Poor Communities Research Articles

Bystanders or active participants? Mobilising meaningful participation in River Basin management: lessons from the Gauteng Province, South Africa

ABSTRACT This paper explores the concept of meaningful participation in river basin management, using the case study of the Hennops River in Gauteng Province, South Africa. Experiences of different stakeholders and communities regarding their involvement in the management of the Hennops River basin are analysed following engagement through interviews, workshops and clean-up initiatives. Several barriers and enablers for meaningful participation, such as lack of awareness, capacity, coordination, trust and incentives, are identified. Some recommendations are proposed for improving stakeholder and community participation, based on the lessons learned from the case study. This includes the formulation of a social fund to support small community-based projects such as clean-up campaigns. Projects should be reflective, keeping the community engaged and active. The paper argues that meaningful participation requires not only formal mechanisms of engagement and decision-making but also informal and practical actions that empower stakeholders and communities to take ownership and responsibility for their water resources and environment. For meaningful participation to take place, more needs to be done to shift communities away from a ‘bystander’ position to a more active role. A new approach to community engagement is therefore necessary to support stakeholder-driven initiatives and the raising of awareness in poorer communities.

Determinants of under-five mortality in informal settlements in Nairobi, Kenya from 2002 to 2018

BackgroundChildhood mortality persists as a significant public health challenge in low and middle-income countries and is uneven within countries, with poor communities such as urban informal settlements bearing the highest burden. There is limited literature from urban informal settlements on the risk factors of mortality. We assessed under-five mortality and associated risk factors from the period 2002 to 2018 in Nairobi urban informal settlements.MethodsWe used secondary data from the Nairobi Urban Health and Demographic Surveillance System (NUHDSS), a longitudinal surveillance platform that routinely collects individual and household-level data in two informal settlements (Viwandani and Korogocho) in Nairobi, Kenya. We used Kaplan-Meier curves to estimate overall survival and the Cox proportional hazard model with a frailty term to evaluate the impact of risk factors on survival time.ResultsOverall under-five survival rate was 96.8% and this improved from 82.6% (2002-2006) to 95% (2007-2012) and 98.4% (2012-2018). There was a reduced risk of mortality among children who had BCG vaccination, those born to a married mother or a mother not engaging in any income-generating activity (both from 2007 to 2011), children from singleton pregnancy, children born in Viwandani slum and ethnicity of the child.ConclusionUnder-five mortality is still high in urban informal settlements. Targeted public health interventions such as vaccinations and interventions empowering women such as single mothers, those with multiple pregnancies, and more impoverished slums are needed to further reduce under-five mortality in urban informal settlements.

The economic burden of visceral leishmaniasis and barriers to accessing healthcare in Tigray, North Ethiopia: A field based study.

Visceral leishmaniasis (VL) is an important public health problem, which mainly affects the poor rural dwelling communities in Low- and Middle-Income Countries. However, little is known about the health and economic burdens of this disease in East Africa, including Ethiopia. The aim of this study was to assess the household level economic burden of VL among affected communities in Tigray, Northern Ethiopia. Between April and August 2020, a cross-sectional household survey was conducted on 96 patients who had been treated for VL within 12 months prior to the survey, in six districts of Tigray. Data on households' health seeking behavior, direct and indirect costs and coping strategies were collected using a structured questionnaire and the responses were analyzed using SPSS software. Most (82%) of the patients surveyed were males and the majority (74%) of them were between 16 and 30 years of age. The education level of participants was very low: over 33% had not received any form of education; 48% of patients were farmers dependent on subsistence agriculture and about 32% were daily laborers. Just under half of household families (46%) resided in "poor houses" with structures made from entirely local materials. Forty-one percent of patients from the surveyed households had traveled 48 to 72 kilometers to reach VL treatment hospitals. The median total household cost for one VL episode was estimated to be US$ 214. This is equated to 18% of the mean total annual household income or 72.5% of annual per capita income of the study population. More than 80% of the households surveyed incurred catastrophic costs of VL, where this is defined as exceeding 10% of annual household income. The median delay between the onset of symptoms and arrival at a care provider hospital was 37 days; once the patient arrived at hospital, the median delay during diagnosis was 3 days. Direct and indirect costs represented 44% and 56% of the total costs incurred, respectively. To cope with VL treatment costs, 43% of the households used more than one coping strategy: 48% took out loans, 43% sold livestock and 31% of households mobilized cash savings. VL in Tigray is concentrated among young males with low educational background and mostly engaged in subsistence economic activities. Despite the free diagnostic and treatment provisions that were available at public hospitals at the time of the study, our work shows that the household economic burden of the disease had significant impact among VL-affected communities in Tigray. Initiating community awareness towards prevention, early treatment seeking and decentralization of VL treatment centers are strongly recommended. In addition, we recommend efforts to reduce household treatment costs through transport and food provisions for patients (and their accompanying carers where possible) or through cash reimbursement for patients who complete treatment at public hospitals, in order to reduce the barriers to seeking treatment for this life-threatening disease.

