Evolution of adolescent mental health in a rapidly changing socioeconomic environment: a review of mental health studies in adolescents in India over last 10 years

Background: Significant changes in the economic, familial and social support aspects in India have occurred in recent times, making it an interesting naturalistic setting to observe the effects of a dynamic socioeconomic environment on behavioral and emotional disorders in adolescents. Objective: This systematic review attempts to synthesize and evaluate the available evidence on mental health disorders and interventions in adolescents in India in last 10 years as well as identify conceptual trends and methodological lacunae in these studies. Method: A systematic search of electronic databases was performed in March 2014 and 27 school and community based studies evaluating behavioral problems, psychiatric morbidity, stress, suicide-related behaviors, depression, anxiety, aggression, self concept in adolescents in India were reviewed. Conclusion: There is a wide variation in the reported prevalence of psychiatric morbidity and behavioral problems in Indian adolescents. Some of the risk and protective factors are similar to those identified by other International studies in this age group. These include female gender, academic difficulties, parental fights, strained familial relationships, school absenteeism, school dropout and other school related factors. However, there are certain variables that appear to be context specific and need further investigation. These are mother's working status, studying in Government institutions or belonging to a nuclear family as risk factors and praying as a coping skill, parental involvement as a protective factor for psychiatric disorders. The suspected upward trend in the psychiatric morbidity in this age group needs more studies to be established. © 2014 Elsevier B.V.

Socioeconomic differences in outdoor food advertising at public transit stops across Melbourne suburbs.

To assess and compare the number and type of outdoor food advertisements at public transit stops within suburbs of varying levels of socioeconomic disadvantage.

Is there an interaction between socioeconomic status and FRAX 10-year fracture probability determined with and without bone density measures? Data from the Geelong Osteoporosis Study of female cohort.

FRAX(©) evaluates 10-year fracture probabilities and can be calculated with and without bone mineral density (BMD). Low socioeconomic status (SES) may affect BMD, and is associated with increased fracture risk. Clinical risk factors differ by SES; however, it is unknown whether aninteraction exists between SES and FRAX determined with and without the BMD. From the Geelong Osteoporosis Study, we drew 819 females aged ≥50 years. Clinical data were collected during 1993-1997. SES was determined by cross-referencing residential addresses with Australian Bureau of Statistics census data and categorized in quintiles. BMD was measured by dual energy X-ray absorptiometry at the same time as other clinical data were collected. Ten-year fracture probabilities were calculated using FRAX (Australia). Using multivariable regression analyses, we examined whether interactions existed between SES and 10-year probability for hip and any major osteoporotic fracture (MOF) defined by use of FRAX with and without BMD. We observed a trend for a SES * FRAX(no-BMD) interaction term for 10-year hip fracture probability (p = 0.09); however, not for MOF (p = 0.42). In women without prior fracture (n = 518), we observed a significant SES * FRAX(no-BMD) interaction term for hip fracture (p = 0.03) and MOF (p = 0.04). SES does not appear to have an interaction with 10-year fracture probabilities determined by FRAX with and without BMD in women with previous fracture; however, it does appear to exist for those without previous fracture.

Reframing 'the problem': students from low socioeconomic status backgrounds transitioning to university

At the heart of this book are people enrolling at university for the first time and entering into the broad variety of social relations and contexts entailed in their ‘coming to know’ at, of and through university.

Small area-level socioeconomic status and all-cause mortality within 10 years in a population-based cohort of women: Data from the Geelong Osteoporosis Study

Background: The social gradient of health and mortality is well-documented. However, data are scarce regarding whether differences in mortality are observed across socio-economic status (SES) measured at the small area-level. We investigated associations between area-level SES and all-cause mortality in Australian women aged ≥. 20. years. Methods: We examined SES, obesity, hypertension, lifestyle behaviors and all-cause mortality within 10. years post-baseline (1994), for 1494 randomly-selected women. Participants' residential addresses were matched to Australian Bureau of Statistics Census data to identify area-level SES, and deaths were ascertained from the Australian National Deaths Index. Logistic regression models were adjusted for age, and subsequent adjustments made for measures of weight status and lifestyle behaviors. Results: We observed 243 (16.3%) deaths within 10. years post-baseline. Females in SES quintiles 2-4 (less disadvantaged) had lower odds of mortality (0.49-0.59) compared to SES quintile 1 (most disadvantaged) under the best model, after adjusting for age, smoking status and low mobility. Conclusions: Compared to the lowest SES quintile (most disadvantaged), females in quintiles 2 to 5 (less disadvantaged) had significantly lower odds ratio of all-cause mortality within 10. years. Associations between extreme social disadvantage and mortality warrant further attention from research, public health and policy arenas.

