Low Socioeconomic Neighborhoods Research Articles

How Engaged Are Family Physicians in Addressing the Social Determinants of Health? A Survey Supporting the American Academy of Family Physician's Health Equity Environmental Scan

Purpose: Public health leaders have advocated for clinical and population-based interventions to address the social determinants of health (SDoH). The American Academy of Family Physicians has worked to support family physicians with addressing the SDoH. However, the extent that family physicians are engaged and the factors that influence this are unknown.Methods: A survey was used to identify actions family physicians had taken to address the SDoH and perceived barriers. Physician and community characteristics were linked. Ordinal logistic regression was used to identify factors associated with engagement in clinical and population-based actions, separately.Results: There were 434 (8.7%) responses. Among respondents, 81.1% were engaged in at least one clinical action, and 43.3% were engaged in at least one population-based action. Time (80.0%) and staffing (64.5%) were the most common barriers. Physician experience was associated with higher levels of clinical engagement, lower median household income was associated with higher levels of population-based engagement, and working for a federally qualified health center (FQHC) was associated with both.Conclusions: The study provides preliminary information suggesting that family physicians are engaged in addressing the SDoH through clinical and population-based actions. Newer family physicians and those working in FQHCs may be good targets for piloting clinical actions to address SDoH and family physician advocates may be more likely to come from an FQHC or in a lower socioeconomic neighborhood. The study also raises questions about the value family physicians serving disadvantaged communities place on clinical interventions to address the SDoH.

Associations between Neighborhood Open Space Features and Walking and Social Interaction in Older Adults-A Mixed Methods Study.

Neighborhood Open Spaces (NOS) such as public spaces around people’s homes, parks and village greens, may support activity and socializing for older adults. These spaces might be especially important for older adults as they typically are less mobile and have smaller activity spaces and social networks than other age groups. The present exploratory sequential mixed methods study investigates the association between built environment features, social interaction, and walking within NOS, among older adults living in a low socio-economic neighborhood in Copenhagen. Interviews, the Community Park Audit Tool, and the System for Observing Play and Recreation in Communities (SOPARC) were used to capture quantitative and qualitative data on 353 older adults (59–90 years old) within 11 NOS. Walking was predicted by the condition and shade along paths, seating and landscaping. Social interaction was negatively associated with walking, suggesting that older adults tend to sit down when engaging in social activities. Interviews highlighted the importance of social interaction within NOS. Future designs of NOS should acknowledge the importance of social meeting places, but at the same time provide walkable spaces for older adults to promote healthy aging.

Tuberculosis care: enhancing directly observed therapy in a peri-urban, low socioeconomic status neighbourhood.

Tuberculosis (TB) is a major health issue in the Philippines. TB-Care was introduced in 2011 to tackle pulmonary TB among the urban poor in Payatas, Quezon City, Philippines. We evaluated the efficacy of TB-Care in increasing treatment success and compliance rates. This retrospective case series reviewed 44 patients with pulmonary TB enrolled in TB-Care from 2013 to 2014. Diagnosis and treatment of pulmonary TB was made in accordance with World Health Organization guidelines. Treatment outcomes included cure, completed treatment, successfully treated, failed treatment and transferred to another facility. 14 (73.7%) out of 19 patients tested were bacteriologically cured. The average 100% compliance rate was 90.8% over six months. The programme successfully treated 39 (88.6%) patients. This was comparable to the overall national treatment success rate of 90% for Philippines and 79% for Singapore, with higher compliance rates than were previously reported in this community.

Does social environment mediate the association between perceived safety and physical activity among adults living in low socioeconomic neighborhoods?

BackgroundEnvironmental and social factors may affect residents’ physical activity, which has a strong impact on their well-being. PurposeThe present study examines the association between perceived safety variables and physical activity (Leisure-Time Physical Activity (LTPA), Transport-Related Physical Activity (TRPA), and Total Physical Activity (TPA)) and whether these correlations are mediated by the social environment. MethodsFor this purpose, a questionnaire was distributed systematically among 2000 adults living in low socioeconomic neighborhoods in Bandar Abbas city, Iran. A total of 1833 qualified questionnaires were used for further analysis. ResultsMen were more likely to do TRPA and TPA than women; in addition, married people were less likely to do these activities than single people. Aging significantly decreased the odds of LTPA and TPA. Having at least one motor vehicle in the households decreased the chance of TRPA. Perceived safety from crime, general safety, and social ties were positively associated with all types of physical activity. Collective efficacy also increased the odds of TPA. Incivilities associated with LTPA after social variables were added to model. The findings revealed the mediatory effect of social environment on the link between perceived safety and physical activity. Additionally, findings recommended that perceived safety also slightly mediates the relationship between social environment and physical activity. ConclusionsStrategies that empower collective efficacy and social ties within the neighborhoods can be utilized to limit the effect of neighborhood problems on healthy physical activities.