Unravelling the Environmental Challenges: a State-of-the-Art Review of the Legal Framework of Solid Waste Management in Metropolitan Cities of India

Abstract This article provides insights into the challenges and current state of solid waste management in metropolitan cities of India. It emphasizes the importance of legal regulations in ensuring effective waste management to address environmental concerns. This research highlights the need for coordinated efforts among public authorities, adopting technologically advanced best practices globally, and incorporating Waste Hierarchy and Circular Economy concepts for efficient waste management. By addressing challenges like poor community engagement, understaffing, and political interference, the article underscores the significance of robust legal frameworks and strategic policies to mitigate environmental impacts and improve waste management practices in metropolitan cities. Recommendations include enhancing transparency in environmental information, establishing sustainable waste management systems, improving legislation, and promoting stakeholder engagement.

Unlocking Customer Happiness and Enhancing Quality of Life: The Potential of Small and Medium-Sized Enterprise ICT Initiatives in Stress-Inducing Environments

Customers in resource-poor communities still grapple with many information and communication technology (ICT) failures as they strive to access goods and services in small and medium enterprises near them. From a customer perspective, these challenges often lead to stress-related issues such as frustrations and anxiety, which can even result in transaction abandonment. Extended ICT failures result in SMEs failing to achieve sustainable e-commerce. This study delves into the impact of ICT initiatives by SMEs in stress-inducing environments on customers’ quality of life. The study further examines whether customer stress and happiness play a role in this association. Quantitative data were acquired using the mall intercept method, while the developed hypotheses were examined using structural equation modeling (SEM) in SMART-PLS 4. The results shed light on how customers navigate daily ICT-related failures experienced by SMEs operating in poor resource communities as they strive for happiness and stress-free lives, ultimately leading to an improved quality of life. The study recommends that the government, through its agencies, the Department of Communications and Digital Technologies and the Department of Science and Technology, among others, not only create an environment supporting SME ICT initiatives but also find strategies for sustaining SME ICT adoption for improved human well-being and socio-economic development within resource-constrained communities.

Testing technological Kuznets curve implications on achieving sustainable development goal 10 in seven Asian countries

This study investigates the relationship between technological innovations, financial development, and income inequality implications on achieving Sustainable Development Goal 10 (SDG10) in seven Asian economies via testing the inverted U-shaped hypothesis of technological innovation on income inequality in the concept of technological Kuznets curve hypothesis. The significant contribution of this study is introducing the Technological Kuznets Curve (TKC) as an extension to the Kuznets curve (KC) framework to capture the impact of technological innovation on income inequality. The PMG/ARDL was applied to estimate the coefficients to accomplish the study's objective. The panel cointegration tests confirm that all variables are cointegrated with income inequality. The empirical findings validate the KC hypothesis and demonstrate that technological innovations contribute to reducing income inequality within the Kuznets curve framework in the long run. Financial development (money supply) was negatively correlated with income inequality. The study further validates the TKC hypothesis, revealing an inverted U-shaped relationship between technological innovations and income inequality. Financial development, measured by domestic credit to the private sector, also shows a negative correlation with income inequality within the TKC framework. However, the money supply demonstrates a positive link with income inequality. The study recommended the necessity to prioritize policies that support technological innovation through subsidies, encouragement for research and development, and collaborations between the public and private sectors will greatly lower income inequality and support achieving Sustainable Development Goal 10 (SDG10). Financial development significantly facilitates access to financial services and contributes to diminishing income inequality by building an effective and inclusive banking system (mobile banking services for poor communities), easing access to credit for emerging and small and midsize enterprises (SMEs), and money circulation. Governments should strategically allocate resources toward programs and initiatives that directly address income inequality and promote inclusive growth.