Neighbourhood socioeconomic disadvantage and fruit and vegetable consumption: a seven countries comparison

BACKGROUND: Low fruit and vegetable consumption is a risk factor for poor health. Studies have shown consumption varies across neighbourhoods, with lower intakes in disadvantaged neighbourhoods. However, findings are inconsistent, suggesting that socio-spatial inequities in diet could be context-specific, highlighting a need for international comparisons across contexts. This study examined variations in fruit and vegetable consumption among adults from neighbourhoods of varying socioeconomic status (SES) across seven countries (Australia, Canada, Netherlands, New Zealand, Portugal, Scotland, US). METHODS: Data from seven existing studies, identified through literature searches and knowledge of co-authors, which collected measures of both neighbourhood-level SES and fruit and vegetable consumption were used. Logistic regression was used to examine associations between neighbourhood-level SES and binary fruit and vegetable consumption separately, adjusting for neighbourhood clustering and age, gender and education. As much as possible, variables were treated in a consistent manner in the analysis for each study to allow the identification of patterns of association within study and to examine differences in the associations across studies. RESULTS: Adjusted analyses showed evidence of an association between neighbourhood-level SES and fruit consumption in Canada, New Zealand and Scotland, with increased odds of greater fruit intake in higher SES neighbourhoods. In Australia, Canada, New Zealand and Portugal, those residing in higher SES neighbourhoods had increased odds of greater vegetable intake. The other studies showed no evidence of a difference by neighbourhood-level SES. CONCLUSIONS: Acknowledging discrepancies across studies in terms of sampling, measures, and definitions of neighbourhoods, this opportunistic study, which treated data in a consistent manner, suggests that associations between diet and neighbourhood-level socioeconomic status vary across countries. Neighbourhood socioeconomic disadvantage may differentially impact on access to resources in which produce is available in different countries. Neighbourhood environments have the potential to influence behaviour and further research is required to examine the context in which these associations arise.

Between policy and a hard pedagogical place: the emotional geographies of teaching for citizenship in low socioeconomic schools

Reflecting an international trend, Australian education policy increasingly charges schools with fostering active citizens who have the will and capacity to improve the democratic fabric and drive needed social change. This policy prescription also resonates with some teachers’ critical commitments to pedagogical practices that encourage young people to see themselves as transformative citizens capable of engineering a more just and equitable society. In particular, in low socio-economic school contexts, however, the pursuit of such practices may be subject to the complex physical and emotional geographies that attend the project of schooling in such contexts. In this article, I consider the empirical data derived from my recent discourse analysis of two schools in which teachers have introduced what I have termed the pedagogies of active citizenship. Both of these schools are located in low socio-economic Australian communities, that is, communities where structural, socio-geographic and socio-economic forms of marginalisation are an issue. I consider what motivates, enables and authorises such teachers, as well as what risks may attend the championing of such pedagogies in contexts that are subject to conflicting or competing education discourses and priorities. Theoretically, I draw on ideas of risk as well as on a growing body of scholarship that is concerned with the emotional geographies of citizenship and schooling.

Age at migration, language proficiency, and socioeconomic outcomes: evidence from Australia

This study estimates the causal effects of language proficiency on the economic and social integration of Australian immigrants. Identifying the effects of languages on socioeconomic outcomes is inherently difficult owing to the endogeneity of language skills. Using the phenomenon that younger children learn languages more easily than older children, we construct an instrumental variable for language proficiency. To achieve this, we consider the age at arrival of immigrants who came as children from Anglophone and non-Anglophone countries. We find a significant positive effect of English proficiency on wages and promotions among adults who immigrated to Australia as children. Higher levels of English proficiency are associated with increased risk-taking, more smoking, and more exercise for men, but have considerable health benefits for women. English language proficiency has a significant influence on partner choice and a number of social outcomes, as well as on children's outcomes, including their levels of academic achievement. The results are robust to alternative specifications, including accounting for between-sibling differences and alternative measures of English skills.

