural and urban areas, childrearing expenditures steadily increase as a child grows older; and
• Families spend more or less on a child depending on the number of children in the household.

The author notes that states may use USDA's annual childrearing-expenditure estimates to determine child support guidelines and foster care payments. The author suggests that (1) a primarily rural state may want to work from the cost of raising a child in rural areas; however, states that are both urban and rural may want to use an average of the cost of raising a child in the two areas; and (2) states need to recognize the difference in childrearing expenditures depending on the child's age and the number of children in the family. The author concludes that "given the increasing percentage of mothers in the labor force and the growing burden of health care costs on households, expenses on children are likely rising."

Lino M. 2002. Expenditures on children by rural families. Rural America 17(1):26-33.

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4. STUDY COMPARES RURAL ELEMENTARY STUDENTS', PARENTS', AND TEACHERS' PERCEPTIONS OF BULLYING

"Cumulative evidence suggests that bullying has acute consequences. . . . Thus bullying should not be dismissed as a normal developmental process," state the authors of an article published in the July/August 2002 issue of the American Journal of Health Behavior. The study described in this article examined the prevalence of bullying among fourth-, fifth-, and sixth-grade students in seven elementary schools in rural Illinois. The study sought to determine (1) the prevalence of bullying in these rural school districts, and whether prevalence varies by gender and grade level; (2) how students', parents', and teachers' perceptions of bullying compare; and (3) to what extent the experience of bullying relates to aggressive behaviors and violence-supporting attitudes, and whether the pattern of these associations differs by subjective vs. behavioral measurements.

A total of 739 students participated in this study. Students reported their race as follows: 81% white, 5.7% American Indian, 4.9% Hispanic, 1.7% Asian, 1.5% African American, and 5.3% other. Three hundred and sixty-seven parents and 37 teachers also participated. Three parallel surveys were developed: (1) a subjective measure of bullying that asked "How many times in the past week have you [or your child or children at your school] been bullied?" (2) a 16-item behavior measure with two subscales -- physical bullying and verbal bullying, and (3) a bullying perceptions scale with three subscales measuring respondents' awareness of whether verbal behaviors constitute bullying.

The authors found that

• There was a high prevalence of bullying in the schools studied;
• Gender differences on bullying experiences were found on only one dimension of bullying (boys reported more physical bullying than girls), and there were no grade-level differences;
• Being bullied was correlated with being aggressive;
• Students who had been bullied were more likely than those who had not to be bullies themselves;
• Students were more likely to indicate that they had experienced a physical or verbal bullying behavior than to admit that they had been bullied;
• Students were more likely than their parents to indicate experiencing physical bullying behaviors; and
• More parents and teachers than students perceived that bullying takes place in a variety of places and that verbal, exclusionary, and physical behavior constitute bullying.

The authors conclude that "creative methods for interviewing, observing, and measuring the extent and impact of bullying are needed for research in this area to move forward."

Stockdale MS, Hangaduambo S, Duys D, et al. 2002. Rural elementary students', parents', and teachers' perceptions of bullying. American Journal of Health Behavior 26(4):266-277.

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5. ARTICLE ASSESSES ADOLESCENTS' DISCUSSION OF HEALTH ISSUES WITH PROVIDERS

"Many adolescents indicated a desire to have their provider discuss a variety of health issues; however, most adolescents also did not have the majority of these topics addressed," state the authors of an article published in the March issue of the Journal of Adolescent Health. The study described in this article sought to determine what health-related topics adolescents think health care providers should discuss, what they actually discussed, and whether providers discussed the health risks these adolescents reported engaging in.

The authors analyzed data from the 1997 Commonwealth Fund Survey of the Health of Adolescent Girls, a nationally representative stratified school-based sample of adolescent boy and girls. A total of 6,748 boys and girls in grades 5 through 12 completed the survey. The responses are weighted to reflect the U.S. population of in-school adolescents in terms of grade enrollment, region, race, and gender.

The authors found that

• Adolescents most frequently reported wanting to discuss drugs (65%), STDs (61%), smoking (59%), and good eating habits (57%) with their health care provider, and they most frequently discussed good eating habits (49%), weight (43%), and exercise (41%);
• One-third of the adolescents had not discussed any of the desired topics, and only 12% had discussed all the desired topics;
• Younger adolescents were more likely than older adolescents to have all the desired topics discussed (14.0% vs. 9.8%), as were adolescents reporting having private time with their provider (14.1% vs. 9.8%);Among adolescents who reported any of the eight risk factors (abuse, alcohol use, binging and purging, drug use in the past month, exercising less than twice a week, being willing to have sex without contraception, smoking, and high stress), 62.7% had not spoken with their health care provider about any of the risks, and only 14% had discussed all of their risks with their provider; and
• Adolescents with a female provider were more likely than those with a male provider to have had their risks discussed (45.0% vs. 36.3%).

The authors of this article conclude that "our findings . . . suggest that those who provide care to adolescents must be aware not only of the high prevalence of health risks among their patients but also of the barriers they may face in bringing up issues during a visit."

Klein JD, Wilson KM. 2002. Delivering quality health care: Adolescents' discussion of health risks with their providers. Journal of Adolescent Health 30(3):190-195.

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MCH Alert © 2002 by National Center for Education in Maternal and Child Health and Georgetown University. MCH Alert is produced by MCH Library Services at the National Center for Education in Maternal and Child Health under its cooperative agreement (U02 MC 0001-01) with the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. The Maternal and Child Health Bureau reserves a royalty-free, nonexclusive, and irrevocable right to use the work for federal purposes and to authorize others to use the work for federal purposes.

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The editors welcome your submissions, suggestions, and questions. Please contact us at the address below.

EDITORS: Jolene Bertness, Tracy Lopez

COPYEDITOR: Ruth Barzel

National Center for Education in Maternal and Child Health
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