Lessons Learned from the Field: Teaching in High-risk Physical Education Environments

According to the U.S. Department of Education, a child is considered “at risk” if they receive low academic achievement scores, are at risk of dropping out of school, have little support from parents, or live in a low-socioeconomic neighborhood. Currently in the United States, somewhere between 10% and 25% of all youth are considered at risk and attend a Title-1 funded public school. While these numbers are substantial, it is reasonable to suggest that many children in these communities do not receive adequate opportunities to be physically active. The purpose of this article is to provide tangible teaching practices that have been effective in delivering high-quality physical education in some of the most dangerous contexts. Co-creating positive rules, employing consistent routines, holding students to high expectations, building relationships, and other curricular strategies will be expanded on in this article.

Impact of Health Insurance on Stage at Cancer Diagnosis Among Adolescents and Young Adults

Uninsured adolescents and young adults (AYAs) and those with publicly funded health insurance are more likely to be diagnosed with cancer at later stages. However, prior population-based studies have not distinguished between AYAs who were continuously uninsured from those who gained Medicaid coverage at the time of cancer diagnosis. AYA patients (ages 15-39 years) with nine common cancers diagnosed from 2005 to 2014 were identified using California Cancer Registry data. This cohort was linked to California Medicaid enrollment files to determine continuous enrollment, discontinuous enrollment, or enrollment at diagnosis, with other types of insurance determined from registry data. Multivariable logistic regression was used to evaluate factors associated with later stages at diagnosis. The majority of 52 774 AYA cancer patients had private or military insurance (67.6%), followed by continuous Medicaid (12.4%), Medicaid at diagnosis (8.5%), discontinuous Medicaid (3.9%), other public insurance (1.6%), no insurance (2.9%), or unknown insurance (3.1%). Of the 13 069 with Medicaid insurance, 50.1% were continuously enrolled. Compared to those who were privately insured, AYAs who enrolled in Medicaid at diagnosis were 2.2-2.5 times more likely to be diagnosed with later stage disease, whereas AYAs discontinuously enrolled were 1.7-1.9 times and AYAs continuously enrolled were 1.4-1.5 times more likely to be diagnosed with later stage disease. Males, those residing in lower socioeconomic neighborhoods, and AYAs of Hispanic or black race and ethnicity (vs non-Hispanic white) were more likely to be diagnosed at a later stage, independent of insurance. Our findings suggest that access to continuous medical insurance is important for decreasing the likelihood of late stage cancer diagnosis.

Kids in Action: the protocol of a Youth Participatory Action Research project to promote physical activity and dietary behaviour

IntroductionIn this study, researchers collaborate with children from a low socioeconomic neighbourhood in Amsterdam in developing, implementing and evaluating interventions targeting their health behaviours. This Youth Participatory Action Research project...

Association of Behavior in Boys From Low Socioeconomic Neighborhoods With Employment Earnings in Adulthood

