Children's health-related quality of life, neighbourhood socio-economic deprivation and social capital. A contextual analysis

How do determinants of health relate to children's quality of life? A cross-sectional study in Izmir, Turkey

AIM

This study aims to determine health-related quality of life (QoL) and the related factors from the perspective of social determinants of health among children.

BACKGROUND

Childhood is the most intense period of life, and environmental factors surrounding children, as well as individual lifestyle factors, are related to the child's physical and mental well-being. To our knowledge, there is a lack of studies evaluating the relationship between determinants of health and the QoL of healthy children in general.

METHODS

This cross-sectional study was executed in the Bayrakli district of Izmir city. Stratified clustered sampling was used including 24 schools and 3367 7th-grade children, and 1284 students were targeted (50% prevalence, 95% CI, %5 margins of error, 2.25 design effect, and 20% replacement). The response rate was 84.9% (n = 1090). The Turkish KID-KINDL Health-Related Quality of Life Questionnaire for Children was used to assess QoL. Independent variables were examined in four layers using Dahlgren's Determinants of Health Model: basic characteristics, lifestyle factors, family characteristics, and life conditions.

RESULTS

The mean QoL score was 71.3 ± 12.6. Our study explained 31.7% of the variance in QoL. Higher QoL scores were associated with better health status, perceived academic achievement, normal/thin body perception, physical activity (PA), and adequate sleep duration. Living with both parents and having fewer siblings positively influenced QoL. Moreover, the presence of structural problems in the household and poorer health perceptions were associated with lower QoL scores (P < 0.05) This study highlighted the multifaceted nature of QoL in Turkish children, revealing the importance of various determinants of health. The results show that in order to improve the general well-being of this population, interventions and policies are required that concentrate on elements including health status, academic accomplishment, body perception, physical activity, family structure, and living situations.

Association of Socioeconomic Factors and Physical Activity with Health-Related Quality of Life in Italian Middle School Children: An Exploratory Cross-Sectional Study

Health-related quality of life (HRQoL) provides a broad assessment of an individual's well-being and can serve as a good prognosticator of life's outcomes later for children and adolescents. Understanding the factors associated with HRQoL is crucial for promoting better health and life satisfaction. This study investigated the cross-sectional association of socioeconomic status, cardio fitness, and physical activity levels with HRQoL in 224 Italian early adolescents attending secondary school in the Emilia-Romagna region located in Northern Italy. In a multivariate path regression model, younger students and females reported a higher quality of life (β = -0.139, p = 0.015, 95% CI: -0.254--0.023 and β = 0.142, p = 0.019, 95% CI: 0.011-0.273, respectively). Having both parents employed and having a higher familiar educational status were also associated with a higher quality of life (β = 0.142, p = 0.013, 95% CI 0.027-0.257 and β = 0.133, p = 0.017, 95% CI 0.022-0.244, respectively). Greater engagement in routine physical activity levels from moderate to vigorous intensity was positively associated with quality of life (β = 0.429, p < 0.001, 95% CI: 0.304-0.554). Endurance (speed) was positively associated with quality of life (β = 0.221, p = 0.001, 95% CI: 0.087-0.355), and students with longer times on the shuttle run reported less quality of life (β = -0.207, p = 0.002, 95% CI: -0.337--0.077). These relations remained intact even when controlling for socioeconomic factors. The current findings reinforce the importance of promoting regular physical activity among younger children and also addressing socioeconomic status disparities to improve children's well-being. Future studies may want to consider expanding the array of measures used to assess physical activity and include additional measures assessing nutrition, cultural factors, and family functioning, all of which can influence a child's willingness to engage in physical activity and their well-being. The emphasis on fitness and physical activity and their contribution to a child's well-being should be the prime focus for stakeholders who work in the education, public health, and health policy sectors.

Community social capital, migration status, and Chinese rural children's psychosocial development

Migration's impact on Chinese rural children's psychosocial development is the subject of growing research attention. While scholars highlight the critical role of social support, they have yet to systematically examine whether and how community social capital, which provides proximal social support for families, affects rural children's psychosocial development as well as whether such associations vary by children's migration status. Using data from the child component of the 2012 Chinese Urbanization and Labor Migration Survey, this article shows that community social capital reduces children's behavioral and emotional problems; however, left-behind children and migrant children gain less from community social capital than children with at-home parents. In addition, left-behind girls fare worse and gain less from community social capital than left-behind boys. Together, these findings imply that community social capital reinforces the disadvantaged psychosocial development of rural children who experience parental migration and evidence the enduring gender inequality in rural China.

Perception of Social and Educational Quality of Life of Minors Diagnosed with Rare Diseases: A Systematic Review and Meta-Analysis

This study explores the perception of social and educational quality of life in minors with rare diseases (RDs). Two meta-analyses were performed, applying the random effects model. Results: Regarding the social Quality of Life, the meta-sample consisted of k = 40 samples, with a total population of 1943 children (mean age = 9.42 years), of whom 687 (35.3%) were girls, 615 (31.4%) were boys and 641 (33%) did not report their sex. The effect size was large (mean size = 7.68; p < 0.000; 99% Confidence Interval; lower limit = 7.22; upper limit = 8.14). The results of the meta-regression and model analysis showed the importance of the measurement instrument (Paediatric Quality-of-Life Inventory and Prototypes of the Quality of life) and the dissimilarity of perception among caregivers. The nationality and the type of RD were not relevant. With respect to the educational Quality of Life, the meta-sample consisted of k = 19 samples, with 699 minors (mean age = 10.3 years), of whom 266 (38%) were girls, 242 (34.6%) were boys and 191 (27.4%) did not report their sex. The effect size was large (mean size = 7.15; p < 0.000; 99% CI; lower limit = 6.35; upper limit = 7.94). The meta-regression and comparison of models showed that the type of RD was essential. The measurement instrument was a moderating variable, especially the Parent version Paediatric Quality-of-Life Inventory. This study reveals the need for further research on RDs and their social−educational effects.

Early Childhood Development and Social Determinants

In human beings, the development of a child involves biological, emotional, and psychological changes that happen between birth and the conclusion of adolescence. Childhood is divided into three stages: early childhood, middle childhood, and late childhood (preadolescence). Early childhood is typically from infancy to six years of age. The methods for maintaining health and dealing with already-existing sicknesses and the social and economic settings in which children are born, grow up, live, and eventually work are referred to as the social determinants of health. Despite advances in health, child malnutrition remains a problem salutariness (severe) issue with massive human and economic resource implications. There is currently a growing corpus of research on how early development influences a child’s success later in life. From conception to two years of age, the first 1,000 days of life are becoming more well-recognized as important for the development of brain circuits that lead to linguistic, cognitive, and socio-emotional abilities, all of which are predictors of later-life labor market outcomes. The social patterning of health, sickness, and illness can be influenced by the social determinants of a child's health. This can also influence a person's overall well-being and functioning throughout their lifetime factors of a child's health, early childhood care, and development from an ecological standpoint, and as planned, a participatory approach in early childhood care and development is implemented. The social determinants of health are the elements that cause positive or negative changes in health or alter disease risks. The social determinants of health, which are different from medical treatment, can be altered by social policy. Social gradients and health equality are ideas that are related to understanding how social factors impact health.

Does the longitudinal association between neighbourhood cohesion and mental health differ by ethnicity? Results from the UK Household Longitudinal Survey

PURPOSE

While the association between neighbourhood cohesion and mental health has been widely studied in the general population, the effects of neighbourhood cohesion across ethnic groups are not well understood. Ethnicity is often left out of study design, many studies do not consider effect modification by ethnicity, or they rely on overly simplistic ethnic categories.

