> \ L4I(.( C f 1 Table of Contents: What is Bullying? 4  Types of Bullying (Infographic) What is Rural? 5  Rural v. Urban Missouri (Map)  Rural, 75%+ Rural, and Urban Counties in Missouri (Map) How Many Children are in Rural Missouri? 6  Percentage of Children in All of Missouri (Map)  Figure 1: Counties with highest population of children  Figure 2: : Counties with the lowest population of children Why is Bullying a Rural Concern? 7  Figure 3: How often is a child bullied in school What are the Most Common Types of Bullying in Rural Areas? 8  . Figure 5 How often a child is bullied at school broken down by the four types of bullying in rural areas Risk Factors for Bullying? 9 Childhood Obesity and Bullying 9-10  Figure 9: Obesity rates by geographic area  Figure 10: Obesity rates and victimization by geographic areas  Figure 11: Obesity rates and bullying by geographic areas Mental Health, Childhood Obesity, and Bullying 11-12  Obesity and Bullying (Infographic)  Missouri Youth Suicidal Ideation by Grade Level (2014) (Graph)  Figure 12: Factors that influence bullying rates Gender 13  Gender and Bullying (Infographic)  Gender and Bullying (Graph)  Figure 13: How often a student has been bullied by another student at school Age 14-15  Age and Bullying (Bully Rates) (Infographic)  Age and Bullying (Victim Rates) (Infographic)  Figure 15: Have you ever engaged in bullying– by age  Victimization by Age Groups (Graph)  Bullying by Age Groups (Graph)  Cyberbullying by Age Groups (Graph) Geography 16-17  Bullying in Rural Areas (Infographic)  Types of Bullying by Geographic Setting (Graph)  Victim Rates in Rural v. Urban Areas (Graph)  Bully Rates in Rural v. Urban Areas (Graph)  Types of Bullying by Geographic Settings  Rural v. Urban Settings 2 Table of Contents : (cont.) Rural Missouri Factors 18-19  Figure 16: Victim Rates and Various Factors  Figure 17: Bullying Rates and Various Factors  Healthful Foods Access by Geographic Area (Graph) Poverty 20  Percentage of Children in Poverty in Rural Missouri (Map)  Counties in Missouri with Percentages Higher than the State Average of Children in Poverty Inadequate Parenting: 21-26  Single Family Homes  Figure 19: Single Parent Homes and their Impact on Bullying Rates  Figure 20: Single Parent Homes and their Impact on Victim Rates  Percentage of Single Family Homes in Rural Missouri (Map)  Counties Over the Missouri Average for Percentage of Single Family Homes (Map)  Parental Inattentiveness  Figure 21: How Often have you bullied another student  Figure 22: Unemployment Rates and Victimization  Figure 23: Unemployment Rates and Bullying  Bullying based on Parental Access (Graph)  Bullying Rates based on Parental Accessibility ( Graph)  Parental Unemployment  Figure 24: Parental Employment status on Bullying Rates  Figure 25 Parental Employment status on Victim Rates  Percentage of Unemployed Adults in Rural Missouri (Map) Lack of Access: 27-33  Food Access and Insecurity  Figure 26: Counties with the highest percent of the population who lack access to food  Figure 27: Counties with the highest percent of the population who lack access to healthful foods  Percentage of Food Insecurity in Rural Missouri (Map)  Percentage of Food Access in Rural Missouri (Map)  Transportation  Figure 28: Transportations effect of victim and bully rates  Figure 29: Counties with higher percentages of the population with no vehicle  Percentage of Population with no vehicle in Rural Missouri (Map)  Exercise Opportunities  Figure 30: How often are you bullied at school?  Figure 31: How often do you bully at school?  Bullying based on TV Time and Exercise (Graph)  Victimization based on TV Time and Exercise (Graph)  Percentage of Physically Inactive Adults in Rural Missouri (Map)  Figure 32: Counties with 35% or more physically inactive adults Limitations 34 Conclusion 34 4Appendix 35-39 References 40 3 What is Bullying? Below are the most common types of bullying children endure: Bullying, according to the American Psychological Association, is defined as “a PHYSICAL form of aggressive behavior in which The use of physical force (hitting, someone intentionally and repeatedly pushing, shoving, kicking, tripping etc.) to causes another person injury or gain power and/or control over the discomfort. Bullying can take the form of victim. physical contact, words or more subtle actions.” 1 https://www.stopbullying.gov In recent years, this definition has been CYBER expanded to include “cyberbullying.” The use of social media sites and Cyberbullying according the National technology to send mean text messages Crime Prevention Council “is similar to or emails, rumors sent by email or other types of bullying, except it takes posted on social networking sites, and place online and through text messages embarrassing pictures, videos, websites, or fake profiles. sent to cell phones. Cyberbullies can be https://www.stopbullying.gov classmates, online acquaintances, and even anonymous users, but most often VERBAL they do know their victims.” 