Obesity and undernutrition in sub-Saharan African immigrant and refugee children in Victoria, Australia

The study assessed the anthropometric status of 337 sub-Saharan African children aged between 3-12 years who migrated to Australia. These children were selected using a snowball sampling method stratified by age, gender and region of origin. The prevalence rates for overweight and obesity were 18.4% (95%CI: 14 - 23%) and 8.6% (95%CI: 6% -12%) respectively. The prevalence rates for the indicators of undernutrition were: wasting 4.3% (95%CI: 1.6%-9.1%), underweight 1.2% (95%CI: 0.3%-3.0%), and stunting 0.3 (95%CI: 0.0%-1.6%). Higher prevalence of overweight/obesity was associated with lower household income level, fewer siblings, lower birth weight, western African background, and single parent households (after controlling for demographic and socio-economic factors). Higher prevalence rates for underweight and wasting were associated with lower household income and shorter lengths of stay in Australia respectively. No effect was found for child's age, gender, parental education and occupation for both obesity and undernutrition indices. In conclusion, obesity and overweight are very prevalent in SSA migrant children and undernutrition, especially wasting, was also not uncommon in this target group.

Fat, rich and beautiful: changing socio-cultural paradigms associated with obesity risk, nutritional status and refugee children from sub-Saharan Africa

There has been an increase in Australia's intake of refugees and migrants from sub-Saharan Africa over the last two decades. These refugees have been exposed to nutritional risks prior to migration, which, together with changes associated with acculturation, impact on their health and nutritional status post-migration. However, there is a paucity of data in Australia that has examined the health and nutritional status of this ethnic minority in Australia. Despite basic research assessing the nutritional status of children, none have specifically concentrated on the health and nutritional situation of sub-Saharan refugee children. In the absence of such studies, this paper explores issues relating to obesity in sub-Saharan African refugee children within a cultural and public health framework. We begin by outlining the history of obesity and its cultural meaning. We then move to a consideration of predisposing factors for obesity and how these factors translate into obesity risk contexts of sub-Saharan refugees post-migration. We argue there are a number of key challenges related to culture and the relationship between socio-economic factors post-migration that require addressing by health professionals, dieticians and health educators to ensure the delivery of successful health outcomes.

Does democracy facilitate economic growth or does economic growth facilitate democracy? an empirical study of Sub-Saharan Africa

This paper examines the relationship between democracy and economic growth in 30 Sub-Saharan African countries. As our proxy for democracy we first use the democracy index constructed by Freedom House and then check the sensitivity of our findings using, as an alternative proxy for democracy, the Legislative Index of Electoral Competitiveness (LIEC). We find support for the Lipset hypothesis - in the long run, real GDP Granger causes democracy and an increase in GDP results in an improvement in democracy ??? in Botswana and Niger with both datasets, for Chad with the Freedom House data only and for Cote d???Ivoire and Gabon with the LIEC data only. Support for the compatibility hypothesis - in the long run democracy Granger causes real income and an increase in democracy has a positive effect on real income - is found for Botswana with the Freedom House data and for Madagascar, Rwanda, South Africa and Swaziland with the LIEC data. Support for the conflict hypothesis - in the long run democracy Granger causes real income and an increase in democracy has a negative effect on real income - is found for Gabon with the Freedom House data and Sierra Leone with the LIEC data.

Does gender inequality reduce growth in sub-Saharan African and Arab countries?

This paper uses 1974 to 2001 panel data for 31 sub-Saharan African and 10 Arab countries and Arellano–Bond estimations to empirically assess the impact on growth of an important indicator associated with MDG 3; namely the ratio of 15–24-year-old literate females to males. Our findings indicate that gender inequalities in literacy have a statistically significant negative effect that is robust to changes in the specification. In addition, it seems that gender inequality has a stronger effect on growth in Arab countries. Interestingly, we find that the interaction between openness to trade and gender inequality has a positive impact. This result suggests that trade-induced growth may be accompanied by greater gender inequalities.