METHODS

Data from the UK household longitudinal study were used to investigate whether changes in neighbourhood cohesion are independently associated with changes in mental health (measured using the GHQ) over 9 years (2009-2018), and whether the association differed across 17 ethnic groups. The study used a fixed-effect modeling approach that includes within-person estimators that allow each participant to act as their own control.

RESULTS

Compared to British White, the following ethnic groups all saw a similar improvement in GHQ (- 0.76, 95% CI - 0.83 to - 0.70) for each point increase in neighbourhood cohesion: Irish, any other White, White and Asian mixed, Chinese, Caribbean, African, any other Black, Arab, and others. Some ethnic groups saw stronger improvements in mental for each point increase in neighbourhood cohesion, including White and Black Caribbean mixed, any other mixed, Indian, Pakistani, any other Asian, with the strongest effect seen in Bangladeshi participants (- 2.52. 95% CI - 3.48 to - 1.56).

CONCLUSION

Our study highlights the importance of ethnocultural data in research examining neighbourhood effects on mental health. Future research should evaluate policies to improve neighbourhood cohesion for ethnic minorities to address ethnic mental health disparities.

The association of social capital with depression and quality of life in school-aged children

Social capital is an important factor that affects mental health. The purpose of this study was to examine the relationship between social capital and depression and between social capital and quality of life (QoL) in children in elementary and junior high school and to examine how this relationship differs in relevant patterns at both the individual- and school-level. The study was conducted in all elementary and junior high schools in a single municipality; the subjects consisted of 3,722 elementary school and 3,987 junior high school students (aged from 9 to 15). A multilevel linear mixed effect model analysis revealed that all three subscales of social capital were associated with depression and QoL at the individual-level: The school social capital at the individual-level showed the strongest association with depression and QoL. We also found that some of social capital at the school-level was associated with depression and QoL. An interactive effect was observed between educational stage (elementary and junior high) and some of social capital subscales. Specifically, the inverse association between school social capital and depression was stronger among the junior high students, while the positive association between school and neighborhood social capital and QoL was stronger among the elementary students. These interactions suggest that social capital impacts depression and QoL differently in elementary and junior high students. These findings suggest that the degree of association of social capital domains differs in mental health among the educational stage.

Relationship between social capital and quality of life among adult stroke patients: a cross-sectional study in Anhui Province, China

Objectives

Few studies have investigated the association between social capital and quality of life (QoL) among stroke patients. To address this research gap, we aimed to explore the association between social capital and QoL among stroke patients in Anhui Province, China.

Study design

Cross-sectional study.

Methods

This cross-sectional study was conducted using a multi-stage stratified random sampling method. The following data including demographic characteristics, health-related conditions, five dimensions of social capital status, and quality of life (QoL) were collected using a questionnaire. Generalized linear models were then used to determine the relationship between social capital and QoL after adjusting for confounding factors.

Results

A total of 390 participants were included for the final analysis in this study. Our results indicated that subjects with higher social capital including social connection (coefficient: 28.28, 95% CI: 19.39–37.16), social support (coefficient: 21.17, 95% CI: 10.63–31.71), trust (coefficient: 13.46, 95% CI: 2.73–24.19), reciprocity (coefficient: 25.56, 95% CI: 15.97–35.15), and cohesion (coefficient: 19.30, 95% CI: 9.90–28.70) had increased odds of reporting poor QoL when compared with lower social capital group. We also observed that the association between social capital and QoL varied across cities.

Conclusions

Our findings show that social capital is associated with QoL in adult stroke patients, suggesting that social capital may be significant for enhancing QoL among adults with stroke.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-022-01925-x.

Social cohesion, psycho-physical well-being and self-efficacy of school-aged children in Lombardy: Results from HBSC study

Within the literature on health inequalities and social determinants of health, there is a growing interest in studying how the context of residence is able to influence health conditions and health-related outcomes, over and above individual characteristics. Life context affects people's well-being in a material way, through the availability of services and resources, but also through social, cultural and relational resources, to the extent to which people within the same context share norms, values and behaviours affecting their health conditions. In this study, we analysed the association between social cohesion in the context of residence and two health-related outcomes, psycho-physical well-being and self-efficacy, in school-aged children in Lombardy, using data from the Health Behaviour in School-aged Children (HBSC) study for 2014. The results show a positive association between the variables, indicating that social cohesion matters for young people's health and well-being and suggesting new areas of intervention in policies aiming at promoting health and reducing inequalities.

Cognitive Empathy in Subtypes of Antisocial Individuals

Cognitive empathy allows individuals to recognize and infer how others think and feel in social situations and provides a foundation for the formation and maintenance of mutually constructive relationships. It may seem intuitive to assume that individuals who engage in antisocial behavior, who disregard the rights of others, might have problems with cognitive empathy. However, careful examination of the literature suggests that any dysfunction in cognitive empathy associated with antisociality varies by subtype of antisocial individual and is specific to subcomponents of cognitive empathy. In this review, we (1) briefly define subtypes of antisocial individuals ("psychopathic" vs. "antisocial-only"), (2) summarize specific components of cognitive empathy; (3) review existing literature examining cognitive empathy through questionnaires, behavioral tasks, and neuroimaging within different antisocial subtypes; and (4) discuss the limitations of the current research and potential future directions. Individuals in the psychopathic subtype fail to implicitly engage in cognitive empathy, and potentially lack insight into this issue reflected in no self-reported problems with cognitive empathy, but show an ability to engage in cognitive empathy when explicitly required. Individuals in the antisocial-only subtype appear able to engage in cognitive empathy, showing no differences on questionnaire or behavioral tasks that tap explicit cognitive empathy, but may display subtle difficulties accurately inferring (affective theory of mind) the emotions of others. We end the review by noting areas for future research, including the need to: (1) document the patterns of equifinality that exist across levels of analysis for these antisocial subtypes; (2) examine the temporality of empathy and antisociality development; (3) carefully consider and label subcomponents of cognitive empathy in research on antisocial behavior; and (4) investigate the intersection among environmental experiences, cognitive empathy, and antisocial behavior.

Caregiver-reported health-related quality of life of New Zealand children born very and extremely preterm

BACKGROUND

Children born preterm, particularly at earlier gestations, are at increased risk for mortality and morbidity, but later health-related quality of life (HRQoL) is less well described. Neurodevelopmental impairment and socio-economic status may also influence HRQoL. Our aim was to describe the HRQoL of a cohort of New Zealand children born very and extremely preterm, and how this is related to neurodevelopmental impairment, gestational age, and socio-economic deprivation.

METHODS

Children born <30 weeks' gestation or <1500 g birthweight were assessed at 7 years' corrected age. Caregivers completed the Child Health Questionnaire Parent Form (CHQ-PF50), and the Health Utilities Index Mark 2 (HUI-2). Neurodevelopmental impairment was defined as Wechsler full scale intelligence quotient below -1 standard deviation (SD), Movement Assessment Battery for Children total score ≤15 percentile, cerebral palsy, deafness, or blindness.

RESULTS

Data were collected for 127 children, of whom 60 (47%) had neurodevelopmental impairment. Overall, HRQoL was good: mean (SD) CHQ-PF50 physical summary score = 50.8 (11.1), psychosocial summary score = 49.3 (9.1) [normative mean 50 (10)]; HUI-2 dead-healthy scale = 0.92 (0.09) [maximum 1.0]. Neurodevelopmental impairment, lower gestational age, and higher socio-economic deprivation were all associated with reduced HRQoL. However, on multivariable analysis, only intelligence quotient and motor function were associated with psychosocial HRQoL, while intelligence quotient was associated with physical HRQoL.

CONCLUSIONS

Most seven-year-old children born very and extremely preterm have good HRQoL. Further improvements will require reduced neurodevelopmental impairment.