2 Using demeaning language, such as name calling, unwanted teasing, and making threats. https://www.stopbullying.gov • • It is estimated that every 7 minutes SOCIAL a child is a victim of bullying. 3 The intentional exclusion of a person, t the spreading of malicious gossip and rumors, public embarrassment, and convincing others not to hang out with aspecifi, pmoo. https://www.stopbully1ng.gov children in the United States will be bullied this year 4 What is Rural? There are many different definitions for what defines rural and urban populations. For the purpose of this report, rural is defined as any county that does not have a population density over 150 persons per square mile.4 The maps below show the counties classified as either rural and urban. Some maps will narrow the rural population down further by selecting counties that are classified as 75% or more rural. This measure is determined simply by the amount of the population per county that lives in rural areas. There are 49 counties in Missouri who would be classified as 75% or more rural. Rur,all v. Urlban Mliissouri 20·17 Putnam Ru irall IMlost: C1ou nty :: Cass Vemoo Barton Dade Texas Greene ight Jasper Newton Douglas Howell Donal Taney Oudc 5 HOW MANY CHILDREN ARE IN RURAL MISSOURI? The following maps show the percentage of children in all Missouri counties. Of the 20 counties with 24.6% or more of the population composed of children under the age of 18, 16 are classified as rural counties, and 5 are classified as being 75% or more rural. Scotland has the highest percentage of children at 28.3%. Figure 1: Counties with the highest percent- Figure 2: Counties with the lowest per- ages of Children within the Population centages of Children within the Population Name: Percentage: Name: Percentage: Scotland 28.3% DeKalb 16.8% Webster 27.2% Nodaway 16.9% Pemiscot 26.9% Hickory 17.0% Lincoln 26.4% Stone 17.6% McDonald 26.3% Benton 17.6% ~ ,ess ilh an :2 - □JO .- 2.0i;~ - 2_1 . - 4';~ - 24_11 . - 6'o/,. - ·• er:2.6~ 6 WHY IS BULLYING A RURAL CONCERN? Studies have shown that rural children are 3-5% more likely to experience bullying than urban children.5 This number can vary based on the survey and the type of study. This paper will focus on The Health Behavior in School-Aged Children (HBSC), 2009-2010. study for data analysis. While the overall average among studies shows a 3-5% increase, the HBSC shows a slightly larger percent increase for rural students and bullying rates. Geography is not the only factor that influences the likelihood of a child to engage in bullying. There is a higher prevalence among males to engage in bullying than females. 6 Bullying rates also vary by age. The younger a child is the less likely they are to engage in bullying, but the more likely they are to be victims.5 There is also an increase in bullying rates the higher the BMI of the child. Overweight and obese children are at a greater risk for being bullied than normal or underweight children. 7 Figure 3 shows the victimization rates and factors for bullying in schools. There is an increase in children who bully others in school if they reside in rural areas. Female students are less likely to bully in school than male students. There is an increase in students who have reported to have bullied another student as their grade level increases as well as when their BMI increases. Older students, and overweight and obese students, are reporting higher rates of in school bullying than their counterparts. Figure 4 uses the same variables as Figure 3, but Figure 4 uses how often a child is a bully where Figure 3 uses how often a child is a victim. Figure 3: How often is a child bullied in school Figure 4: How often has a child bullied another child in school Variable: Impact: Significance: Variable: Change: Significance: Rural Area .066 .002* Rural Area .038 .039 BMI .086 .0001* BMI .036 .001* Gender -.021 .267 Gender -.130 .0001* Grade Level -.064 .0001* Grade Level .029 .0001* 7 WHAT ARE THE MOST COMMON TYPES OF BULLYING IN RURAL AREAS? Residing in a rural area increases a child's chance of being bullied by 0.155 (15.5%) based on The Health Behavior in School-Aged Children (HBSC), 2009-2010. While cyberbullying tends to show a decrease in rural areas when compared to the other forms of bullying, it is still a fairly significant concern when compared to the age of the child. Figure 5 shows that if a child is bullied, there is a 0.686 (68.6%) increase in cyberbullying. What this number shows is cyberbullying is often used as an extension of in school bullying, which would be physical, social, or verbal bullying, where the numbers are much higher (Figure 6). Cyberbullying is more likely to occur outside of school, rather than during. The