Effective integration of COVID-19 vaccination with routine immunization: A case study from Kinshasa, DRC

BackgroundIn response to the challenge of maintaining COVID-19 vaccination coverage amidst the pandemic, VillageReach, in collaboration with the Ministry of Public Health Prevention and Hygiene in Kinshasa, DRC, integrated COVID-19 vaccination with routine immunization services at two primary healthcare facilities. This initiative, launched in July 2022, represented the first of its kind in the DRC, aiming to assess the effectiveness and scalability of a multimodal vaccination approach. MethodsThrough a rapid appraisal involving key informant interviews and analysis of pre- and post-integration service delivery data, this case study explores the operational dynamics and outcomes of integrating COVID-19 and routine immunizations. ResultsResults demonstrated that the integrated approach not only maintained COVID-19 vaccine coverage but also significantly enhanced routine immunization uptake, particularly among under-immunized and zero-dose children. Overall, the vaccination sites, outreach, and integrated health facilities administered 229,983 (33 %) of COVID-19 vaccines in Kinshasa, of which 53 % were referred by community health workers. Additionally, 998 under-immunized children received routine immunizations, of whom 126 were zero-dose children. Key success factors included sustained community health worker engagement, neighborhood-specific strategies, accessible vaccination points, and robust data management. The findings suggest that such integrative strategies can effectively bolster immunization coverage in urban poor communities, offering valuable insights for similar initiatives in the DRC and beyond. ConclusionThis study advocates for sustained investment in innovative immunization models to strengthen primary healthcare systems post-pandemic.

Individual-Level Exposure to Residential Redlining in 1940 and Mortality Risk.

Historic redlining, the practice by the Home Owners' Loan Corporation (HOLC) of systematically denying credit to borrowers in neighborhoods that were inhabited by primarily African American individuals, has been associated with poor community outcomes, but the association with individual risk of death is not clear. To examine if exposure to residential redlining practices by HOLC in 1940 is associated with increased risk of death later in life. The study linked individuals who resided within HOLC-graded neighborhoods (defined as Census Enumeration Districts) in 1940 with administrative death records data. The study estimated hazard ratios as well as age-specific life expectancy gaps (at age 55, 65, and 75 years) for HOLC grading exposure. This was done using methods that adapted standard parametric survival analysis to data with limited mortality coverage windows and incomplete observations of survivors. The analysis sample consisted of 961 719 individual-level observations across 13 912 enumeration districts within 30 of the largest US cities (based on 1940 population counts) across 23 states. Data were analyzed between December 1, 2023, and September 4, 2024. The exposure was HOLC grade based on historic HOLC maps, with A representing "best" or creditworthy areas; B, "still desirable"; C, "definitely declining"; and D, "hazardous" areas not worthy of credit (ie, redlined), and the main outcome was age at death from the Social Security Numident file. The 961 719-person individual sample had a mean (SD) age of 19.26 (9.26) years in 1940 and a mean (SD) age at death of 76.83 (9.22) years. In a model adjusted for sex (52.48% female; 47.52% male), race and ethnicity (7.36% African American; 92.64% White), and latent place effects, a 1-unit lower HOLC grade was associated with an 8% (hazard ratio, 1.08 [95% CI, 1.07-1.09]) increased risk of death. At age 65 years, these hazard differentials translated into an estimated life expectancy gap of -0.49 (95% CI, -0.56 to -0.43) years for each 1-unit decrease of the HOLC grade. This study found that individuals who resided within redlined neighborhoods in 1940 had lower life expectancy later in life than individuals who resided within other HOLC-graded areas.