A Multilevel Perspective on the Health Effect of Social Capital: Evidence for the Relative Importance of Individual Social Capital over Neighborhood Social Capital

Employing a multilevel perspective on the health effects of social capital, this study analyzes how individual and neighborhood differences in self-rated health in Ghent (Belgium), relate to individual and collective social mechanisms, when taking demographic and socioeconomic characteristics of individuals into account. This study estimates the health effects of social trust, informal social control and disorder at the neighborhood level and social support and network size at the individual level, using indicators indebted to both the normative and resource-based approaches to social capital. Instead of the mere aggregation of individual indicators of social capital, this study uses the key informant technique as a methodologically superior measurement of neighborhood social capital, which combined with a multilevel analysis strategy, allows to disentangle the health effects of individual and neighborhood social capital. The analysis highlights the health benefits of individual social capital, i.e., individual social support and network size. The study indicates that controlling for individual demographic and socioeconomic characteristics reduces the effect of the neighborhood-level counterparts and the neighborhood characteristics social trust and neighborhood disorder have significant, but small health effects. In its effects on self-rated health, social capital operates on the individual level, rather than the neighborhood level.

The association of community and individual parental social capital with behavior problems among children in Japan: results from A-CHILD longitudinal study

PURPOSE

The purpose of this study was to determine the association of individual-level and community-level parental social capital with childhood behavior problems using population-based longitudinal data in Japan.

METHODS

We analyzed data from a population-based longitudinal survey study which followed first-grade elementary school children (6-7 years old) in Adachi City, Tokyo, Japan. At baseline, the parents of first-grade students from all 69 elementary schools in Adachi City were asked to respond to a questionnaire assessing behavior problems and prosocial behavior (using the Strengths and Difficulties Questionnaire) and parental social capital in the community (N = 5494). Data on follow-up questionnaires on behavior problems were collected when children were second grade. Among both surveys, 3656 parents returned valid responses. The association between individual-level and community-level parental social capital and children's behavior problems were analyzed using multilevel analyses adjusting for covariates.

RESULTS

Community-level social capital was positively associated with prosocial behaviors, but not for total difficulties, after adjustment for covariates (coefficient = 0.19, 95% CI 0.03 to 0.36). Individual-level parental social capital was also positively associated with prosocial behaviors (coefficient = 0.27, 95% CI 0.12 to 0.41) and negatively associated with total difficulties (coefficient = - 0.54, 95% CI - 0.89 to - 0.19).

CONCLUSIONS

This study showed that greater community-level social capital can benefit children with increased prosocial behaviors. Individual-level parental social capital can be protective of youth by increasing prosocial behaviors and reducing difficult behaviors. Boosting both community and individual social capital can be a promising means to enhance children's well-being.

Mapping the Cultural Identities of Youths in Hong Kong from a Social Capital Perspective

With its unique geopolitical status and multicultural setting, Hong Kong has harbored different youth groups generated from cross-border migration with mainland China who are tied to different cultural values and identifications. This study aims to investigate how social capital embedded in the family, school, and community influences the cultural identities across three groups of Chinese youths in the educational system: local students; cross-border students (born in Hong Kong, living in the neighbor city of mainland China but attending schools in Hong Kong on daily commute); and new immigrant students (born in mainland China but living in Hong Kong for less than seven years). Using data from a cross-sectional survey with 2180 fourth- to ninth-grade students in Hong Kong, the logistic regression results suggest that family and community social capital play significant roles in shaping the cultural identity of youths. Implications of the research findings are discussed.

Neighbourhood wealth, not urbanicity, predicts prosociality towards strangers

Urbanization is perhaps the most significant and rapid cause of demographic change in human societies, with more than half the world's population now living in cities. Urban lifestyles have been associated with increased risk for mental disorders, greater stress responses, and lower trust. However, it is not known whether a general tendency towards prosocial behaviour varies across the urban-rural gradient, or whether other factors such as neighbourhood wealth might be more predictive of variation in prosocial behaviour. Here, we present findings from three real-world experiments conducted in 37 different neighbourhoods, in 12 cities and 12 towns and villages across the UK. We measured whether people: (i) posted a lost letter; (ii) returned a dropped item; and (iii) stopped to let someone cross the road in each neighbourhood. We expected to find that people were less willing to help a stranger in more urban locations, with increased diffusion of responsibility and perceived anonymity in cities being measured as variables that might drive this effect. Our data did not support this hypothesis. There was no effect of either urbanicity or population density on people's willingness to help a stranger. Instead, the neighbourhood level of deprivation explained most of the variance in helping behaviour with help being offered less frequently in more deprived neighbourhoods. These findings highlight the importance of socio-economic factors, rather than urbanicity per se, in shaping variation in prosocial behaviour in humans.

Impact of flooding on health-related quality of life in England: results from the National Study of Flooding and Health

BACKGROUND

Flooding can have extensive effects on the health and wellbeing of affected communities. The impact of flooding on psychological morbidity has been established; however, the wider impacts of flooding exposure, including on health-related quality of life (HRQoL), have not been described.

METHODS

Using data from the English National Study of Flooding and Health cohort, HRQoL 2 and 3 years post-flooding was assessed with the EuroQol Group EQ-5D-5L tool. Associations between exposure groups (flooding and disruption from flooding) and HRQoL were assessed, using ordinal and linear regression, adjusting for a priori confounders.

RESULTS

For both 2 and 3 years post-flooding, the median HRQoL scores were lower in the flooded and disrupted groups, compared with unaffected respondents. A higher proportion of flooded and disrupted respondents reported HRQoL problems in most dimensions of the EQ-5D-5L, compared with unaffected respondents. In year 2, independent associations between exposure to flooding and experiencing anxiety/depression [adjusted odds ratio (aOR) 7.7; 95% CI 4.6-13.5], problems with usual activities (aOR 5.3; 95% CI 2.5-11.9) and pain/discomfort (aOR 2.4; 95% CI 1.5-3.9) were identified. These problems persisted 3 years post-flooding; associations between exposure to flooding and experiencing anxiety/depression (aOR 4.3; 95% CI 2.5-7.7), problems with usual activities (aOR 2.9; 95% CI 1.5-6.1) and pain/discomfort (aOR 2.5; 95% CI 1.5-4.2) were identified.

CONCLUSIONS

Exposure to flooding and disruption from flooding significantly reduces HRQoL. These findings extend our knowledge of the impacts of flooding on health, with implications for multi-agency emergency response and recovery plans.

Social capital, social cohesion, and health of Syrian refugee working children living in informal tented settlements in Lebanon: A cross-sectional study

BACKGROUND

Since 2011, the protracted Syrian war has had tragic consequences on the lives of the Syrian people, threatening their stability, health, and well-being. The most vulnerable are children, who face interruption of schooling and child labor. This study explored the relationship between social capital and the physical health and emotional well-being of Syrian refugee working children in rural areas of Lebanon.

METHODS AND FINDINGS

In this cross-sectional study, we surveyed 4,090 Syrian refugee children working in the Bekaa Valley of Lebanon in 2017. Children (8-18 years) gave direct testimony on their living and social environment in face-to-face interviews. Logistic regressions assessed the association of social capital and social cohesion with the health and emotional well-being of Syrian refugee working children; specifically, poor self-rated health, reporting a health problem, engaging in risky health behavior, feeling lonely, feeling optimistic, and being satisfied with life. Of the 4,090 working children in the study, 11% reported poor health, 16% reported having a health problem, and 13% were engaged in risky behaviors. The majority (67.5%) reported feeling lonely, while around 53% were optimistic and 59% were satisfied with life. The study findings suggest that positive social capital constructs were associated with better health. Lower levels of social cohesion (e.g., not spending time with friends) were significantly associated with poor self-rated health, reporting a physical health problem, and feeling more lonely ([adjusted odds ratio (AOR), 2.4; CI 1.76-3.36, p < 0.001], [AOR, 1.9; CI 1.44-2.55, p < 0.001], and [AOR, 0.5; CI 0.38-0.76, p < 0.001], respectively). Higher levels of social support (e.g., having good social relations), family social capital (e.g., discussing personal issues with parents), and neighborhood attachment (e.g., having a close friend) were all significantly associated with being more optimistic ([AOR, 1.5; CI 1.2-1.75, p < 0.001], [AOR, 1.3; CI 1.11-1.52, p < 0.001], and [AOR, 1.9; CI 1.58-2.29, p < 0.001], respectively) and more satisfied with life ([AOR, 1.3; CI 1.01-1.54, p = 0.04], [AOR, 1.2; CI 1.01-1.4, p = 0.04], and [AOR, 1.3; CI 1.08-1.6, p = 0.006], respectively). The main limitations of this study were its cross-sectional design, as well as other design issues (using self-reported health measures, using a questionnaire that was not subject to a validation study, and giving equal weighting to all the components of the health and emotional well-being indicators).

