| 1. |
- De Neve, Jan-Walter, et al.
(författare)
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Are out-of-school adolescents at higher risk of adverse health outcomes? Evidence from 9 diverse settings in sub-Saharan Africa
- 2020
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Ingår i: Tropical Medicine & International Health. - : Wiley. - 1365-3156 .- 1360-2276. ; 25:1, s. 70-80
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We analysed mutually comparable surveys on adolescent attitudes and behaviours from nine sites in seven sub‐Saharan African countries, to determine the relationship between school enrolment and adolescent health outcomes.Methods: Data from the Africa Research, Implementation Science, and Education Network cross‐sectional adolescent health surveys were used to examine the associations of current school enrolment, self‐reported general health and four major adolescent health domains: (i) sexual and reproductive health; (ii) nutrition and non‐communicable diseases; (iii) mental health, violence and injury; and (iv) healthcare utilisation. We used multivariable Poisson regression models to calculate relative risk ratios with 95% confidence intervals (CI), controlling for demographic and socio‐economic characteristics. We assessed heterogeneity by gender and study site.Results: Across 7829 adolescents aged 10–19, 70.5% were in school at the time of interview. In‐school adolescents were 14.3% more likely (95% CI: 6–22) to report that their life is going well; 51.2% less likely (95% CI: 45–67) to report ever having had sexual intercourse; 32.6% more likely (95% CI: 9–61) to report unmet need for health care; and 30.1% less likely (95% CI: 15–43) to report having visited a traditional healer. School enrolment was not significantly associated with malnutrition, low mood, violence or injury. Substantial heterogeneity was identified between genders for sexual and reproductive health, and in‐school adolescents were particularly less likely to report adverse health outcomes in settings with high average school enrolment.Conclusions: School enrolment is strongly associated with sexual and reproductive health and healthcare utilisation outcomes across nine sites in sub‐Saharan Africa. Keeping adolescents in school may improve key health outcomes, something that can be explored through future longitudinal, mixed‐methods, and (quasi‐)experimental studies.
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| 2. |
- Harling, Guy, et al.
(författare)
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Impairment in Activities of Daily Living, Care Receipt, and Unmet Needs in a Middle-Aged and Older Rural South African Population : Findings From the HAALSI Study
- 2020
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Ingår i: Journal of Aging and Health. - : Sage Publications. - 0898-2643 .- 1552-6887. ; 32:5-6, s. 296-307
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objective of this study is to analyze the degree to which care needs are met in an aging rural African population. Method: Using data from the Health and Aging in Africa: Longitudinal Study of an INDEPTH Community (HAALSI) baseline survey, which interviewed 5,059 adults aged older than 40 years in rural South Africa, we assessed the levels of limitations in activities of daily living (ADLs) and in unmet care for these ADLs, and evaluated their association with sociodemographic and health characteristics. Results: ADL impairment was reported by 12.2% of respondents, with the proportion increasing with age. Among those with ADL impairment, 23.9% reported an unmet need and 51.4% more a partially met need. Relatives provided help most often; formal care provision was rare. Unmet needs were more frequent among younger people and women, and were associated with physical and cognitive deficits, but not income or household size. Discussion: Unmet care needs in rural South Africa are often found among individuals less expected to require care.
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| 3. |
- Harling, Guy, et al.
(författare)
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Interviewer-driven variability in social network reporting : results from health and aging in africa: a longitudinal study of an INDEPTH community (HAALSI) in South Africa
- 2018
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Ingår i: Field Methods. - : SAGE PUBLICATIONS INC. - 1525-822X .- 1552-3969. ; 30:2, s. 140-154
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Tidskriftsartikel (refereegranskat)abstract
- Social network analysis depends on how social ties to others are elicited during interviews, a process easily affected by respondent and interviewer behaviors. We investigate how the number of self-reported important social contacts varied within a single data collection round. Our data come from Health and Aging in Africa: a Longitudinal Study of an INDEPTH community (HAALSI), a comprehensive population-based survey of individuals aged 40 years and older conducted over 13 months at the Agincourt health and demographic surveillance site in rural South Africa. As part of HAALSI, interviewers elicited detailed egocentric network data. The average number of contacts reported by the 5,059 respondents both varied significantly across interviewers and fell over time as the data collection progressed, even after adjusting for respondent, interviewer, and respondent-interviewer dyad characteristics. Contact numbers rose substantially after a targeted interviewer intervention. We conclude that checking (and adjusting) for interviewer effects, even within one data collection round, is critical to valid and reliable social network analysis.
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| 4. |
- Harling, Guy, et al.
(författare)
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Social contact, social support, and cognitive health in a population-based study of middle-aged and older men and women in rural South Africa
- 2020
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 260
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several theories seek to explain how social connections and cognitive function are interconnected in older age. These include that social interaction protects against cognitive decline, that cognitive decline leads to shedding of social connections and that cognitive decline leads to increased instrumental support. We investigated how patterns of social contact, social support and cognitive health in rural South Africa fit with these three theories.Method: We used data from the baseline of "Health and Aging in Africa: a Longitudinal Study of an INDEPTH community in South Africa" (HAALSI), a population-based study of 5059 individuals aged >= 40 years. We evaluated how a range of egocentric social connectedness measures varied by respondents' cognitive function.Results: We found that respondents with lower cognitive function had smaller, denser social networks that were more local and more kin-based than their peers. Lower cognitive function was associated with receipt of less social support generally, but this difference was stronger for emotional and informational support than for financial and physical support. Impairment was associated with greater differences among those aged 40-59 and those with any (versus no) educational attainment.Conclusions: The patterns we found suggest that cognitively impaired older adults in this setting rely on their core social networks for support, and that theories relating to social connectedness and cognitive function developed in higher-income and higher-education settings may also apply in lower-resource settings elsewhere.
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| 5. |
- Yu, Shao-Tzu, et al.
(författare)
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The double-edged role of accessed status on health and well-being among middle- and older-age adults in rural South Africa : The HAALSI study
- 2022
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Ingår i: SSM - Population Health. - : Elsevier. - 2352-8273. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: Social capital theory conceptualizes accessed status (the socioeconomic status of social contacts) as interpersonal resources that generate positive health returns, while social cost theory suggests that accessed status can harm health due to the sociopsychological costs of generating and maintaining these relationships. Evidence for both hypotheses has been observed in higher-income countries, but not in more resource-constrained settings.We therefore investigated whether the dual functions of accessed status on health may be patterned by its interaction with network structure and functions among an older population in rural South Africa.Method: We used baseline survey data from the HAALSI study (“Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa”) among 4,379 adults aged 40 and older. We examined the direct effect of accessed status (measured as network members’ literacy), as well as its interaction with network size and instrumental support, on life satisfaction and self-rated health.Results: In models without interactions, accessed status was positively associated with life satisfaction but not self-rated health. Higher accessed status was positively associated with both outcomes for those with fewer personal contacts. Interaction effects were further patterned by gender, being most health-protective for women with a smaller network and most health-damaging for men with a larger network.Conclusions: Supporting social capital theory, we find that having higher accessed status is associated with better health and well-being for older adults in a setting with limited formal support resources. However, the explanatory power of both theories appears to depending on other key factors, such as gender and network size, highlighting the importance of contextualizing theories in practice.
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