Urban and rural differences in the relationship between substance use and violence

This article examines the relationship between substance use and violence across rural-urban and Appalachian places of residence. The data come from a larger study on the health service use of 637 men who have a history of chronic substance abuse and who were incarcerated in four Kentucky prisons. The findings generally support previous research on substance use and violence but do not support Fischer's (1995) subculture theory of urbanism. Contrary to expectations, the population size of the prisoners' residence was not significantly associated with the prisoners' levels of violent victimization, violence toward others, violence toward intimate partners, or overall violence in the year prior to incarceration. Appalachian residency was also not associated with violence. Recognizing that the effect of substance use on violence perpetrated against others does not vary significantly by urban or rural residence may be helpful for designing violence prevention programs and planning law enforcement efforts.