Response of inflation to shocks: new evidence from Sub-Saharan African countries

In this paper, we investigate whether or not the inflation rate of 17 Sub-Saharan African countries can be modelled as a stationary process. We achieve this goal through using univariate and panel stationarity tests for data over the period 1966 to 2002. We use the Kwiatkowski, Phillips, Schmidt and Shin (KPSS, 1992) univariate test and allow for multiple structural breaks. We find that except for Burkina Faso, Burundi and Gambia, the inflation rate is stationary for the rest of the 14 countries. We then apply the panel version of the KPSS test, developed by Carrion-i-Silvestre et al. (2005), which accounts for multiple structural breaks. We find strong evidence of panel stationarity of the inflation rate. However, for a panel consisting of Burkina Faso, Burundi and Gambia, we could not find evidence that the inflation rate is stationary. © 2013 Elsevier B.V.

Migration-related influences on obesity among sub-Saharan African migrant adolescents in Melbourne, Australia

Aim: The aim of the present study was to examine migration- and socioeconomic-related influences on obesity among African migrant adolescents in Melbourne, Australia. Methods: Anthropometric data were collected from 99 parents and 100 adolescent offspring who also completed questionnaires eliciting demographic, socioeconomic and migration data. Multiple linear regressions were used to assess the relationship between migration- and socioeconomic-related factors and adolescent body mass index (BMI). Results: Only gender and parental BMI were associated with adolescent BMI after adjusting for adolescent age, adolescent gender, religion, parental BMI, parental education level and annual income. Boys (β=-1.45; P < 0.05) had lower BMI than girls. Parental and adolescent BMI were positively associated (β = 0.11; P < 0.05). In examining migration-related factors and adolescent BMI, after adjusting for gender and parental BMI, parental acculturation patterns and pre-migration life environment were associated with adolescent BMI, explaining, respectively, 6.5 and 4.0% of the variance in BMI. An integrated parental acculturation pattern was negatively associated with adolescent BMI (β=-0.17; P < 0.05) while adolescents whose parents came from rural areas had a higher BMI (β = 1.48; P < 0.05) than those whose parents came from urban areas. Adolescent acculturation patterns and length of stay in Australia were non-significantly associated with their BMI. Conclusions: Gender, pre-migration life environment and parental acculturation patterns seem to influence the prevalence of overweight and obesity among African migrant adolescents. Culturally competent obesity prevention programmes targeted towards African adolescents should consider these aspects in their design and delivery; however, further research is required to determine their relative contributions to African adolescent obesity in Australia.

Sociocultural factors and perceptions associated with type 2 diabetes among sub-Saharan African migrants in Melbourne, Victoria

Aim: To explore how non-diabetic sub-Saharan African migrants residing in Melbourne, construct and interpret type 2 diabetes mellitus (T2DM) and its risk factors and to provide an evidence-based theoretical framework to inform community-based prevention programs. Methods: Seven focus group discussions (two with women only, two with men only and three of mixed gender) were carried out among Ghanaian, Zimbabwean, Sudanese and Burundian migrants living in Melbourne (n = 61; age range: 18 to 61 years). Results: Three distinct themes emerged: not paying much attention to the threat of T2DM and othering; T2DM being outside the individuals' control; and entrapment within rich industrialised culture and lifestyle. Participants perceived T2DM to be a disease of the wealthy caused by intake of too much sugar and sedentary behaviour, which were particularly compounded by lifestyle-related changes upon migration to an industrialised country. However, they also perceived T2DM to be associated with bad luck. Conclusions: Culturally competent prevention and education programs are needed to increase health literacy and dispel religious and cultural myths about T2DM among sub-Saharan African migrants.

