Abstract
Welfare generosity's influence on the relationship between childhood measles vaccination and measles cases
Mary Ellen Walker, RN, MN, PhD(c)1, Michael Szafron, PhD1 and June Anonson, RN, PhD2
(1)University of Saskatchewan, Saskatoon, SK, Canada, (2)University of Saskatchewan, Prince Albert, SK, Canada
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
The political and economic contexts in which people live have important implications for their lives. Welfare policy may reflect this political-economic context because it can influence the human experience, including health. Previous research has explored how welfare policies influence health, but no research has explored how welfare generosity influences the relationship between a health intervention and its associated outcome. Furthermore, no research on welfare policy has used spatial analysis. This study explores the influence of welfare generosity on the relationship between measles vaccination rates and measles cases over time and geographic location using all country-level data available from 1990 to 2016. Control variables include female employment rate, world region, gross domestic product per capita, level of democracy, and the Gini inequality index. Generalized linear mixed model regression will be used to quantify the relationship between welfare generosity and measles data, and spatial models and maps will be used to determine the influence of geographic location on this relationship. Results reported will include the overall influence that welfare generosity has on the relationship between national childhood measles immunization rates and national measles cases. The influence of time and geographical location will also be discussed. This research will allow public health professionals to consider new ways of looking at the larger influences on health. It also provides public health professionals with examples of countries where welfare generosity policies are having a positive influence on prevention interventions for health. This research may inspire further study of the influence that policies have on health interventions.
Public health or related public policy Public health or related research
Abstract
Towards creating a healthy nation: A qualitative study on social determinants of young people’s health and well-being in Lagos state, Nigeria
Ucheoma Nwaozuru, PhD1, Sarah Blackstone, PhD, MPH2 and Juliet Iwelunmor, PhD3
(1)Saint Louis University, St. Louis, MO, (2)James Madison University, Harrisonburg, VA, (3)Saint Louis University, Saint Louis, MO
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
introduction: Engaging young people in understanding factors that influence their health is critical to developing effective interventions to address their health needs. This study explored young people’s perceptions of social determinants influencing their health and well-being in Lagos state, Nigeria.
methods: Fifty-three young people residing in Festac Town, Lagos state participated in focus group discussions to elicit their perspectives on factors influencing young people’s health. Transcripts were analyzed thematically using open and axial coding.
results: A total of twenty-five females and twenty-eight males between the ages of 15 and 30 years (mean age= 19 years) participated in the study. The study identified several factors that influence young people’s health in Nigeria. These factors were further grouped into the following seven major themes:1) impact of poverty and unemployment; 2) role of education; 3) safety and security concerns; 4) social relationships; 5) limited living amenities; 6) lack of access to health care; and 7) religious values and beliefs. In general, participants highlighted the role of government and social relationships (family and peers) on young people’s health and well-being.
conclusion: These findings demonstrate that young peoples’ health and well-being in Nigeria is influenced by an interplay of various social, economic and structural factors. This suggests that interventions targeting young people in Nigeria need to integrate strategies that engage with these social determinants of health to address their health priorities and enhance wellbeing.
Public health or related research Social and behavioral sciences
Abstract
A call for mental health promotion intervention among people who inject drugs receiving addiction treatment services in the Kathmandu Valley, Nepal
Krishna C. Poudel, PhD1, Kalpana Poudel-Tandukar, PhD2, Prawchan KC3 and Bishnu Sharma4
(1)School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, (2)University of Massachusetts, Amherst, MA, (3)SPARSHA Nepal, Lalitpur, Nepal, (4)Richmond Fellowship Nepal, Kathmandu, Nepal
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Depression is one of the most common co-morbid conditions among people who inject drugs (PWID) and is associated with poor quality of life and adverse impact of addiction treatment. Social support has a positive effect on mental health by providing emotional support and resources to deal with crises and by reducing the negative effects of stressors. Although the role of social support in mental health is acknowledged, limited studies have examined the role of social support in mental health disorders among PWID. We examined the relationship of social support with anxiety and depression among PWID.
Methods: In 2016, we conducted a cross-sectional study among 200 PWID receiving residential addiction treatment services from 20 centers in Kathmandu, Nepal. The Hopkins Symptom Checklist-25 was used to measure anxiety (10-item) and depression (15-item) with a cutoff mean score of ≥1.75 for moderate to severe symptoms. Social support was measured using 12-item multidimensional scale of perceived social support. Associations of social support with anxiety or depression scores were assessed using multiple-linear and logistic regression analyses.
Results: The proportion of participants with above threshold anxiety and depression were 55.0% and 68.2%, respectively. Participants with high social support had a significantly decreased risk of anxiety (adjusted odds ratio [OR] and 95% confidence interval [CI] for the highest versus lowest social support was 0.39 [0.19-0.80; p=0.011]) and depression (OR=0.49; 95% CI=0.21-0.98; p=0.047). Support from family was inversely associated with both anxiety (p=0.034) and depression (p=0.020), though support from friends and significant others were not.
