and Health Resources and Services Administration, 2000; Reading, 1997; Stevens et al., 2006; Zeni et al., 2007). This fact is particularly distressing when viewed in light of the most recent data related to adolescents living in poverty. In 2005, the U.S. Census Bureau reported that 17.6 percent of adolescents under age 18 were living in poverty. Black and Hispanic adolescents under age 18 experience poverty at a higher rate than their Asian and white non-Hispanic counterparts. This is a consistent trend seen since 1980 (see Figure 1-3) (DeNavas-Walt, Proctor, and Hill Lee, 2006).

Where adolescents live and with whom may also directly affect health status, health-related behavior, health needs, and health services because of the potential impact of these variables on financial stability and stress level. In 2006, 35 percent of those aged 9–17 lived either in one-parent households or in households where no parent was present (U.S. Census Bureau, 2006a).

Access to quality health services may be a particular challenge in rural areas (Gamm, Hutchison, and Bellamy, 2002), which have fewer health services within a reasonable distance of where people live. Of U.S. adolescents aged 12–17, 19 percent, or 4.6 million, live in rural areas (nonmetropolitan counties including no city with a population of greater than 10,000) (Fields,

FIGURE 1-3 Percentage of adolescents under age 18 in poverty by race/ethnicity, 1980–2006.

NOTES: Poverty is defined by the U.S. Census Bureau using the Office of Management and Budget’s Statistical Policy Directive 14. NH = non-Hispanic.

SOURCE: DeNavas-Walt, Proctor, and Hill Lee (2006).

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