Medicine and Health Sciences Commons^™

Adolescence In The Kibera Slums Of Nairobi, Kenya, Annabel Erulkar, James K. Matheka

Poverty, Gender, and Youth

Rates of urbanization in Kenya are among the highest in the world and young people form a large proportion of those moving from rural to urban areas of the country. For many young people, the first point of entry into urban areas are the slums. Adolescents and young people make up a significant proportion of the slum-dwelling population, yet little is known about their experiences growing up in these poor urban environments. This population-based study of adolescents took place in the Kibera slum in Nairobi, Kenya, in 2006. The study explores the adolescent experience in one of Africa’s largest slum …

The Experience Of Married Adolescent Girls In Northern Nigeria, Annabel Erulkar, Mairo Bello

Poverty, Gender, and Youth

Programs for young people in sub-Saharan Africa have been directed largely toward unmarried adolescents, neglecting the fact that a large proportion of adolescents—especially girls—are married in some settings. Early marriage is a common feature of girls’ adolescence in Northern Nigeria, yet few programs are in place to support this sizable and vulnerable group. To suggest directions for future programming, Adolescent Health and Information Projects (AHIP) and the Population Council examined the lives of married and unmarried girls in two geopolitical regions of Nigeria, North West and North East. The study, as described in this report, consisted of secondary analysis of …

Changing Transitions To Adulthood In Vietnam's Remote Northern Uplands: A Focus On Ethnic Minority Youth And Their Families [Vietnamese], Bussarawan Teerawichitchainan, Hac Van Vinh, Nguyen Thi Phuong Lan

Poverty, Gender, and Youth

Ethnic minorities, who tend to live in remote mountainous areas, account for 15 percent of Vietnam’s 84 million total population and, according to a recent estimate, 61 percent of them are poor. Evidence suggests that despite recent efforts by the Government of Vietnam to promote poverty reduction in remote areas, a majority of ethnic minorities have not yet experienced positive change, contrary to their Kinh (ethnic Vietnamese) neighbors who have enjoyed substantial improvement in living standards. To identify program interventions that promote healthy human development and, in turn, positively affect Vietnam’s economic growth, it is crucial to have a comprehensive …

Teacher Absence As A Factor In Gender Inequalities In Access To Primary Schooling In Rural Pakistan, Sharon Ghuman, Cynthia B. Lloyd

Poverty, Gender, and Youth

This paper examines the case of Pakistan, where primary school enrollment among girls in rural areas is substantially lower than among children in urban areas and boys in rural areas, owing to lack of access to government girls’ schools. The focus is on teacher absence as a further barrier to schooling for girls. Using data from a panel study of primary schooling in rural Punjab and NWFP in 1997 and 2004, the report examines trends in teacher absence, examine the factors correlated with teacher absence in the government and private sector, and assesses the implications of these absence levels for …

The Role Of Schools In Promoting Sexual And Reproductive Health Among Adolescents In Developing Countries, Cynthia B. Lloyd

Poverty, Gender, and Youth

This Population Council working paper reviews the state of knowledge about relationships between schooling and adolescent reproductive health. With the spread of mass schooling and the growing share of adolescents who attend school, the opportunities for synergies between health and education policies and programs are growing. Data on cross-country variations in health conditions on the one hand, and variations in attendance and attainment patterns and school systems on the other hand, provide a framework for assessing alternative approaches to the promotion of adolescent sexual and reproductive health in different contexts. Disappointing findings from recent school-based reproductive health interventions in poor …

Girls' Adolescence In Burkina Faso: A Pivot Point For Social Change, Martha Brady, Lydia Saloucou, Erica Chong

Poverty, Gender, and Youth

As closer attention is paid to the lives of adolescents in sub-Saharan Africa, girls are found to be clearly disadvantaged, compared with their male counterparts. Burkinabé girls are frequently married at a young age, and more than one-third of married girls find themselves in polygamous unions as second or third wives, married to much older men. Understanding and recognizing girls’ realities is an important first step in planning appropriate and meaningful interventions for them. Girls who are unmarried, “promised,” engaged, or married face different constraints and merit different program approaches. This report by the Population Council aims to fill gaps …

Providing New Opportunities To Adolescent Girls In Socially Conservative Settings: The Ishraq Program In Rural Upper Egypt—Full Report, Martha Brady, Ragui Assaad, Barbara L. Ibrahim, Abeer Salem, Rania Salem, Nadia Zibani

Poverty, Gender, and Youth

Adolescent girls in the poorest villages of Upper Egypt, who were kept from school by poverty and other obstacles, face a bleak future that will replicate the poverty and disadvantage of their own families. This stark picture of vulnerability encouraged four long-standing nongovernmental organizations working in Egypt—Caritas, CEDPA (Centre for Development and Population Activities), the Population Council, and Save the Children—to create a multidimensional program for 13–15-year-old out-of-school girls. The pilot intervention, known locally as Ishraq, sought to transform girls’ lives by changing gender norms and community perceptions about girls’ roles in society while bringing them safely and confidently into …