Gender Construction at Islamic Poor Community

This study focuses on studying gender construction in the Islamic community in Surabaya. This community is in Kampung Sidosermo Dalam, one of the Islamic area in Surabaya. In everyday social and cultural conditions, women always wear the hijab and men wear koko shirts and sarongs. Women are always constructed as the second social class below men. The social construction that is built is not only agreed upon by men, but women also agree on it. The motto that women live by every day is suwargo nunut neroko katut. That a woman's heaven and hell is with her husband. The aim of the research is to dismantle unfair gender constructions so that hopefully there will be enlightenment leading to correct gender constructions. The research method uses qualitative with a critical ethnographic approach. The data collection technique used in-depth interviews for 15 informant with Sidosermo Dalam figures, kyai, nyai, RT, RW, as well as women who agreed that they were always in the second class. Apart from that, researchers also used participant observation techniques to explore data. The research results show that women have always experienced oppression since childhood. Every day they receive different treatment from men. The doctrine that women are always subordinate to men has been taught to the population from generation to generation. The construction of suwargo nunut neroko katut becomes a guide for interaction. This social construction is built and maintained using religious arguments as legitimacy. This patriarchal and oppressive condition must be immediately changed and corrected by the government, mass organizations and citizens themselves.

Policing Is Reproductive Oppression: How Policing and Carceral Systems Criminalize Parenting and Maintain Reproductive Oppression

Since the era of chattel slavery, the state has used institutionalized abuse and violence as a tool for reproductive control. Today, public institutions and social services have been established by the state to police and surveil the behavior of poor communities and parents to maintain the reproductive violence and oppression that began centuries ago. This paper uses a reproductive justice framework to explore how the history of criminalizing pregnancy, surveilling Black and Indigenous communities, and denying reproductive autonomy are connected to and maintained by the present-day family policing system. In doing so, this paper expands on existing literature to create a stronger link and build solidarity between the movements against family policing and reproductive oppression.

Assessing the Implications of Deforestation and Climate Change on Rural Livelihood in Ghana: a Multidimensional Analysis and Solution-Based Approach.

The Ashanti region in Ghana, abundant in natural resources such as forests and vegetation biomes, significantly supports the livelihoods of a significant portion of the population. The sustainable management of forest resources remains a significant challenge to achieving environmental and economic growth and poverty alleviation. The study aims to identify the drivers of deforestation and assess its impact on the livelihoods of the poor and vulnerable communities in the Ashanti region. The study utilized qualitative and space-based data to examine the patterns of vegetation cover and deforestation from 2000 to 2020. The results revealed moderate to sparse vegetation in Ashanti from 2002, 2005, 2011, 2015, 2017, and 2018, with no vegetation in the northcentral part, attributed to climate change, agricultural practices, government policies, and deforestation-related disasters. The study found a significant correlation (R² = 0.8197) between years and deforestation areas, especially in 2018 at around 16,000 Sqkm, indicating an exponential increase with severe implications for sustainable livelihoods. Much of these changes were reflected in 2020 with a high peak of deforestation towards the southeastern parts of the region. Additionally, the results show that the poor groups are not passive actors but are actively involved in identifying systems and processes through which to build their adaptive capacity and resilience to environmental and climate change-induced changes. The findings provide evidence-based and all-inclusive approaches that would encourage vulnerable and marginalized groups to participate in the co-production and co-creation of policies and strategies. This outcome is geared towards transformative and sustainable communities while ensuring efficient and effective response and recovery capacities of deforested lands.

