Cannabis use, social support and social engagement among working-age adults in rural America.

Objective: Cannabis use has been linked to physical, psychological, and behavioral changes. Although research indicates separately that informal social support and formal social engagement - which are correlated measures - serve as protective factors in cannabis use, much of this research focuses on youth and more urban samples, limiting our understanding of if these findings are true for rural populations where social support and social engagement are particularly important for health and health behaviors. To fill the research gap, this study examines the effects of informal social support (tangible support and emotional support) and formal social engagement on cannabis use among rural working-age adults. Methods: This research analyzed 1,122 observations from a cross-sectional online survey conducted in 2022 of working-age adults (18-64) from rural America. Multilevel logistic regression models were used to predict cannabis use in the past 12 months using informal social support (tangible support and emotional support) and formal social engagement and other sociodemographic covariates and state legalization status. Results: Multilevel logistic modeling indicates that low emotional support and low formal social engagement are associated with a higher odds of reporting cannabis use in the past 12 months among rural working-age adults, net of other sociodemographic variables and state legalization status. Conclusions: The study suggests that emotional support and social engagement may contribute to cannabis use prevention among rural working-age adults. These findings should inform future research as well as the development of tailored health interventions targeting rural working-age adults.

Social Infrastructure Availability and Suicide Rates among Working-Age Adults in the United States.

Social infrastructure (SI) may buffer against suicide risk by improving social cohesion, social support, and information and resource sharing. This study uses an ecological approach to examine the relationship between county-level SI availability and suicide rates among working-age adults (ages 25-64) in the United States, a population for whom suicide rates are high, rising, and geographically unequal. Mortality data are from the National Vital Statistics System for 2016-2019. SI data are from the National Neighborhood Data Archive for 2013-2015 and capture the availability of typically free SI (e.g. libraries, community centers) and commercial SI (e.g. coffee shops, diners, entertainment venues). Results from negative binomial models show that suicide rates are significantly lower in counties with more SI availability, net of county demographic, socioeconomic, and health care factors. This relationship held for both typically free and commercial SI. Policymakers should consider strengthening existing and developing new social infrastructure, particularly in counties with less educated populations, as part of a broader strategy to reduce suicide rates in the United States.

Implementing a Teaching Rural Mobile Health Clinic: Challenges and Adaptations.

In 2022, Penn State College of Medicine launched the LION Mobile Clinic, a teaching mobile health clinic offering preventive health services in rural Snow Shoe, Pennsylvania. We outline four challenges the clinic team faced in implementation, along with adaptations made to tailor the model to Snow Shoe's needs and opportunities.

Socio-Spatial Disparities in County-Level Availability of Aging and Disability Services Organizations.

Aging and disability services are essential for supporting older adults in living independently in their homes and communities as they age. Applying theoretical perspectives of community gerontology and spatial inequality, we use county-level data (N=3142) from the National Neighborhood Data Archive (NaNDA) and the American Community Survey to explore if and how availability of aging and disability services organizations varies across the rural-urban continuum and across compositional characteristics of counties. Results show that rural counties are significantly more likely to be aging and disability services deserts. Stratified models show that poverty rates and relative shares of non-Hispanic Blacks are positively associated with greater odds of aging and disability services deserts across rural and urban counties, but divergent findings appear for county-level shares of Hispanics. These findings are discussed as well as implications for research, policy, and practice on equitable access to aging and disability services.