CONCLUSIONS

This study highlights the association between social capital, social cohesion, and refugee working children's physical and emotional health. In spite of the poor living and working conditions that Syrian refugee children experience, having a close-knit network of family and friends was associated with better health. Interventions that consider social capital dimensions might contribute to improving the health of Syrian refugee children in informal tented settlements (ITSs).

Income and clinical depression versus non-clinical mental health: Same associations or different structures? A dissociation strategy using a national representative random survey based on EUROHIS (INHIS-2)

We use a unique, large survey on health conditions conducted in Israel (10,331 respondents, 52.8% females, mean age 49.8) to explore whether clinical determined depression and/or anxiety has different associations in compare to non-clinical determined terms such as mental health. We find that absolute income is significantly associated with a decrease in negative mental health but have no significant association with depression and/or anxiety prevalence, whereas relative income is significantly associated with a decrease in depression and/or anxiety prevalence but have no significant association with negative mental health. The two specifications differed also with respect to several important risk factors, including personal attributes such as being of African origin, of a non-Jewish Arab minority or divorced. However, they were similar with general characteristics, such as participation in sport and smoking activities, whether a person has children, age and gender. Our results put forth sever questions about the wide use of non-clinical mental health, happiness and wellbeing as a sole proxy for a person's true wellbeing or utility.

Association of mental health problems in childhood with prenatal and postnatal physical growth

Aims

The present study was conducted to examine (i) prenatal and postnatal patterns of growth in relation to the risk of later mental health problems in children and (ii) the possible mediating effect of these patterns of growth in the association between parental socioeconomic status (SES) and children’s mental health.

Subjects and methods

The present study is part of a blinded, matched case control study, involving a retrospective analysis of prospectively collected data from routine examinations at community health services for children and adolescents. The sample comprised 80 patients, referred between the age of 6–13 years to the Community Mental Health Centre in Maastricht, and 320 matched population controls.

Results

Children coming from unemployed families weighed less at birth, but postnatal growth was not associated with this or other indicators of SES. Although children using mental health care were somewhat smaller at birth, there was no evidence that leanness during childhood was a risk factor for the development of mental health problems.

Conclusions

The present results showed some evidence for the impact of intrauterine development on children’s mental health problems. In addition, neither prenatal nor postnatal physical growth were on the pathway between parental SES and children’s mental health problems.

Evaluating the cross-cultural validity of the Dutch version of the Social Exclusion Index for Health Surveys (SEI-HS): A mixed methods study

Background

The recently developed Social Exclusion Index for Health Surveys (SEI-HS) revealed particularly strong social exclusion in non-Western immigrant groups compared to the native Dutch population. To qualify such results, cross-cultural validation of the SEI-HS in non-Western immigrant groups is called for.

Methods

A sequential explanatory mixed methods design was used, employing quantitative data from the Netherlands Public Health Monitor along with qualitative interviews. Data from 1,803 adults aged 19 years or older of Surinamese, 1,009 of Moroccan and 1,164 of Turkish background and 19,318 native Dutch living in the four largest cities in the Netherlands were used to test the factorial structure of the SEI-HS and differential item functioning across immigrant groups. Additionally, 52 respondents with a high score on the SEI-HS and from different background were interviewed on the item content of the SEI-HS and subjective feelings of exclusion. For each SEI-HS item the semantic, conceptual and contextual connotations were coded and compared between the immigrant groups and native Dutch.

Results

High levels of social exclusion were found in 20.0% of the urban population of Surinamese origin, 20.9% of Moroccan, 28.7% of Turkish and 4.2% of native Dutch origin. The 4-factor structure of the SEI-HS was confirmed in all three immigrant groups. None of the items demonstrated substantial differential item functioning in relation to immigration background. The interviews uncovered some methodological shortcomings, but these did not substantially impact the observed excess of social exclusion in immigrant groups.

Conclusions

The present study provides evidence in support of the validity of the SEI-HS in adults of Surinamese, Moroccan and Turkish background and confirms the major social exclusion of these immigrant groups in the main cities in the Netherlands. Policy measures to enhance social inclusion and reduce exclusion are urgently needed.

Family and neighborhood socioeconomic status and temperament development from childhood to adolescence

OBJECTIVE

Children differ in their temperament and these differences predict consequential outcomes, including mental health, peer relations, substance use, academic performance, and adult personality. Additionally, children's temperament develops over time in response to environmental factors, such as the socioeconomic status (SES) of their family and the neighborhood in which they are raised. However, there has been lack on research on the relation between neighborhood SES and the development of temperament or personality.

METHOD

Using data from two cohorts of the Longitudinal Study of Australian Children (LSAC; N = 9,217) that followed children from 4 to 15 years old, the present analyses examined whether parent income, parent education, and neighborhood disadvantage were associated with three child temperament traits that are precursors to Five-Factor Model (FFM) adult personality traits.

RESULTS

Longitudinal hierarchical linear models (HLM) generally found that children with lower neighborhood SES or family SES tended to have lower sociability, higher reactivity, and lower persistence and these associations did not decrease over time.

CONCLUSIONS

This research demonstrates that both the neighborhood and the family SES in childhood are important for the development of temperament across childhood and adolescence.

Exploring the Linkage between the Neighborhood Environment and Mental Health in Guangzhou, China

The relationship between the neighborhood environment and mental health has been investigated mostly in developed countries. Yet few studies have systematically examined the impact of the neighborhood-level built-environment and social environment on mental health within different localities in the Chinese context. Based on a household survey and geographical data in Guangzhou, China, this study aimed to explore the linkage between the neighborhood environment and mental health, with a particular focus on aspects of the built-environment that are related to new urbanism or compact cities and contextual social capital, using three geographic delineations. Our findings indicated that built-environment indicators based on a road network buffer had a higher explanatory power towards residents’ mental health than did those based on a circular buffer. The analytical models demonstrated that neighborhood floor-area ratio, building density, and per capita green area were positively correlated with mental health. Neighborhood safety and contextual neighborhood interactions and reciprocity had positive associations with mental health. These findings provide policy makers and urban planners with valuable information on the role of the compact city strategy and the neighborhood social environment to improve the mental health of residents.