Conclusions: Remarkably high rates of anxiety and depression among PWID receiving residential addiction treatment services in the Kathmandu Valley suggest the need to address the mental health burden among PWID. Involvement of family members in mental health promotion interventions could be a potential strategy to improve mental health status among PWID.
Advocacy for health and health education Epidemiology Public health or related research Social and behavioral sciences
Abstract
Social support and its effects on adolescent sexual risk taking: A look at vulnerable populations in Baltimore and Johannesburg
Aimee Bruederle, MPH1, Sinead Delany-Mortelwe, PhD, MD2, Kristin Mmari, Dr.PH, MA3 and Heena Brahmbhatt, PhD4
(1)The William and Flora Hewlett Foundation, Menlo Park, CA, (2)University of the Witwatersrand, Johannesburg, South Africa, (3)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (4)Johns Hopkins University, Baltimore, MD
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Introduction: The present study seeks to understand whether and to what degree social support affects adolescent sexual risk taking behaviors in disadvantaged urban environments.
Methods: Data were collected as part of the Wellbeing of Adolescents in Vulnerable Environments (WAVE) study, which is a global study of disadvantaged adolescents aged 15-19 years in five cities. The outcomes of interest were sexual experience, age at sexual debut, number of lifetime sexual partners, and condom use at last sex. Social support scales represented whether adolescents experienced support. Logistic and linear regressions were used to examine associations between social support and sexual risk taking after controlling for age, schooling, and family structure.
Results: Having higher social support of some kind was associated among adolescents from both Baltimore and Johannesburg choosing less risky sexual behaviors but were context- and gender-specific. Males raised by male caregivers had lower odds of having sex (aOR=0.01-0.19). Female social support at home was associated with delayed sexual debut among adolescent females in Baltimore (aOR=0.03 (CI=0.02-0.5)) and male support in Johannesburg had similar effects on girls (aOR=0.01 (CI=0.00-0.58)). Neighborhood support was associated with lower numbers of sexual partners among both females (aOR=0.19 (CI=0.17-0.21)) and males (aOR=0.74 (CI=0.47-1.17)) in Baltimore. At least one measure of social support was present for adolescents using condoms.
Conclusion: The findings from our study suggest that social support plays a role in adolescent sexual risk taking in vulnerable populations but it varies by context and gender. This may result from unstable social environments and family structures.
Diversity and culture Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Provision of health care to the public Public health or related nursing Social and behavioral sciences
Abstract
Psychosocial risk factors among women and childhood stunting: Lifetime economic impact for 137 developing countries
Mary C. Smith Fawzi, ScD1, Kathryn Andrews2, Gunther Fink, PhD2, Goodarz Danaei2, Dana Charles McCoy3, Christopher Sudfeld2, Evan Peet2, Jeanne Cho2, Yuanyuan Liu1, Jocelyn Finlay4, Majid Ezzati5, Sylvia Kaaya, MD, PhD6 and Wafaie Fawzi2
(1)Harvard Medical School, Boston, MA, (2)Harvard T. H. Chan School of Public Health, Boston, MA, (3)Harvard Graduate School of Education, Cambridge, MA, (4)Harvard Center for Population and Development Studies, Cambridge, MA, (5)Imperial College, London, United Kingdom, (6)Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Objective:
The first 1,000 days of life is a period of great potential and vulnerability. In particular, physical growth of children can be affected by the lack of access to basic needs as well as psychosocial factors, such as maternal depression. The present study quantifies the burden of childhood stunting in developing countries attributable to psychosocial risk factors and the related lifetime economic costs.
Methods:
The proportion of stunting prevalence and the number of cases attributable to low maternal education, intimate partner violence (IPV), maternal depression, and orphanhood were calculated. The joint effect of psychosocial risk factors on stunting was estimated. The economic impact, as reflected in the total future income losses per birth cohort, was examined.
Results:
7.2 million cases of stunting in developing countries were attributable to psychosocial factors. The leading risk factor was maternal depression with 3.2 million attributable cases and an estimated cost of $14.5 billion per birth cohort. The second and third leading causes were low maternal education ($10.0 billion) and IPV ($8.5 billion). The joint cost of these risk factors was $29.3 billion per birth cohort.
Conclusions:
The cost of neglecting these psychosocial risk factors is significant. Improving access to secondary education for girls may in part offset the risk of maternal depression, IPV, and orphanhood. Focusing on maternal depression may play a key role in reducing the burden of stunting. Overall, addressing psychosocial factors among perinatal women can have a significant impact on child growth and well-being in the developing world.
Epidemiology Public health or related public policy Public health or related research