Care-seeking pathways and treatment practices for snakebite in Odisha, India

PurposeSnakebites represent a pressing global public health concern, with India shouldering a disproportionate burden and often dubbed the "snakebite capital." Traditional and spiritual healing methods prevail in India, yet their efficacy and potential adverse health consequences warrant investigation. This study seeks to elucidate the perspectives of healthcare providers and caretakers regarding snakebite treatment practices, with a specific emphasis on traditional healing modalities.MethodsAn exploratory study was conducted among ten healthcare providers–five traditional and five modern treatment providers, two snake trappers/catchers and 120 snakebite victims or their caretakers across three districts of Odisha, India. Data were collected through in-depth interviews and analysed using content analysis.ResultsThe analysis revealed five main categories: various snakebite treatment practices, care-seeking pathways of victims, perspectives of patients and caretakers on treatment, traditional healers’ views on modern treatment, and allopathic doctors’ views on traditional treatment. Treatment practices observed included allopathic treatment, cold treatment, spiritual healing practices at temples, brass plate treatment, mantra enchanting, herbal treatment, and self-medication. Reasons for treatment delay included strong community beliefs in traditional healing, lack of control over irrational treatment by traditional healers, suboptimal care at primary and secondary healthcare facilities, and poor community literacy on snakebites.ConclusionsThe study emphasizes the need for improved snakebite preparedness strategies, community literacy, active involvement in prevention programs, and strong political commitment to control irrational treatment practices.

Social Justice Coalition & 2 others v Minister of Police and 4 others: Right to City as a Mitigating Concept to Harms on Public Safety

The South African constitution in section 9(3) prohibits unfair discrimination against anyone. This paper aims to unpack a judgement handed down by the Constitutional Court of South Africa on 19 July 2022 relating to the unfair allocation of policing resources in South Africa, thus resulting in unfair discrimination. The case discussed is the case of Social Justice Coalition and 2 others v Minister of Police and 4 others. Systematic discrimination has seen less allocation of police resources amongst poorer communities such as Khayelitsha in Cape Town. The paper further aims to see how local government can play a meaningful role in promoting public safety in its law and policy, thus promoting the ‘right to city’ and adhering to United Nations normative approaches on Urban crime and safety. This may mitigate systematic discrimination that historically disadvantaged areas have in policing resources across South Africa. Generally, South Africa is ranked one of the most violent societies. Murder, robbery, rape, femicide, and domestic violence occur at alarming levels. Cities such as Cape Town rank amongst the twenty most violent cities in the world, with the likes of some Latin and Central American cities, which are countries that are not in any form of civil war or civil unrest. It is a general norm that some areas have developed a reputation of being high risk to public safety because of various violent crimes such as gun shooting, stabbing, and rape. Certain areas in metropolitan cities, such as Khayelitsha Cape Town, are known to have high unreported incidents of violent crimes. It is worth pointing out that the application brought before the courts focuses on the lack of policing resources in Cape Town. This judgement also fits into the reality of the situation across South African townships under-resourced with policing resources to deal with violent crime and other crime. The paper will be structured in a way that first gives a background of the case, secondly a critical analysis of the case through the concept of ‘right to city’ and thirdly, submissions and a conclusion.

(Amoralny) familizm: propozycja rekonceptualizacji z wykorzystaniem psychologii ewolucyjnej i międzykulturowej

In his 1958 book Moral Basis of a Backward Society, Edward Banfield introduced the term amoral familism to describe social relations and values in a poor rural community in southern Italy. In my analysis, I propose to abandon the value-laden epithet "amoral" and consider familism as an evolutionary adaptive strategy activated in times of scarcity or crises. I base the thesis of the evolutionary roots of familism on the inclusive fitness theory (Hamilton 1964) and the theory of kin and reciprocal altruism (Trivers 1971). The perspective of evolutionary psychology makes it possible to see the positive functions of familism and to propose a new biological-cultural understanding of familism. Familism has so far been diagnosed primarily "indirectly" in sociological studies of bonding (and bridging) capital and in research on social trust conducted as part of cyclical social surveys such as the World Values Survey and the European Social Survey. In the search for accurate measures of biological-cultural familism we can additionally turn to the research of cross-cultural psychologists conducted for international management. I argue that the dimension of particularism on the 7-dimensional cultural map of Fons Trompenaars and Charles Hampden-Turner (2002) and the dimension of in-group collectivism on the 9-dimensional cultural map of the GLOBE project (House et al. 2004), can valuably complement the measures used in sociological sciences and make the diagnosis of familism more reliable. Finally, I call for in-depth research on Polish familism aimed at testing whether it is possible to build bridging capital on the basis of familist bonding capital.