Community disadvantage, inequalities in adolescent subjective well-being, and local social relations: The role of positive and negative social interactions

Studies identify the existence of inequalities in adolescent subjective well-being (SWB) across levels of community socio-economic disadvantage. One posited explanation is that community disadvantage harms SWB through undermining positive social relations among residents (often termed social capital). However, social relations can be both positive and negative; for example, social interactions between residents can be friendly or unfriendly, or involve being helped or harmed. Little work has explored negative social relations in communities and their impact on SWB. This study therefore examines the role that local negative social relations may play, alongside positive relations, in understanding inequalities in SWB across communities. Data are taken from a nationally representative survey of 16-17-year olds in England in 2015. Applying multilevel models, findings demonstrate that adolescents living in more disadvantaged communities exhibit lower SWB. In line with current theories, part of this association can be accounted for by weaker positive social relations: the results show that while positive local interactions are important for youth SWB (primarily via higher neighbour trust), young people in more disadvantaged communities report fewer local positive social interactions. However, the models also demonstrate that part of the negative association between community disadvantage and SWB is also accounted for by stronger negative social relations: the results show that negative local interactions are harmful for youth SWB (both directly, and indirectly via lower neighbour-trust), and young people in disadvantaged communities report more frequent negative local social interactions. Importantly, the negative indirect-effect of community disadvantage via increasing negative social interactions is almost twice as strong as the negative indirect-effect of disadvantage via reducing positive interactions. Taken together, community disadvantage appears to harm SWB not only by reducing positive relations but also increasing negative relations. These form dual, independent, social relations pathways through which community disadvantage affects SWB.

Social participation as an indicator of successful aging: an overview of concepts and their associations with health

Objectives Social participation has generated a wealth of research in gerontology, but the concept suffers from a lack of conceptual clarity that renders it difficult to define and measure. This means that research on social participation is difficult to compare directly. The aim of the present study was to draw the literature on social participation in older adults together to inform health services researchers seeking to investigate social participation as an indicator of successful aging. Methods A narrative review of studies investigating the association between social participation and health in adults aged 65 years and older was conducted. Results Three concepts of social participation (i.e. social connections, informal social participation and volunteering) were defined, their measurement instruments described and evidence of their associations with health explored. All three concepts have demonstrated associations with an array of health indicators. Prospective studies reveal that social participation at baseline is positively associated with mental and physical health. Conclusion A model of social participation on health is presented, showing the evidence that all three concepts contribute to the association between social participation and health through their shared mechanisms of social support and social cohesion with the wider community. Using an instrument that can be separated into these three distinct concepts will assist health services researchers to determine the relative effect of each form of participation on the health of older adults. What is known about the topic? Social participation has generated a wealth of research in gerontology. The scope of the literature on social participation is broad and the concepts diverse. For this reason, most previous systematic reviews have been unable to comprehensively assess the effect of all concepts of social participation on health. This means the research on social participation is difficult to compare directly, and indicators of social participation in older adults are difficult for policy makers to select. What does this paper add? This paper overviews the three concepts of social participation, their methods of measurement and their associations with health in older adults. We present a model of social participation that incorporates all three concepts of social participation and their effects on health. We argue that the use of a measure that can be segmented into each of the three forms of social participation will predict more of the variance in health outcomes than any measure on its own. What are the implications for practitioners? Enhancing the social participation of older adults is a key factor in successful aging that many older adults value. However, many service provision organisations tend to focus on meeting the specific physical needs of clients, rather than targeting services that connect older adults with their community. Targeting social participation may present one of the greatest opportunities to improve older adults' general health, and will also generate societal benefits by increasing community contributions from this group. Selecting an indicator of social participation that measures each of the three concepts overviewed in this paper will enable policy makers to identify the areas in which social interventions for older adults will have the most effect.

Social capital and health: A systematic review of systematic reviews

There are many systematic reviews on social capital (SC) and various health outcomes, but each of these reviews shows one piece of the larger SC and health puzzle. The aim of this research was to systematically review systematic reviews on SC and health, in order to provide an overview of existing evidence and to identify strategies for future research. Nine databases were searched for key words that could fall under the broad umbrella of SC and health outcomes. We screened 4941 titles and abstracts and read 187 reviews before retaining 20 of them. A critical appraisal of each review was conducted. The reviews show there is good evidence to suggest that SC predicts better mental and physical health, and indicators of SC are protective against mortality. At the same time, many reviews also found numerous non-significant and negative relationships that are important to consider. It was unclear whether SC interventions for health were really improving SC, or other aspects of the social environment. Overall, this research shows that evidence on how various aspects of SC affect different health outcomes for different actors remains unclear. Intergroup and lifecourse perspectives could help clarify this link. Future research could benefit from conceptualizing the link between SC and health in a what, who, where, when, why and how framework.

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Social capital predicts better health.

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Other aspects of social capital should also be considered in health research.

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Recommendations on how to improve social capital and health research are made.

Local Housing Characteristics Associated with Early Childhood Development Outcomes in Australian Disadvantaged Communities

Disadvantaged communities tend to have poorer early childhood development outcomes. Access to safe, secure, and stable housing is a well-known social determinant of health but there is a need to examine key features of neighbourhood housing that reduce early childhood development inequities. The 2012 Australian Early Development Census (AEDC), a population-wide measure of early childhood development, and the Australian Bureau of Statistics Socio-economic Index for Areas Index of Relative Socio-economic Disadvantage were used to select fourteen disadvantaged local communities in five Australian states and territories based on those performing better (off-diagonal), or as expected (on-diagonal) on the AEDC relative to their socio-economic profile. Between 2015-2017, qualitative and quantitative housing data were collected in the local communities. In total, 87 interviews with stakeholders, 30 focus groups with local service providers and parents, and Australian Census dwelling information were analysed. A comparative case study approach was used to examine differences in housing characteristics (e.g., public housing, density, affordability, and tenure) between disadvantaged local communities performing 'better than expected' and 'as expected' on early childhood development. Perceived better housing affordability, objectively measured housing tenure (ownership) and perceived and objectively measured lower-density public housing were housing characteristics that emerged as points of difference for disadvantaged local communities where children had relatively better early childhood development outcomes. These characteristics are potential modifiable and policy sensitive housing levers for reducing early childhood development inequities.

Predictors of Quality of Life in Montreal, Canada: A Longitudinal Study

This study sought to assess factors associated with quality of life (QoL), and predictive of improvements in QoL over time, in a population-based cohort study. A 4-year longitudinal survey was administered to 2433 individuals at the study baseline; of these, 1828 individuals participated in Wave 2, and 1303 participated in Wave 3. QoL was measured by the Satisfaction with Life Domains Scale. Thirty-two variables were correlated with baseline QoL and together explained 58.2% of the variance. Eleven variables were independent predictors of improvement in QoL over time. Among these variables, social support and stress/coping showed the strongest association with QoL, and neighbourhood characteristics had an additional influence. Multidimensional modelling of a broad spectrum of the factors related to QoL enabled situating mental health and well-being in an ecological system with attendant implications for public health and social policy intervention to facilitate improvement of QoL in the population.

How different contexts of social capital are associated with self-rated health among Lithuanian high-school students

Background. Adolescents’ self-rated health is related to a number of sociodemographic and socio-economic factors, health-related behaviors, and their social environment. The impact of the latter is still not well explored. An adolescent’s social environment is represented by the social capital, i.e. social resources that they can access. The relationships between various contexts of social capital (family, neighborhood, peers, and school) and self-rated health among adolescents are still unclear.

Objective. This study aims to examine the relationships between various social capital contexts and self-rated health in Lithuanian adolescents.

Methods. The current cross-sectional study includes a nationally representative sample of 1863 adolescents (51.4% were girls) aged 14–18 years. The indicators of self-rated health as well as indicators of social capital in family, neighborhood, and school contexts were assessed. The results of the relationships between self-rated health and contexts of social capital were calculated controlling for the following covariates: physical activity, psychological distress, gender, body mass index, and family socioeconomic status.

Results. Results indicate that there are significant relationships between good self-rated health and a higher level of family support, neighborhood trust, and vertical school trust. In the final logistic regression model, while controlling for all covariates, a higher level of family support and neighborhood trust remain significant predictors of good self-rated health.

Conclusions. Family support and neighborhood trust are important correlates of self-rated health in adolescents.

