Results of three national surveys suggest that the prevalence of drinking was lower in nonmetropolitan areas than in metropolitan areas. However, nonmetro and metro areas were similar in the presence of risk for heavy, dependent, and problem drinking. Therefore, they probably share similar risks for health consequences of such levels of consumption. These consequences include alcoholism; chronic health effects on the liver, brain, heart, and reproductive system; increased risk of cancer; fetal alcohol syndrome; depressed immune system; accelerated diabetes; and acute effects such as increased motor vehicle accidents, other accidents, and related injuries and mortality. A study of alcohol consumption and related health problems in rural Georgia found more alcohol-related mortality in rural Georgia than in the nation, but somewhat less than in the state. However, the wide variation among the rural counties indicates a need for research focused on subpopulations at increased risk, a critical step in the development of effective intervention strategies. A study of predictors of alcohol use among rural African American adolescents focused on family processes in 90 African American families with married parents and a first-born child aged 9-12, living in rural Georgia or South Carolina. Analysis of observational data supported a proposed mediational model of relationships among family economic resources, family processes, and the development of externalizing behaviors that place rural youth at risk for alcohol problems. (Contains 86 references and 6 figures.) (SV)