Changes in the medical admissions and mortality amongst children in four South African hospitals following the COVID-19 pandemic: A five-year review.

Vulnerable children from poor communities with high HIV and Tuberculosis(TB) burdens were impacted by COVID-19 lockdowns. Concern was raised about the extent of this impact and anticipated post-pandemic surges in mortality. Interrupted time series segmented regression analyses were done using routinely collected facility-level data of children admitted for medical conditions at four South African referral hospitals. Monthly admission and mortality data over 60 months from 01 April 2018 to 31 January 2023 was analysed using models which included dummy lockdown level variables, a dummy post-COVID period variable, Fourier terms to account for seasonality, and excess mortality as a proxy for healthcare burden. Of the 45 015 admissions analysed, 1237(2·75%) demised with significant decreases in admissions during all the lockdown levels, with the most significant mean monthly decrease of 450(95%, CI = 657·3, -244·3) p<0·001 in level 5 (the most severe) lockdown. There was evidence of loss of seasonality on a six-month scale during the COVID periods for all admissions (p = 0·002), including under-one-year-olds (p = 0·034) and under-five-year-olds (p = 0·004). No decreases in mortality accompanied decreased admissions. Post-pandemic surges in admissions or mortality were not identified in children with acute gastroenteritis, acute pneumonia and severe acute malnutrition.During the COVID-19 pandemic, paediatric admissions in 4 hospitals serving communities with high levels of HIV, TB and poverty decreased, similar to global experiences; however, there was no change in in-hospital mortality. No post-pandemic surge in admissions or mortality was documented. Differences in the impact of pandemic control measures on the transmission of childhood infections and access to health care may account for differing outcomes seen in our setting compared to the global experiences. Further studies are needed to understand the impact of pandemic control measures on healthcare provision and transmission dynamics and to better inform future responses amongst vulnerable child populations.

Mapping Population Densities and Waste Management Systems in Mombasa County: A Literature Review of GIS and Remote Sensing Techniques

Mombasa County is one of the five counties along the coastline of Kenya. Currently, Mombasa County has a human population of 1.2 million people, and the population is rapidly increasing through rural-urban immigration and natural births. However, the inadequacy of well-established waste management systems on the mainland and coastlines of the County is a threat to the well-being of the local residents. Poorly disposed of wastes both on land and at sea can lead to health problems not only for humans and terrestrial animals but also for aquatic animals such as fish, with the latter being one of the main sources of affordable proteins for poor coastal communities. This paper aimed to conduct a review of the spatial human population density of Mombasa County and the geospatial location of waste dumping sites and their proximity to settled areas. This literature review synthesized existing research on the application of Geographic Information Systems (GIS) and Remote Sensing techniques in mapping population densities and assessing waste management systems. The review began by examining studies that investigate population distribution patterns in urban and rural areas, utilizing GIS to analyze demographic data and satellite imagery. It explored methodologies used to estimate population densities, including dasymetric mapping, spatial interpolation, and land use classification techniques. Key findings were that limited studies have utilized GIS technologies to assess the population in Kenya. GRASP and Random Forest (RF) were the main techniques previously used to assess population densities in the rural Taita Hills area and along the coastal region. The population has exponentially increased in Mombasa County since the 1950s and is projected to increase further. Additionally, waste management in Mombasa County is majorly controlled by the county government. Ten geo-tagged waste collection spots were identified during the review, spread across the residential areas. In conclusion, the county should endeavor to employ GIS techniques to assess the rapid population change within the county and have targeted interventions to address the disparities in waste collection systems against population increase.

Review of the Current Status on Ruminant Abortigenic Pathogen Surveillance in Africa and Asia.