Childhood neighborhood context and adult substance use problems: the role of socio-economic status at the age of 30 years

OBJECTIVES

To examine whether the (a) childhood neighborhood context predicts alcohol use disorder, nicotine dependence, and cannabis use disorder symptoms at the age of 39 years; and (b) socio-economic status during young adulthood mediates these relationships. Gender differences were also examined.

STUDY DESIGN

The Seattle Social Development Project is a prospective longitudinal study of 808 individuals followed up from ages 10 to 39 years in Seattle, Washington, United States. The sample was gender balanced (51% were men).

METHODS

Alcohol, nicotine, and cannabis use disorder symptoms were assessed using the Diagnostic and Statistical Manual of Mental Disorders IV-based Diagnostic Interview Schedule. Childhood neighborhood data consisted of 10 neighborhood-level variables from the 1990 national census, which were consolidated using principal component analyses. Two components with eigenvalues greater than 1 were extracted-neighborhood disadvantage and neighborhood stability. Educational attainment and employment status represented socio-economic status during young adulthood. Covariates included baseline symptoms of psychopathology, baseline substance use, gender, ethnicity, and childhood socio-economic status at the family level. Negative binomial regression was used as the primary modeling strategy. Six models for each outcome measure were estimated. The first three models examined associations between two neighborhood components and each substance use outcome measure. Next, we tested the second research question by adding unemployment and college graduate indicators at the age of 30 years as potential mediators underlying the link between the childhood neighborhood context and three substance use measures.

RESULTS

Study findings revealed that childhood neighborhood stability significantly reduced alcohol and cannabis use disorder symptoms nearly 3 decades later. Path analyses suggested that socio-economic status during the transition to adulthood did not influence these relationships but rather had independent effects on problematic nicotine and cannabis use. Furthermore, the effects of childhood neighborhood factors on problematic nicotine use were stronger for men.

CONCLUSIONS

Neighborhood characteristics during childhood may be important factors for alcohol and cannabis use disorder symptoms among adults and nicotine dependence disorder symptoms among men. Prevention efforts that address community stability and disadvantage can and should start in childhood, with a focus on intervention targets that might gain salience later in life to discourage the development and persistence of problematic substance use in adulthood.

Evidence suggests a need to rethink social capital and social capital interventions

In the 21 years since social capital first appeared in the public health literature, the evidence base has grown enormously, now reaching 28 systematic reviews encompassing more than 850 individual studies. We summarise this evidence and explain why conclusions relating to both the relationship between social capital and health, and the effectiveness of interventions to promote population health remain elusive and contradictory. A critical factor is the inadequate way that context is treated in the research, and especially how context interacts with efforts to promote health in a dynamic fashion. Of all the different types of interventions one could employ to improve the health of the public, 'social capital' interventions are likely to be the most context specific and especially affected by the boundaries placed around the context. A way forward is offered that requires a combination of insights from systems thinking, community-based participatory research, and intervention and improvement sciences. This requires renewed focus on the specific components of social capital, an understanding of how context interacts dynamically with efforts to improve health, a greater role for practice in the design, implementation, adaptation and evaluation of interventions, and the support of researchers to develop better methods for recognising and classifying the knowledge generated by complex interventions.

Social Capital Associated with Quality of Life Mediated by Employment Experiences: Evidence from a Random Sample of Rural-to-Urban Migrants in China

Working-age migrants need to possess adequate social capital in order to secure a stable and satisfactory job so that they can pursue a better quality of life (QOL). The positive relationship between social capital and vocational experiences, including successful employment, has been well established. In this study we focused on testing a multi-step mediation model linking social capital with employment experiences, and further to QOL. Survey data from rural-to-urban migrants randomly selected from Wuhan, China were analyzed. Social capital, including bonding and bridging capital, was measured using the Personal Social Capital Scale; employment experiences were measured using five job-related items; and QOL was measured using the Brief Symptoms Inventory. Structural equation modeling analysis indicated that job security and job satisfaction were positively and significantly associated with QOL, and social capital measures were significantly associated with higher QOL (primarily for males). Furthermore, job security and job satisfaction fully mediated the relationship between social capital and QOL after controlling for covariates. Findings of this study suggest the significance of social capital, job security and satisfaction in improving migrants' QOL, implying the importance of vocational experiences in mediating the effect from social capital to QOL. If the findings can be confirmed with longitudinal data, these factors should be considered in decision making to improve rural-to-urban migrants' QOL in China.

The relationship between urbanization and depression in China: the mediating role of neighborhood social capital

BACKGROUND

Previous studies in developed countries have found that living in rapidly urbanizing areas is associated with higher risk of mental illness and that social capital had a protective effect on individual mental health. However, the literature is missing empirical studies of the relationship between urbanization, neighborhood social capital and mental health in rapidly urbanizing countries. To bridge this knowledge gap, this study investigated the effects of urbanization on depressive symptoms in China, with an emphasis on the mediating role of neighborhood social capital in the relationship between urbanization and individual-level depressive symptoms.

METHODS

Nationally representative survey data from the 2016 wave of China's Labor-force Dynamics Survey were used. A sample of 20,861 individuals was obtained from 401 neighborhoods in 158 prefecture-level divisions of 29 provinces. Depressive symptoms were measured using CES-D scores. Neighborhood social capital was assessed by three individual-level variables aggregated to the neighborhood level: perceptions of neighborly trust, the extent of neighborly reciprocity, and membership to neighborhood social groups. Multilevel linear regression and mediation analyses were used to estimate the statistical relationships.

RESULTS

The multilevel linear regression analyses found negative relationships between urbanization rate and CES-D score. The mediation analysis found that neighborhood-level social capital was an inconsistent mediator in the relationship between urbanization rate and CES-D score. Interaction terms between urbanization rate and two measures of neighborhood-level social capital were statistically significant, indicating that the protective effects of neighborly reciprocity and membership to neighborhood social groups on CES-D scores (negative relationships) were stronger in the relatively more urbanized areas.

CONCLUSION

Urbanization supports mental health in the Chinese context, although it might undermine residents' mental health by reducing neighborhood social capital. The protective effect of neighborhood-level reciprocity and social group membership on mental health increased with urbanization.

Change and Stability of Emotional Health of Rural Pennsylvania Youth During High School

PURPOSE

Few prior studies have examined change in emotional health of high school students in a rural context. Considering the multifaceted nature of emotional health, this research aims to identify the patterns and explore change and stability of the emotional health of rural Pennsylvania youth. It also investigates the influence of family, peers, school, and the community environment on rural adolescents' emotional health.

METHODS

Using panel data from the Rural Youth Education Project, we employed latent transition analysis to examine changes in patterns of rural students' self-reported emotional health from 9^th grade to 11^th grade (N = 1,294).

FINDINGS

Four distinct emotional health subgroups for rural adolescents were identified. Over half of the youth in the sample felt emotionally well, or positive, in both 9^th and 11^th grades. Roughly 60% of rural youth remained in the same emotional health category from 9^th to 11^th grade, but a substantial minority experienced change in emotional health. One-fifth reported lower emotional health status in 11^th grade, and one-fifth indicated more positive emotions in 11^th than in 9^th grade. We found strong evidence of family, school, community, and peer influences on the emotional health of rural youth in 9^th grade.

CONCLUSIONS

The results suggest that while a large share of rural youth exhibit positive emotional health and remain positive across their high school years, a substantial share of rural youth experience changing emotional health. The study underscores the important role that family, peers, school, and the community environment play for rural youth's emotional health over time.

Chains of risk for alcohol use disorder: Mediators of exposure to neighborhood deprivation in early and middle childhood

Our goal was to test a cascade model to identify developmental pathways, or chains of risk, from neighborhood deprivation in childhood to alcohol use disorder (AUD) in young adulthood. Using Swedish general population data, we examined whether exposure to neighborhood deprivation during early and middle childhood was associated with indicators of social functioning in adolescence and emerging adulthood, and whether these were predictive of AUD. Structural equation models showed exposure to neighborhood deprivation was associated with lower school achievement during adolescence, poor social functioning during emerging adulthood, and the development of AUD for both males and females. Understanding longitudinal pathways from early exposure to adverse environments to later AUD can inform prevention and intervention efforts.