most common form of in school Figure 5: How often a child is bullied at bullying likely to occur in rural settings is physical bullying. school broken down by the four types of bullying in Rural Areas Variable: Impact: Significance: Rural .155 .036* Area Cyber -.252 .0001* Physical .801 .0001* Social .143 .007* Verbal .366 .0001* Figure 6: How often a child is bullied Figure 7: How often a child is cyberbullied in focusing on cyberbullying only rural areas Variable: Impact: Significance: Variable: Impact: Significance: Rural -.008 .317 Rural .067 .001* Area Area BMI .006 .151 Cyber .686 .0001* Age .006 .002* Age -.055 .0001* 8 RISK FACTORS FOR BULLYING? As the data from the Health Behavior in School-Aged Children (HBSC), 2009-2010 survey suggests, gender, age, and BMI are all factors that influence bullying. The biggest factor that has recently been discovered is geography; rural areas often have higher rates of bullying that urban ones.5 Studies have shown the following to be the best predictors as to whether or not a child will be bullied: overweight and obesity, gender, age, school size, and geographic location. It is important though to remember that the predictive factors will change depending on the type of bullying. For example, boys are more likely to engage in physical bullying, and girls are more likely to engage in verbal. Obese v. Overweight: CHILDHOOD OBESITY: Overweight: A child is classified as being overweight when their Body Mass Index (BMI) is above When a child’s Body Mass Index (BMI) increases, the likelihood the 85th percentile, but be- that child will be bullied also increases.7 To be considered obese, a child’s BMI is 30 or greater.8 31.9% of children in the United States low the 95th percentile for are classified as obese. 31.1% of children in Missouri are classified children and teens of com- as obese. 9 parable age and sex. In Missouri, 74,666 children ages 0-4 are obese, 137,311 children Obese: ages 10-17 are obese, 31,413 children in High School are obese. In A child is classified as being total 494,949 children are estimated to be obese based on the Missouri state average, or 1 in 3 children. 9 obese when their Body Mass Index (BMI) is greater than 80% of adults who are classified as obese were classified as obese or equal to the 95th percen- are children.10 Using the adult obesity rates by county in Missouri, tile of children and teens of an inferred estimation can be made on how many children are likely to be obese within those counties. comparable age and sex. Figure 8: Childhood obesity estimation based on Adult obesity percentages in the six most obese counties County Percentage Approximate Name: of Obese Number of Obese Adults: Children: Caldwell 39% 860 DeKalb 39% 847 Saline 38% 2040 Dade 37% 606 Washington 37% 2156 Butler 37% 3700 10,209 Children are estimated to be obese based on the adult obesity rates in the above counties, and the population of children under the age of 18. 9 Childhood Obesity and Bullying: 16.8% of students who had a BMI of 30 or greater reported being bullied before. Studies have shown that being overweight or obese was the primary reason the child was the target of bullying.7 Rural areas have higher percentages of obese children than urban and suburban areas as seen in Figure 6. In rural areas, there is a sharp increase in the number of overweight and obese kids. Only the outskirts of large urban areas show similar rates of obese children as reported in rural areas. When analyzing bullying and victim rates to other geographic areas, rural children are among the highest in the overall categories for reporting obese children and bullying. Figure 10: Obesity rates and Bullying Figure 11: Obesity rates and Victimization by geographic area by geographic area Figure 9: Obesity rates by Area: Percentage of Percentage of Area: Percentage of Percentage geographic area obese children obese children obese children of obese Area: Percentage: who are victims who are victims who bully children who (Within Region): (Overall): (Within Region): bully Large City 20% (Overall): Large City 35% 7% Mid Size City 11% Large City 12% 2% Mid Size City 36% 4% Urban Fringe of 29% Mid Size City 11% 1% Urban 33% 10% a Large City Fringe of a Urban Fringe 7% 2% Urban Fringe of 6% Large City of a Large City a Mid Size City Urban 30% 2% Urban Fringe 8% < 1% Fringe of a of a Mid Size Large Town 1%* Mid Size City City Small Town 4% Large Town 39%* < 1%* Large Town 54%* < 1%* Rural: 29% Small Town 30% 1% Small Town 9% < 1% Rural: 32% 9% Rural: 9% 3% * Percentage is not reliable since the sample size was less than N= 30 Weight and Geographic Location Is the Child Overweight or· 1000.00 Obese? Is the Child Obese? 800.00 600.00 400.00 200.00 .00 I Mid size Urban Urban Large Small Rural city fringe of fringe of town town large city rnid size city MORE SPECIFIC RESIDENCE CLASSIFICATION 10