Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Partick Dunn



Low population density in rural areas makes it difficult to deliver services to people with mental health problems and nonmedical prescription opioid abuse remains a problem in the United States. The purpose of this cross-sectional study was to determine whether a parent's socioeconomic status affected care opportunities for children 12 to 17 years of age and whether bipolar disorder increased the likelihood of substance abuse in those children. The theory of reasoned action/planned behavior provided the framework for the study. Secondary data from the Interuniversity Consortium for Political and Social Research 36361 data system, specifically the National Survey on Drug Use and Health 2014, were collected that included information about the socioeconomic status of adolescents and their parents. Cross-sectional analysis was used to analyze data. The first research examined the extent to which bipolar disorder influenced opioid abuse in those between the ages of 12 and 17. There was a nonsignificant association between the variables: chi-square probability values (p > 0.05) for mental health difficulties and ever-used pain relievers non-medically. There was a significant association between mental health and emotional difficulties at p < 0.05. The second research question examined whether a parent's socioeconomic status impacted the level of care opportunities for those 12 to 17 years' old in relation to bipolar disorder in rural communities. Using multivariate logistic regression analysis, no significance was found between level-of-care opportunities and a parent's socioeconomic status. The findings of this study have potential to bring about social change by increasing clinician skills related to intervention planning related to opioid abuse in rural communities among adolescents with bipolar disorder.