Identifying early childhood behavioral problems associated with economic success/failure is essential for the development of targeted interventions that enhance economic prosperity through improved educational attainment and social integration. To test the association between kindergarten teacher-rated assessments of inattention, hyperactivity, opposition, aggression, and prosociality in boys with their employment earnings at age 35 to 36 years as measured by government tax return data. A 30-year prospective follow-up study analyzing low socioeconomic neighborhoods in Montreal, Quebec, Canada. Boys aged 5 to 6 years attending kindergarten in low socioeconomic neighborhoods were recruited. Teacher-rated behavioral assessments were obtained for 1040 boys. Data were collected from April 1984 to December 2015. Analysis began January 2017. Mixed-effects linear regression models were used to examine the association between teacher ratings of inattention, hyperactivity, opposition, aggression, and prosociality at age 6 years and individual earnings obtained from government tax returns at age 35 to 36 years. The IQ of the child and family adversity were adjusted for in the analysis. Complete data were available for 920 study participants (mean age at follow-up was 36.3 years). Mean (SD) personal earnings at follow-up were $28 865.53 ($24 103.45) (range, $0-$142 267.84). A 1-unit increase in inattention (mean [SD], 2.66 [2.34]; range, 0-8) at age 6 years was associated with decrease in earnings at age 35 to 36 years of $1295.13 (95% CI, -$2051.65 to -$538.62), while a unit increase in prosociality (mean [SD], 8.0 [4.96]; range, 0-20) was associated with an increase in earnings of $406.15 (95% CI, $172.54-$639.77). Hyperactivity, opposition, and aggression were not significantly associated with earnings. Child IQ was associated with higher earnings and family adversity with lower earnings in all models. A 1-SD reduction in inattention at age 6 years was associated with a theoretical increase in annual earnings of $3040.41, a similar magnitude to an equivalent increase in IQ. Teacher ratings of inattention and prosociality in kindergarten boys from low socioeconomic neighborhoods are associated with earnings in adulthood after adjustment for hyperactivity, aggression, and opposition, which were not associated with earnings. Interventions beginning in kindergarten that target boys' inattention and enhance prosociality could positively impact workforce integration and earnings.

Recurrent unintended pregnancies among young unmarried women serving in the Israeli military

BackgroundUnintended pregnancy is a major public health problem with known risk factors, however, little is known about the prevalence of variables associated with recurrent unintended pregnancy (RUP) among young, unmarried women.MethodsA retrospective cohort study of unmarried women aged 18–21 serving in the Israeli military between 2013 and 2015. Multivariable logistic regression analysis was used to examine associations between RUP and women’s education, IQ, immigration status, country of origin, socioeconomic status and history of psychiatric illness.ResultsOf 129,638 women drafted by the Israeli military during the study period, 1720 women with unintended pregnancies had a follow up period of at least a year. Three hundred and eighty-nine of them had RUP (22.6%). Multivariable models comparing women with no unintended pregnancies and women with RUP revealed that RUP was more common among (adjusted relative risk; 95% confidence interval) women who had not graduated from high school (6.9; 4.99–9.55), who had low (90–99) IQ scores (3.9; 2.88–5.39) those reporting Africa as the country of origin (2.5; 1.37–4.59) and those from a lower socioeconomic neighborhood (1.6; 1.18–2.05). Multivariate regression modeling comparing women with single unintended pregnancies and women with RUPs showed that recurrent unintended pregnancy was more common among women who had not graduated from high school (3.2; 2.04–4.84) and those who had a low (90–99) IQ score (1.9; 1.32–2.61).ConclusionRate of RUP is high among women serving in the Israeli military. These women have unique epidemiological characteristics. This may serve in identifying populations at high risk and thus may enable policy maker to offer at least to this population Long-Acting Reversible Contraception (LARC) methods. We encourage policy makers to consider the provision of LARC methods to all servicewomen who had an unintended pregnancy.

What Is it About Perceived Discrimination That Can Lead Immigrant Adolescents to Alcohol Use and Delinquency? The Mediating Role of Feelings of Alienation

Background: Despite research examining the relationship between discrimination and alcohol use and delinquency among adolescents, little is understood about the mechanism behind the relationship. Objectives: On the basis of Strain Theory, the current study examined a new theoretical model in which feelings of alienation (from the self, peers, and Israeli society) mediate the relationship between discrimination and alcohol use and delinquency. Methods: A one-year follow-up study was conducted with 146 at-risk youth from the Former Soviet Union and Ethiopia in Israel (63% male), from disadvantaged low socioeconomic neighborhoods. At Time 1 (T1), adolescents were asked about their experiences of discrimination, feelings of alienation, and levels of problem alcohol use (past month/ever drunkenness, past month binge drinking, and regular daily drinking). At time 2 (T2), the participants were again asked as to their experiences of alienation, alcohol use, and delinquency. Results: Perceived discrimination at T1 significantly predicted feelings of alienation at T2, when controlling for the relationship with alienation at T1. Feelings of alienation (from the self and Israeli society) fully mediated the relationship between discrimination and alcohol use. However, there was a direct relationship between discrimination and delinquency. Conclusions: Findings emphasize the negative impact of discrimination on adolescents. They suggest that during the critical developmental period of adolescence, feelings of discrimination may be internalized into negative emotions which may lead to involvement in deviant behaviors. Results suggest a need to help adolescents process and make sense of the discriminatory experiences they perceive.

