How adolescents perceive their communities: a qualitative study that explores the relationship between health and the physical environment

Abstract

BackgroundThe Well-Being of Adolescents in Vulnerable Environments (WAVE) study was conducted among adolescents aged 15-19 years in Baltimore, Ibadan, Johannesburg, New Delhi, and Shanghai to examine perceived factors related to their health. A preliminary analysis of the data, unexpectedly, revealed that the influence of the physical environment on adolescent health was a dominant theme across every site examined. To explore this further, this paper analyzed the specific components of the physical environment that were perceived to influence health, and how they contributed to various health outcomes across sites.MethodsResearchers in each site conducted in-depth interviews among adolescents; community mapping and focus groups among adolescents; a Photovoice methodology, in which adolescents were trained in photography and took photos of the meaning of ‘health’ in their communities; and key informant interviews among adults who work with young people. A total 529 participants from across the sites were included in the analysis.ResultsFindings showed that while there was surprising uniformity in how adolescents characterized their physical environment, perceived health outcomes related to the physical environment varied by site and gender. In Baltimore and Johannesburg, vacant homes and the lack of recreation facilities were perceived to impact on sexual and reproductive health problems for girls, while among boys they contributed to drugs and violence. In Shanghai, New Delhi, and Ibadan, garbage and trash observed in their communities were perceived to have a higher impact on infectious and chronic diseases.ConclusionsAs the world continues to urbanize, our study points to a strong need to examine how the physical aspects of a living environment contribute to the health of adolescents. Specific aspects, such as housing, safety, garbage, and recreational spaces must all be examined as possible pathways for making improvements to health of adolescents, particularly among those living in poor urban environments.

Shining light inside the tunnel: using photovoice as a strategy to define the needs for health promotion among families of low socioeconomic status

“…Improving the upstream determinants, such as education, employment opportunities, social/physical context and people’s mindset, is likely to have a positive impact on the feeling of independence, self-resilience and a sense of belonging, as well as on the long-term health outcomes of the population (Australian Medical Association, 2007; Bharmal, Derose, Felician, & Weden, 2015; Di Domenico & Fournier, 2014; Mmari et al, 2014; Steger, Fitch-Martin, Donnelly, & Rickard, 2015; Van Lenthe et al, 2015). In contrast, improving downstream determinants is often compared to “trying to empty the ocean with a thimble”.…”

Mental Wellbeing and Self-reported Symptoms of Reproductive Tract Infections among Girls

“…Sociocultural norms in India expect unmarried girls and women to be sexually inexperienced and ignorant. In case they face any sexual or reproductive health problems, it is difficult for them to reveal the situation to family members, friends or health-care service providers, which rarely meet the requirements of confidentiality (Mmari et al 2014). South Asian adolescent girls' mental wellbeing is potentially jeopardised by the unhappy combination of vulnerable reproductive health (Bhatia and Cleland 1995), lack of personal autonomy (Ram et al 2014), and social taboos of seeking treatment (Koenig et al 1998).…”

“…Menstrual and other gynaecological problems are reported as being a principal health concern by adolescent slum-dwelling girls in India (Joseph et al 1997;Mmari et al 2014). Reproductive Tract Infections (RTIs) pose a major sexual and reproductive health problem among adolescents, irrespective of their sexual activity.…”

Os Olhares De Enfermeiras Sobre a Vulnerabilidade Dos Adolescentes Em Um Distrito Sanitário

“…Os adolescentes percebem a vulnerabilidade a que estão expostos, em especial pela falta de infraestrutura, segurança, recreação e condições precárias de habitação, entendendo que esta exposição pode acarretar problemas de saúde. Esta percepção dos jovens fez emergir na saúde pública discussões sobre ações que reduzam alguns agravos advindos destas condições de vida (18) .…”