The association of various social capital indicators and physical activity participation among Turkish adolescents

BACKGROUND

Physical activity participation (PAP) has been proven to improve health and promote optimal growth among adolescents. However, most adolescents do not meet the current physical activity (PA) recommendations in Turkey. The role of the social environment and social factors on PAP is being increasingly recognized. Although social capital (SC) indicators have been examined in high-income countries, there are few studies on developing countries. The aim of this study was to examine the relationship between SC indicators and PAP among Turkish adolescents.

METHODS

A survey was conducted among 19 high schools in 4 different cities in Turkey in 2016. A total of 506 female and 729 male high school students participated in this study. The dependent variable was overall PAP, which was measured using the short form of the International Physical Activity Questionnaire. The independent variables included self-perceived family, neighborhood, and school SC. Self-rated health and obesity status, measured by body mass index, were other study covariates in multiple binary logistic regression models. Chi-square tests were used to assess the differences between genders.

RESULTS

PAP levels were significantly different between males and females. A higher percentage of males reported PAP (77.4%) compared to females (51.0%). Among males, teacher-student interpersonal trust and informal social control were inversely associated with PAP, while high students interpersonal trust was positively associated with increased odds of PAP. For females, students interpersonal trust was inversely associated with PAP.

CONCLUSION

Various SC indicators are associated with PAP for males and females. These associations are different from findings of studies conducted in developed countries. Therefore, health-promotion interventions and policies should consider gender and different social agents on the social and cultural background to improve PAP among Turkish adolescents.

It takes a village: Fixed-effects analysis of neighborhood collective efficacy and children's development

Background

Previous studies suggest that neighborhood social capital is associated with children's mental health. The purpose of this study was to examine the association between neighborhood collective efficacy and children's psychosocial development.

Methods

We used data on children and their parents (n = 918) who were part of the Japanese study of Stratification, Health, Income, and Neighborhood (JSHINE) from 2010 to 2013 (wave 1 and wave 2). Households were recruited from the Tokyo metropolitan area through clustered random sampling. Changes in children's psychosocial development (assessed using a child behavioral checklist) between waves 1 and 2 were regressed on parents' perceptions of changes in neighborhood collective efficacy (social cohesion and informal social control).

Results

Change in perception of neighborhood social cohesion was inversely associated with change in child total problems (β = −0.22; 95% confidence interval [CI]: −0.37 to −0.001; effect size d = −0.03). Change in perceptions of neighborhood informal social control was inversely associated with change in children's externalizing problems (β = −0.16; 95% CI: −0.30 to −0.03; d = −0.02).

Conclusions

The results of these fixed-effects models suggest that strengthening neighborhood collective efficacy is related to improvements in child psychosocial development.

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The fixed-effects model can control for time-invariant confounding factors.

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Neighborhood social cohesion was inversely associated with child total problems.

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Neighborhood informal social control was inversely associated with child problems.

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Neighborhood collective efficacy prevents child psychosocial problems.

Trajectories of Neighborhood Cohesion in Childhood, and Psychotic and Depressive Symptoms at Age 13 and 18 Years

OBJECTIVE

Exposure to adverse social environments has been associated with psychotic and depressive symptoms in adolescence in cross-sectional studies, but the longitudinal relation is unclear. This study examined whether longitudinal trajectories of exposure to adverse social environments across childhood are associated with psychotic experiences and depressive symptoms in adolescence.

METHOD

Data on participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) were used to estimate longitudinal trajectories of childhood exposure to neighborhood cohesion (NC), discord (ND), and stress (NS) using latent class growth modeling. Logistic regression was used to examine the association between these trajectories and psychotic experiences and depressive symptoms at 13 and 18 years of age, adjusting for maternal psychopathology, participant sociodemographic and socioeconomic characteristics, and area-level deprivation.

RESULTS

A dose-response association was observed between higher NS and the odds of psychotic experiences at 13 years (medium NS, adjusted odds ratio [aOR] 1.25, 95% CI 1.05-1.49; high NS, aOR 1.77, 95% CI 1.30-2.40), whereas high levels of ND predicted psychotic experiences at 18 years (aOR 1.50, 95% CI 1.10-2.07). High levels of NC (aOR 1.43, 95% CI 1.02-1.71) and NS (aOR 1.55, 95% CI 1.07-2.26) were associated with increased odds of high depressive symptoms at 18 years in a dose-response fashion.

CONCLUSION

Prolonged and more severe exposure to adverse social environments is associated with greater odds of developing psychotic and depressive symptoms in late adolescence.

Social Capital and Adolescent Substance Use: The Role of Family, School, and Neighborhood Contexts

This study assesses the link between social capital factors of norm-setting social arenas including family, school, and neighborhood and adolescent substance use measured by cigarette smoking, alcohol consumption, and illicit drug use among a sample of adolescents in California. The key messages of this study are that socialization processes at different life domains, in varying degrees, are associated with adolescent substance use behavior. Compared with school and neighborhood contexts, family is the most influential setting that should be primarily targeted for youth substance use prevention. Among different aspects of within-family social resources, parental monitoring seems to be the most protective of adolescent substance use. Study implications on family-based interventions are discussed.

Assessing the psychometric and ecometric properties of neighborhood scales using adolescent survey data from urban and rural Scotland

Background

Despite the well-established need for specific measurement instruments to examine the relationship between neighborhood conditions and adolescent well-being outcomes, few studies have developed scales to measure features of the neighborhoods in which adolescents reside. Moreover, measures of neighborhood features may be operationalised differently by adolescents living in different levels of urban/rurality. This has not been addressed in previous studies. The objectives of this study were to: 1) establish instruments to measure adolescent neighborhood features at both the individual and neighborhood level, 2) assess their psychometric and ecometric properties, 3) test for invariance by urban/rurality, and 4) generate neighborhood level scores for use in further analysis.

Methods

Data were from the Scottish 2010 Health Behaviour in School-aged Children Survey, which included an over-sample of rural adolescents. The survey responses of interest came from questions designed to capture different facets of the local area in which each respondent resided. Intermediate data zones were used as proxies for neighborhoods. Internal consistency was evaluated by Cronbach’s alpha. Invariance was examined using confirmatory factor analysis. Multilevel models were used to estimate ecometric properties and generate neighborhood scores.

Results

Two constructs labeled neighborhood social cohesion and neighborhood disorder were identified. Adjustment was made to the originally specified model to improve model fit and measures of invariance. At the individual level, reliability was .760 for social cohesion and .765 for disorder, and between .524 and .571 for both constructs at the neighborhood level. Individuals in rural areas experienced greater neighborhood social cohesion and lower levels of neighborhood disorder compared with those in urban areas.

Conclusion

The scales are appropriate for measuring neighborhood characteristics experienced by adolescents across urban and rural Scotland, and can be used in future studies of neighborhoods and health. However, trade-offs between neighborhood sample size and reliability must be considered.

The impact of community context on children's health and nutritional status in China

The link between community environment and individual health outcomes has been widely documented in Western literature, but little is known about whether community context influences children's health over and above individual characteristics in developing countries. This study examines how community socioeconomic status (SES) influences children's self-rated health and nutritional status in urban and rural China and explores whether the effects of community SES vary by a child's gender and family background. Using data from the China Family Penal Studies in 2010, this study focuses on children aged 10-15 years old living in 261 urban neighborhoods and 293 rural villages in China. Multilevel regression models are estimated to examine the effect of community SES on the probability of reporting poor/fair health and nutritional status measured by height for age while controlling for individual and family characteristics. The results suggest that community SES has a positive and curvilinear effect on children's health and nutritional status in urban China, and it only positively influences children's nutrition in rural China. Community SES has a stronger effect for boys than for girls, and for children in poorer families and families with lower levels of parental involvement.