Trajectory of service use among young Albertans with complex needs

IntroductionYouth with complex-needs are vulnerable as a consequence of exposure to social adversity and/or chronic health conditions, and are at a high risk of school failure and justice involvement. Information about the patterns of service use across government sectors that influence the life outcomes of complex-needs youth is unknown.
 Objectives and ApproachYouth with complex needs often engage with multiple services across multiple government sectors for extended periods of time. Understanding the patterns and trajectory of their service use may inform programs, decision makers and government in the optimal allocation of resources to increase their life outcomes. It may reveal where and when interventions would be most effective to improve the life course for vulnerable youth. In this study, through a unique approach to link over 20 administrative longitudinal datasets and a novel trajectory clustering technique, the patterns of service use among complex-needs young Albertans is revealed and visualized.
 ResultsA trajectory clustering technique was applied to reveal patterns of service use among complex-needs individuals. Compared to the general population, higher proportions of youth with complex needs lived in low socio-economic neighborhoods, suffered from mental health issues, were high cost health service users, and had lower rates of high school completion. Furthermore, youth having complex needs for a longer period of time and who required multiple complex services in a given year had the poorest outcomes, in terms of high school completion, mental health issues, and other health problems. The majority of complex-needs youth came in contact with services via the education system, followed by child services/welfare.
 Conclusion/ImplicationsThe trajectories of service use among complex-needs youth reveals that these individuals are primarily identified through education. Consequently, educational supports would best address the development of effective programs including mental health supports and other needs.

Using administrative data to examine government service transitions of children, youth and young adults in Alberta, Canada

IntroductionA main goal of policy makers is to understand various transition pathways between services to optimize program design and to achieve successful outcomes, for example, securing stable income or having access to disability supports.
 Objectives and ApproachUsing linked administrative data (between 2006 and 2011), this study examines two types of program transition pathways: 1) Toward understanding who may be at risk for relying on income support, we profile Albertans transitioning from an income support training program to a program providing income support but no training, and 2) Toward understanding service delivery from child/youth to adult disability programs, we profile students receiving child/youth disability services, but who did not transition into an adult disabilities program. The socio-demographic characteristics and government service use of these students, including health and education-related services, were examined.
 ResultsFirst, among Albertans who transitioned from an income support training program to one in which only income support was provided: 57% were female; 72% were living in low socio-economic neighbourhoods; 14% were high cost health service users; 20% received mental health services; 30% received an injury/harm diagnosis; and 12% were involved in corrections. Second, among children/youth who received child disability services but did not transition to an adult disability program, lower than expected proportions received Assured Income for the Severely Handicapped (45%) and Income Support (14%), while higher than expected proportions had criminal offences (17%).
 Conclusion/ImplicationsProfiles produced from linked data helps Alberta government to understand clients’ program transitions which allows for: 1) the identification of Albertans requiring supports for securing employment that reduce or eliminate the need for income support, and 2) improvements in service delivery to individuals transitioning from child/youth to adult disability programs.

Changing Neighborhoods and Residents' Health Perceptions: The Heart Healthy Hoods Qualitative Study.

Cities, and therefore neighborhoods, are under constant change. Neighborhood changes may affect residents’ health in multiple ways. The Heart Healthy Hoods (HHH) project studies the association between neighborhood and residents’ health. Focusing on a middle–low-socioeconomic neighborhood in Madrid (Spain), our aim was to describe qualitatively its residents’ perceptions on the urban changes and their impacts on health. We designed a qualitative study using 16 semi-structured interviews including adult residents and professionals living or working in the area. Firstly, we described the perceived main social and neighborhood changes. Secondly, we studied how these neighborhood changes connected to residents’ health perceptions. Perceived major social changes were new demographic composition, new socio–cultural values and economic changes. Residents’ negative health perceptions were the reduction of social relationships, increase of stress and labor precariousness. Positive health perceptions were the creation of supportive links, assimilation of self-care activities and the change in traditional roles. Neighborhood changes yielded both negative and positive effects on residents’ health. These effects would be the result of the interrelation of different elements such as the existence or absence of social ties, family responsibilities, time availability, economic resources and access and awareness to health-promoting programs. These qualitative research results provide important insight into crafting urban health policies that may ultimately improve health outcomes in communities undergoing change.