Ruminant abortion events cause economic losses. Despite the importance of livestock production for food security and the livelihoods of millions of people in the world's poorest communities, very little is known about the scale, magnitude, or causes of these abortions in Africa and Asia. The aim of this review was to determine the current status of surveillance measures adopted for ruminant abortigenic pathogens in Africa and Asia and to explore feasible surveillance technologies. A systematic literature search was conducted using PRISMA guidelines for studies published between 1 January 1990 and 1 May 2024 that reported epidemiological surveys of abortigenic pathogens Africa and Asia. A meta-analysis was used to estimate the species-specific sero-prevalence of the abortigenic agents and the regions where they were detected. In the systematic literature search, 39 full-text manuscripts were included. The most prevalent abortigenic pathogens with sero-prevalence greater than 10% were BHV-1, Brucella, Chlamydia abortus, Neospora caninum, RVFV, and Waddlia chondrophila in cattle, BVDV in sheep, and RVFV and Toxoplasma gondii in goats in Africa. In Asia, Anaplasma, BHV-1, Bluetongue virus, Brucella, and BVDV were prevalent in cattle, whereas Mycoplasma was important in goats and sheep.

Spatial and statistical predictors of voter purge rates in Michigan

AbstractObjectiveVoter purges can protect election integrity by ensuring deceased or moved individuals are removed from election rolls. But they have been used to diminish voting power of marginalized groups, often by anti‐majoritarian forces seeking to undemocratically retain power. Little research has examined “who gets purged?” at the state level, especially with respect to local‐level differences.MethodsWe leverage Michigan's voter purge database from 2014 to 2018. Records are geocoded to their exact address, and a range of spatial correlates are identified to answer the above question. We then used generalized structural equation modeling to incorporate patterns of mobility and mortality.ResultsInitial results showed that more Democratic leaning areas, denser/more urban areas, and areas with more Black residents had higher purge rates. Notably, while these mediation effects were significant, racial composition and median income (i.e. more black and poorer communities) remained a significant factor in voter purge rates. These results suggest a potentially troublesome underlying element in Michigan's pattern of voter purges. We suggest this is an important first step in future research in other states and with subsequent databases, which can help strengthen the case that purges may be being used to uphold discriminatory and anti‐majoritarian goals.

Diet Adequacy and Food Cost of Food-secure and Insecure Households: Evidence from the 2018 ENNS

Access to a nutritious diet is a challenge that often strains many households with limited resources, thus making food choices that are short of recommended intakes. The study compared the one-day food consumption of households in the Philippines in terms of cost and nutritional adequacy by food security status. It also used the food threshold as a reference value for meeting the minimum cost required to meet basic food needs and satisfy energy and nutrient requirements. Secondary data from the 2018 Expanded National Nutrition Survey done by the Department of Science and Technology–Food and Nutrition Research Institute was used in the analysis. Food-insecure households have significantly higher intakes of energy-giving foods such as rice and other cereals and significantly lower intakes of body-building food such as fish, meat, and poultry than food-secure households. Less than half (45.0%) of the households have food costs equal to or higher than the food threshold. Households whose food cost was equal to or higher than the food threshold were 2.86 times more likely to meet their energy adequacy than those who had lower than threshold food costs. Similarly, households who met the food threshold were 4.61 times more likely to meet their protein, 2.11 times more likely to meet their vitamin A, and 1.87 times more likely to meet their iron adequacies, holding other variables constant. The study highlights the importance of economic access to food, especially among food-insecure households. This could be through making food more affordable and reducing physical barriers to food to be more accessible to poor communities or providing livelihood opportunities to increase their means to acquire food.

Creating communities that care: social representation of mental health in two urban poor communities in Ghana

Building caring communities is fundamental to achieving a community-based approach to mental health. Understanding how communities perceive mental illness provides critical insight into fostering mental health awareness and care. We explored the perceptions of mental illness among members of two urban poor communities in Accra, Ghana. Qualitative data were collected from 77 participants through key informant interviews, focus group discussions, and situated conversations. Using theory-driven thematic analysis based on social representations theory, findings revealed cognitive-emotional representations of mental illness. The communities demonstrated high awareness of the multilevel factors contributing to mental illness risk and experiences, drawing on five sources of knowledge: embodied, common sense, medical, cultural, and religious. Mental illness representations informed the classification and legitimization of mental illness based on the severity of conditions and the identity of sufferers. These findings provide valuable insights for planning community mental health interventions that address both social and institutional care needs.