Socioeconomic position in young adulthood is associated with BMI in Australian families

BACKGROUND: Low socioeconomic position (SEP) is associated with increased cardiovascular (CV) disease risk, but the relative importance of SEP in childhood and adulthood, and of changes in SEP between these two life stages, remains unclear. Studies of families may help clarify these issues. We aimed to assess whether SEP in young adulthood, or change in SEP from childhood to young adulthood, was associated with five continuously measured CV risk factors. METHODS: We used data from 286 adult Australian families from the Victorian Family Heart Study (VFHS), in which some offspring have left home (n = 364) and some remained at home (n = 199). SEP (defined as the Index of Relative Socioeconomic Disadvantage) was matched to addresses. We fitted variance components models to test whether young adult SEP and/or change in SEP was associated with systolic blood pressure, diastolic blood pressure, body mass index (BMI), total cholesterol or high-density lipoprotein cholesterol, after adjustment for parental SEP and within-family correlation. RESULTS: An increase in SEP of 100 SEIFA units from childhood to adulthood was associated with a lower BMI (β = -0.49 kg/m(2), P < 0.01) only. CONCLUSIONS: These results suggest that a change in SEP in young adulthood is an important predictor of BMI, independent of childhood SEP.

A systematic review of the effectiveness of whole-of-community interventions by socioeconomic position

Whole-of-community (WOC) interventions have led to modest reductions in population weight gain. Whether they exhibit differential effectiveness by socioeconomic position (SEP) remains unknown. We aimed to summarize evidence of differential effectiveness of WOC interventions by SEP. Electronic databases and grey literature were searched to identify studies that evaluated the effectiveness of a WOC intervention on behavioural change measures, energy balance behaviours and/or anthropometric outcomes according to any measure of SEP. Interventions were assessed for the following characteristics: structural changes to the environment, number of settings the intervention acted in, presence of community engagement and whether equity was considered in its design. Ten studies were included. Nine reported a greater or equal effect among low SEP groups compared with high SEP groups. These studies commonly featured interventions that incorporated structural changes to the environment, acted across more than three settings and/or employed community engagement. Conclusions did not change when excluding low-quality studies (n = 4). WOC interventions represent an effective and equitable approach for the reduction of population weight. Structural components, a larger number of settings and community engagement were common in equitable WOC interventions and should be considered in the design of future WOC interventions.

Making robust policy decisions using global biodiversity indicators

In order to influence global policy effectively, conservation scientists need to be able to provide robust predictions of the impact of alternative policies on biodiversity and measure progress towards goals using reliable indicators. We present a framework for using biodiversity indicators predictively to inform policy choices at a global level. The approach is illustrated with two case studies in which we project forwards the impacts of feasible policies on trends in biodiversity and in relevant indicators. The policies are based on targets agreed at the Convention on Biological Diversity (CBD) meeting in Nagoya in October 2010. The first case study compares protected area policies for African mammals, assessed using the Red List Index; the second example uses the Living Planet Index to assess the impact of a complete halt, versus a reduction, in bottom trawling. In the protected areas example, we find that the indicator can aid in decision-making because it is able to differentiate between the impacts of the different policies. In the bottom trawling example, the indicator exhibits some counter-intuitive behaviour, due to over-representation of some taxonomic and functional groups in the indicator, and contrasting impacts of the policies on different groups caused by trophic interactions. Our results support the need for further research on how to use predictive models and indicators to credibly track trends and inform policy. To be useful and relevant, scientists must make testable predictions about the impact of global policy on biodiversity to ensure that targets such as those set at Nagoya catalyse effective and measurable change.

Global biodiversity indicators reflect the modeled impacts of protected area policy change

Global biodiversity indicators can be used to measure the status and trends of biodiversity relating to Convention on Biological Diversity (CBD) targets. Whether such indicators can support decision makers by distinguishing among policy options remains poorly evaluated. We tested the ability of two CBD indicators, the Living Planet Index and the Red List Index, to reflect projected changes in mammalian populations in sub-Saharan Africa in response to potential policies related to CBD targets for protected areas (PAs). We compared policy scenarios to expand the PA network, improve management effectiveness of the existing network, and combinations of the two, against business as usual. Both indicators showed that more effective management would provide greater benefits to biodiversity than expanding PAs alone. The indicators were able to communicate outcomes of modeled scenarios in a simple quantitative manner, but behaved differently. This work highlights both the considerable potential of indicators in supporting decisions, and the need to understand how indicators will respond as biodiversity changes.