Abstract
BackgroundThe Well-Being of Adolescents in Vulnerable Environments (WAVE) study was conducted among adolescents aged 15-19 years in Baltimore, Ibadan, Johannesburg, New Delhi, and Shanghai to examine perceived factors related to their health. A preliminary analysis of the data, unexpectedly, revealed that the influence of the physical environment on adolescent health was a dominant theme across every site examined. To explore this further, this paper analyzed the specific components of the physical environment that were perceived to influence health, and how they contributed to various health outcomes across sites.MethodsResearchers in each site conducted in-depth interviews among adolescents; community mapping and focus groups among adolescents; a Photovoice methodology, in which adolescents were trained in photography and took photos of the meaning of ‘health’ in their communities; and key informant interviews among adults who work with young people. A total 529 participants from across the sites were included in the analysis.ResultsFindings showed that while there was surprising uniformity in how adolescents characterized their physical environment, perceived health outcomes related to the physical environment varied by site and gender. In Baltimore and Johannesburg, vacant homes and the lack of recreation facilities were perceived to impact on sexual and reproductive health problems for girls, while among boys they contributed to drugs and violence. In Shanghai, New Delhi, and Ibadan, garbage and trash observed in their communities were perceived to have a higher impact on infectious and chronic diseases.ConclusionsAs the world continues to urbanize, our study points to a strong need to examine how the physical aspects of a living environment contribute to the health of adolescents. Specific aspects, such as housing, safety, garbage, and recreational spaces must all be examined as possible pathways for making improvements to health of adolescents, particularly among those living in poor urban environments.
Highlights
The Well-Being of Adolescents in Vulnerable Environments (WAVE) study was conducted among adolescents aged 15-19 years in Baltimore, Ibadan, Johannesburg, New Delhi, and Shanghai to examine perceived factors related to their health
Research design The Well-being of Adolescents in Vulnerable Environments (WAVE) study was launched in the summer of 2011 to: 1) explore adolescents’ perceived health and their top health challenges; 2) describe the factors within their urban communities which were perceived to be related to their health and health seeking behaviors
There were five primary aspects of the physical environment that were mentioned as having an influence over their health: 1) the perception of safety; 2) dirt and pollution; 3) housing; 4) recreational spaces; and 5) water and electricity
Summary
The Well-Being of Adolescents in Vulnerable Environments (WAVE) study was conducted among adolescents aged 15-19 years in Baltimore, Ibadan, Johannesburg, New Delhi, and Shanghai to examine perceived factors related to their health. A preliminary analysis of the data, unexpectedly, revealed that the influence of the physical environment on adolescent health was a dominant theme across every site examined. To explore this further, this paper analyzed the specific components of the physical environment that were perceived to influence health, and how they contributed to various health outcomes across sites. Despite the fact that a disproportionate number of urban migrants are young people between the ages of 16 and 24 years, we know very little about how the urban environment influences the health of adolescents, especially in low resource settings. There is such inequity in many of these settings, that urban poor adolescents may be experiencing an “urban health penalty” that makes them worse off than their rural peers
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