Study protocol of the quasi-experimental evaluation of \u201cKEIGAAF\u201d: a context-based physical activity and nutrition intervention for primary school children

BackgroundThe environment affects children’s energy balance-related behaviors to a considerable extent. A context-based physical activity and nutrition school- and family-based intervention, named KEIGAAF, is being implemented in low socio-economic neighborhoods in Eindhoven, The Netherlands. The aim of this study was to investigate: 1) the effectiveness of the KEIGAAF intervention on BMI z-score, waist circumference, physical activity, sedentary behavior, nutrition behavior, and physical fitness of primary school children, and 2) the process related to the implementation of the intervention.MethodsA quasi-experimental, controlled study with eight intervention schools and three control schools was conducted. The KEIGAAF intervention consists of a combined top-down and bottom-up school intervention: a steering committee developed the general KEIGAAF principles (top-down), and in accordance with these principles, KEIGAAF working groups subsequently develop and implement the intervention in their local context (bottom-up). Parents are also invited to participate in a family-based parenting program, i.e., Triple P Lifestyle. Children aged 7 to 10 years old (grades 4 to 6 in the Netherlands) are included in the study. Effect evaluation data is collected at baseline, after one year, and after two years by using a child questionnaire, accelerometers, anthropometry, a physical fitness test, and a parent questionnaire. A mixed methods approach is applied for the process evaluation: quantitative (checklists, questionnaires) and qualitative methods (observations, interviews) are used. To analyze intervention effectiveness, multilevel regression analyses will be conducted. Content analyses will be conducted on the qualitative process data.DiscussionTwo important environmental settings, the school environment and the family environment, are simultaneously targeted in the KEIGAAF intervention. The combined top-down and bottom-up approach is expected to make the intervention an effective and sustainable version of the Health Promoting Schools framework. An elaborate process evaluation will be conducted alongside an effect evaluation in which multiple data collection sources (both qualitative and quantitative) are used.Trial registrationDutch Trial Register NTR6716 (registration date 27/06/2017, retrospectively registered), METC163027, NL58554.068.16, Fonds NutsOhra project number 101.253.

Abstract A09: Urban neighborhood and residential factors associated with breast cancer in African American women: A systematic review

Abstract Certain residential characteristics in urban neighborhoods have shown to have negative impacts on health, especially in the African American population. The purpose of this systematic review is to understand the relationship between urban neighborhood and residential factors and breast cancer risk, incidence, stage at diagnosis/late stage diagnosis, survival, and mortality in African Americans. Using PubMed and Web of Science, the existing literature was reviewed. Observational, cross-sectional, cohort, and prospective studies until February 2017 were examined. Studies that included populations of African American women, setting in “urban” areas, and a measure of a neighborhood or residential factor were reviewed. Three parameters related to neighborhood/residential factors were extracted, including neighborhood socioeconomic status (SES), residential segregation, and residential pollution. Eighteen studies were identified for systematic review. 10 studies showed significantly higher odds of late-stage diagnosis, higher mortality, and lower survival in African American women living in lower socioeconomic neighborhoods. One study showed slightly higher odds of upward neighborhood change and probability of distant metastasis at diagnosis of African American woman compared to White women (OR=1.24). Similarly, 5 studies showed significantly high associations between residential segregation and late-stage diagnosis, as well as high associations of residential segregation and higher mortality in African American women. Two studies assessed residential pollution on breast cancer risk. The first study showed a weak rate of breast cancer risk in African American women between differentiating levels of trihalomethane in public water (RR=1.2). The second assessed the association of magnetic field exposure and breast cancer risk and found that the odds of getting breast cancer were not significant in African American women (OR=1.02). This review provides a qualitative synthesis of major neighborhood and residential factors on breast outcomes in African American women. By enacting health policies and utilizing tools such as health informatics, steps can be taken to drive the breast cancer disparity down in this population. Citation Format: Brandi Patrice Smith, Zeynep Madak-Erdogan. Urban neighborhood and residential factors associated with breast cancer in African American women: A systematic review [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A09.

Need-supportive teaching practices and student-perceived need fulfillment in low socioeconomic status elementary schools: The moderating effect of anxiety and academic achievement

Connell and Wellborn's Self-System Model of Motivational Development (SSMMD; 1991) posits that structure, autonomy support, and involvement from teachers influence their students' perceptions of competence, autonomy, and relatedness. However, this model has rarely been tested in low socioeconomic elementary school students presenting academic and psychological difficulties. To fill this gap, this study examined whether student anxiety and academic achievement can moderate the association between teaching practices and student self-perceptions. A sample of 424 students and 45 teachers from five elementary schools located in low socioeconomic neighborhoods participated in the study over two consecutive years. Multilevel path analysis revealed that while most students felt competent and related to their teacher in highly structured and warm classrooms, anxious and low-achieving students benefited even more from teachers' structuring practices compared to their non-anxious or higher-achieving peers. Globally, our results partially support the application of the SSMMD for more vulnerable students.