Industrialization in Sub-Saharan Africa and import substitution policy

This article aims to contribute to the understanding of the process of import substitution in Sub-Saharan Africa. The process of industrialization in Sub-Saharan Africa occurred in two phases: a first step, even very early during the colonial regime began around the 1920s and ended in the late forties; a second phase of industrialization began in the late fifties and gained momentum in the sixties, when import substitution was implemented more widely. Although these countries were the last to embark on the strategy of import substitution, they followed the same steps of Latin American countries, and as the structural domestic and external constraints were too strong, the failure of the policy of import substitution arrived early and the negative impact on these economies had a greater magnitude.

Essays on the Empirical Analysis of Economic and Political Development in Sub-Saharan Africa

In Sub-Saharan Africa, non-democratic events, like civil wars and coup d'etat, destroy economic development. This study investigates both domestic and spatial effects on the likelihood of civil wars and coup d'etat. To civil wars, an increase of income growth is one of common research conclusions to stop wars. This study adds a concern on ethnic fractionalization. IV-2SLS is applied to overcome causality problem. The findings document that income growth is significant to reduce number and degree of violence in high ethnic fractionalized countries, otherwise they are trade-off. Income growth reduces amount of wars, but increases its violent level, in the countries with few large ethnic groups. Promoting growth should consider ethnic composition. This study also investigates the clustering and contagion of civil wars using spatial panel data models. Onset, incidence and end of civil conflicts spread across the network of neighboring countries while peace, the end of conflicts, diffuse only with the nearest neighbor. There is an evidence of indirect links from neighboring income growth, without too much inequality, to reduce the likelihood of civil wars. To coup d'etat, this study revisits its diffusion for both all types of coups and only successful ones. The results find an existence of both domestic and spatial determinants in different periods. Domestic income growth plays major role to reduce the likelihood of coup before cold war ends, while spatial effects do negative afterward. Results on probability to succeed coup are similar. After cold war ends, international organisations seriously promote democracy with pressure against coup d'etat, and it seems to be effective. In sum, this study indicates the role of domestic ethnic fractionalization and the spread of neighboring effects to the likelihood of non-democratic events in a country. Policy implementation should concern these factors.

Who can (not) be Greek? Citizenship, Identity and Belonging among youth of sub-Saharan African background in Athens

‘Who can be Greek?’ This was the question posed to the Greek society for the first time before the implementation of the Act 3838 in March 2010 which gave the right to access the Greek citizenship -under specific preconditions- to all children of legal migrants born or schooled in Greece. This change of the Nationality Code in order to include all those children was coincided by the economic crisis resulting into the rise of xenophobia, racism and extreme-right rhetoric. The outcome was the cancellation of the Act 3838 by the State Council in February 2013. Under this particular framework, the notions of identity and belonging formed among the youth of African background in Athens are explored. The ways those youngsters perceive not only themselves but also their peers, their countries of origin and the country they live in, are crucial elements of their self-identification. Researches have shown that the integration of the second generation is highly connected to their legal and social status. However, integration is a rather complex process, influenced and shaped by many variables and multiple factors. It is not linear; therefore, its outcomes are difficult to be predicted. Yet, I argue that citizenship acquisition facilitates the process as it transforms those children from ‘aliens’ to ‘citizens’. How these youngsters are perceived by the majority society and the State is one of the core questions of the research, focusing on the imposed dual ‘otherness’ they are subject to. On the one hand, they have to deal with the ‘otherness’ originating from the migrant status inherited to them by their parents, and on the other with the ‘otherness’ deriving from their different phenotypic characteristics. Race matters and becomes a means of discrimination against youth of African background who are perceived as inassimilable and ‘forever others’.

Adjusting mortality for loss to follow-up: analysis of five ART programmes in sub-Saharan Africa

Evaluation of antiretroviral treatment (ART) programmes in sub-Saharan Africa is difficult because many patients are lost to follow-up. Outcomes in these patients are generally unknown but studies tracing patients have shown mortality to be high. We adjusted programme-level mortality in the first year of antiretroviral treatment (ART) for excess mortality in patients lost to follow-up.