Contextual determinants of adolescent mortality in South Africa

OBJECTIVES

South Africa has a large adolescent population (approximately 20% of the total population). The survival and development of these individuals are a priority among parents and the government. In an effort to better understand the factors contributing to adolescent mortality in South Africa, this study examined the effect of household and community factors on adolescent death.

METHODS

The study used data from Census 2001. Multilevel modelling was used to study the impact of community and household factors on adolescent mortality. A multivariate binary logistic 2-level model was developed. Odds ratios were produced and, statistically significant values (p<0.05) were discussed. There were 41,261 reported adolescent deaths from census data.

RESULTS

This study found that having a few household assets, six or more people living in a residence, and high racial diversity is associated with increased odds of adolescent mortality in South Africa in 2001.

CONCLUSIONS

Socio-economic status of the household and racial diversity within communities is likely to increase adolescent mortality in South Africa. However, there is need to examine the role of other community characteristics, such as number of schools, health facilities and employment opportunities in order to create a holistic profile of the contextual determinants of adolescent mortality in the country.

Environmental adversity and children's early trajectories of problem behavior: The role of harsh parental discipline

This study was performed to examine the role of harsh parental discipline in mediating and moderating the effects of environmental adversity (family socioeconomic disadvantage and adverse life events) on emotional and behavioral problems across early-to-middle childhood. The sample included 16,916 children (48% female; 24% non-White) from the U.K.'s Millennium Cohort Study. We analyzed trajectories of conduct, hyperactivity, and emotional problems, measured at ages 3, 5, and 7 years, using growth curve models. Harsh parental discipline was measured at these ages with parent-reported items on the frequency of using the physical and verbal discipline tactics of smacking, shouting at, and "telling off" the child. As expected, family socioeconomic disadvantage and adverse life events were significantly associated with emotional and behavioral problems. Harsh parental discipline was related to children's trajectories of problems, and it moderated, but did not explain, the effect of environmental risk on these trajectories. High-risk children experiencing harsh parental discipline had the highest levels of conduct problems and hyperactivity across the study period. In addition, harsh parental discipline predicted an increase in emotional symptoms over time in high-risk children, unseen in their counterparts experiencing low levels of harsh parental discipline. However, children in low-risk families were also negatively affected by harsh parental discipline concurrently and over time. In conclusion, harsh parental discipline predicted emotional and behavioral problems in high- and low-risk children and moderated the effects of family poverty and adversity on these problems. (PsycINFO Database Record

The resilience of neighborhood social processes: A case study of the 2011 Brisbane flood

Social disorganization theories position neighborhood social capital and collective efficacy as key social processes that should facilitate community resilience in the aftermath of disaster. Yet limited evidence demonstrates that these social processes are themselves resilient with some studies showing that disaster can fracture even once cohesive neighborhoods. In this paper we assess the stability of neighborhood level collective efficacy and social capital before and after a disaster. We use multilevel structural equation modeling and draw on census and longitudinal survey data collected from over 4000 residents living in 148 neighborhoods in Brisbane, Australia before and after a significant flood event. We examine what happens to social capital and collective efficacy in flooded and non-flooded neighborhoods and assess whether demographic shifts are associated with change and/or stability in these processes. We find strong evidence that these processes operate similarly across flooded and not flooded communities. Our findings also reveal significant stability for our measures of social capital across time, while collective efficacy increases post flood across all neighborhoods, but more so in flooded neighborhoods. Neighborhood demographics have limited effect on patterns of stability or change in these social processes. We discuss the theoretical and practical implications of these findings for our understanding of neighborhood resilience in the wake of disaster.

Teachers' support and depression among Japanese adolescents: a multilevel analysis

PURPOSE

Depression is a major cause of suicide among adolescents. Therefore, childhood and adolescent depression is an important public health concern. This study explored factors as class and individual levels that may influence depression among adolescents in Japan.

METHODS

A questionnaire survey among junior high school students (N = 2968) from two cities in Japan was conducted. Depression was assessed using the Depression Self-Rating Scale for Children; teachers' support was assessed using the Scale of Expectancy for Social Support. The class average score of teachers' support was calculated to indicate what we termed the "homeroom teachers' support." Multilevel analysis was applied to clarify the relation between homeroom teachers' support and depression.

RESULTS

Finally, 2466 students completed the questionnaire without missing variables (valid response rate, 83.1%). There was no random effect of the teachers' support at the class level on depression, although there was a significant association between teachers' support and depression for 9th graders (β = -0.12, p = 0.009). Moreover, there were significant associations between economic status, having a best friend, and experiencing unforgettable stress at the individual level and depression in all grades.

CONCLUSIONS

There was no significant random effect of homeroom teachers' support in class level although there might be marginal negative association between teacher's support and depression. It is suggested that homeroom teachers need to promote population approaches to mental health.

Social Capital, Perceived Economic Affluence, and Smoking During Adolescence: A Cross-Sectional Study

BACKGROUND

Smoking is among the health risk behaviors taken up by many adolescents with lifelong consequences and associations with multiple health risk behaviors. Smoking and smoking initiation in adolescence involves an interaction between micro-, meso-, and macro systems, including neighborhoods and the greater community.

OBJECTIVES

To examine the associations of individual social and economic capital with self-reported health, life satisfaction, and smoking behavior in adolescents.

METHODS

Using a multistage random sampling of junior high school students (16-18 years old) in Crete, Greece, 703 adolescents (90.2% 16 years old; 55.6% girls, participation rate 84.2%) completed an anonymous questionnaire based on HBSC study and the Youth Social Capital Scale (YSCS) during April-June 2008. Multiple logistic regression models were performed adjusted for potential confounders.

RESULTS

Adolescents with high participation in their neighborhoods and communities (higher structural social capital) displayed lower odds for daily smoking; those feeling unsafe (lower cognitive social capital) were at greater odds of daily smoking. Adolescents with less friends and acquaintances had lower odds of having tried tobacco products. Smoking was not related to any economic capital variables (perceived affluence, paternal and maternal employment status). Adolescents with low/medium versus high total social capital were at higher odds for low life satisfaction and fair/bad versus excellent self-rated health. Conclusions/Importance: Social capital theory may provide a better understanding in identifying the social context that is protective or harmful to adolescents' smoking. Public health organizations at all levels need to incorporate social capital theory in their interventions.

The behavioural constellation of deprivation: Causes and consequences

Socioeconomic differences in behaviour are pervasive and well documented, but their causes are not yet well understood. Here, we make the case that a cluster of behaviours is associated with lower socioeconomic status (SES), which we call “the behavioural constellation of deprivation.” We propose that the relatively limited control associated with lower SES curtails the extent to which people can expect to realise deferred rewards, leading to more present-oriented behaviour in a range of domains. We illustrate this idea using the specific factor of extrinsic mortality risk, an important factor in evolutionary theoretical models. We emphasise the idea that the present-oriented behaviours of the constellation are a contextually appropriate response to structural and ecological factors rather than a pathology or a failure of willpower. We highlight some principles from evolutionary theoretical models that can deepen our understanding of how socioeconomic inequalities can become amplified and embedded. These principles are that (1) small initial disparities can lead to larger eventual inequalities, (2) feedback loops can embed early-life circumstances, (3) constraints can breed further constraints, and (4) feedback loops can operate over generations. We discuss some of the mechanisms by which SES may influence behaviour. We then review how the contextually appropriate response perspective that we have outlined fits with other findings about control and temporal discounting. Finally, we discuss the implications of this interpretation for research and policy.