Private Gardens as Urban Greenspaces: Can They Compensate for Poor Greenspace Access in Lower Socioeconomic Neighbourhoods?

The increasing process of urbanisation has major implications for the environment, biodiversity, and health and well-being of urban residents. Empirical evidence for urban greening benefits suggests that it is an appropriate planning and policy approach for tackling some of the problems associated with urbanisation, including biodiversity loss and heat island effects. Gardens on private residential lots represent a substantial proportion of greenspaces in low density cities with extensive suburban areas. Drawing on a qualitative study of residents in Sunshine North, Melbourne, Australia, this paper discusses three questions about the relationship of private gardens to public greenspaces:1) how does residents’ use of private gardens impact their use of other neighbourhood greenspaces;2) can private gardens address inequality of access to greenspaces in lower income neighbourhoods; and,3) what does this imply for planning and neighbourhood design?Contrary to previous research, the findings did not show a meaningful relationship between residents’ use of their gardens and local greenspaces, and further, that large yards and gardens do not substitute for poor access to local greenspaces. The paper concludes that policy makers and planners cannot assume private gardens and public greenspaces are interchangeable. While private gardens and local greenspaces can both provide positive benefits to residents, private gardens do not act as a substitute for local greenspaces in neighbourhoods of varying socio-economic status.

30-year changes in Australian children’s standing broad jump: 1985–2015

ObjectivesMuscular strength is an important component of fitness that enables the execution of a range of daily activities across the lifespan including sport participation. The purpose of this study was to examine changes in children’s standing broad jump, an indicator of muscular strength, between 1985 and 2015. DesignTwo representative cross-sectional population surveys of Australian children age 9–15 years (n=7051). MethodsIn 1985 and 2015 children’s standing broad jump (SBJ; cm) and anthropometry were measured by trained field teams. General linear regression examined the temporal change in SBJ by sex and age adjusting for height, weight, socioeconomic status, and linguistic background. ResultsOver a 30-year period, the height, weight, and BMI of children significantly increased and muscular strength decreased. Among boys, the adjusted SBJ distance declined −4.5cms (95%CI −8.8, −0.10) in 9–11 year olds and 7.6cms (95%CI −12.5, −2.7) in 12–15 year olds. Among girls, the adjusted SBJ distance declined 8.5cms (95%CI −12.9, −4.2) in 9–11 year olds and 9.3cms (95%CI −14.1, −4.6) in 12–15 year olds. Larger declines in the distance jumped were observed among children and adolescents from non-English speaking backgrounds, than English speaking peers and children from low socioeconomic neighbourhoods than the declines among children from high SES neighbourhoods. ConclusionsOverall, the distance children and adolescents jumped in 2015 was lower than the distance their peers jumped in 1985. The declines differed by sex and sociodemographic characteristics, which suggests targeted sub-population interventions to improve children’s muscular strength should be considered.

Descriptive epidemiology of changes in weight and weight-related behaviours of Australian children aged 5 years: two population-based cross-sectional studies in 2010 and 2015

ObjectiveOver the past 10–15 years there has been substantial investment in New South Wales (NSW), Australia, to reduce child obesity through interventions in children aged 0–5 years. We report changes...

Daily life with early orphanhood from HIV/AIDS: An exploratory study

This study explored the everyday lived life by South African early adolescents orphaned by HIV/AIDS. Informants were ten early adolescents (age range 12 to 14 years; females = 6; males = 4) from a low socioeconomic status neighbourhood of Johannesburg. The adolescents completed autobiographical essays and in-depth individual interviews on their quality of life in the school, home, and community. Thematic analysis of the data revealed the early adolescents, orphaned due to HIV/AIDS, to experience extreme sadness, anxiety, and fear. Their sense of emotional distress was compounded by living in material and relational poverty, with frequent exposure to bullying at school, and crime in their neighbourhood. Integrated psycho-social interventions addressing both material and relational poverty might enhance the physical and psycho-social well-being of adolescents with orphanhood from HIV/AIDS.