Empowering Young Mothers In India: Results Of The First-Time Parents Project, K.G. Santhya, Nicole Haberland

Poverty, Gender, and Youth

In India, sexual activity among girls and young women typically takes place within marriage. Nationally, as many as 30 percent of adolescent girls aged 15–19 are married, presumably sexually active, and under pressure to bear a first child early in the marriage. While sexual activity for the majority of adolescent Indian girls occurs within the socially sanctioned institution of marriage, marital sex is not inherently safe, voluntary, or pleasurable. Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 8 describes the Population Council’s efforts to support married adolescent girls. The Council, in partnership with the Child in Need Institute …

Assessing The Multiple Disadvantages Of Mayan Girls: The Effects Of Gender, Ethnicity, Poverty, And Residence On Education In Guatemala, Kelly Hallman, Sara Peracca, Jennifer Catino, Marta Julia Ruiz

Poverty, Gender, and Youth

Although access to primary education in Guatemala has increased in recent years, particularly in rural areas, rates of primary-school completion and literacy for young people remain among the lowest in Latin America, and problems such as late entry, grade repetition, and early dropout persist. Adult literacy is estimated to be 85 percent in Latin America as a whole, compared with 70 percent in Guatemala. Although indigenous peoples in Latin America generally have less schooling than nonindigenous peoples, ethnic differences are greatest in Guatemala, where indigenous (Mayan) adults have less than half the level of schooling of nonindigenous (Ladino) adults. Recent …

Influencing Girls’ Lives: Acceptability And Effectiveness Of A Livelihoods Skill Building Intervention In Gujarat, Shveta Kalyanwala

Poverty, Gender, and Youth

There are 66 million adolescent females aged 13–19 in India. Their lives are characterized by limited education, lack of economic and social opportunities, early marriage and childbearing, and limited influence on decisions affecting their lives. Although programs in India have aimed to empower adolescent girls, they have largely focused on enhancing life skills and awareness. Programs to address women’s social and economic disadvantages have focused exclusively on adult women. To respond to the absence of programs devoted specifically to the social and economic empowerment of adolescent girls and young women, the Population Council partnered with the Self-Employed Women’s Association (SEWA) …

Sexuality And Hiv Education: Time For A Paradigm Shift, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

For decades, curriculum-based sexuality education has been a cornerstone of school- and community-based efforts to improve young people’s sexual and reproductive health, and more recently to prevent HIV infection. Unfortunately, public discourse about sex education has been mired in polarizing debates that distract attention from determining how sex and HIV education programs might best achieve the shared goals of many different constituencies. A recent comprehensive review of the impact of school-based sexuality and HIV education programs in developed and developing countries found that two-thirds of the programs reduced the risk associated with one or more reported sexual behaviors. This finding …

Girls Left Behind: Redirecting Hiv Interventions Toward The Most Vulnerable, Judith Bruce

Poverty, Gender, and Youth

As we enter the third decade of the HIV pandemic in sub-Saharan Africa, young women—often adolescent girls—are the new face of the disease. In particular, HIV/AIDS is threatening those girls and young women with limited social and economic assets—those who are unable to avoid, manage, or leave unsafe sexual relationships inside and outside of marriage. Girls at risk of sexual exploitation are not a small minority; they are counted in the hundreds of millions. Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 23 explores: structural determinants of risk, failure to reach the most vulnerable, moving ahead with the …

Obtaining More Accurate And Reliable Information From Adolescents Regarding Sti/Hiv Risk Behaviors, Barbara Mensch, Paul C. Hewett

Poverty, Gender, and Youth

To investigate the quality of self-reported data on sexual behavior, Population Council researchers conducted a study in a rural district of Malawi. They implemented a randomized experiment to assess whether audio computer-assisted self-interviewing (ACASI) produces more valid data on sexual behavior than face-to-face interviews. The Malawi study builds on an experiment conducted as part of a household-based survey of Kenyan adolescents. In Kenya and Malawi, there is clear evidence that mode of interviewing and probing of various sexual partnerships affect the reporting of sexual activity. According to Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 25, ACASI is …

Evaluación De Las Múltiples Desventajas De Las Niñas Mayas: Efectos Del Género, El Origen Étnico, La Pobreza Y El Lugar De Residencia Sobre La Educación En Guatemala, Kelly Hallman, Sara Peracca, Jennifer Catino, Marta Julia Ruiz

Poverty, Gender, and Youth

Aunque el acceso a la educación primaria en Guatemala se incrementó en los últimos años, especialmente en las áreas rurales, los índices de finalización de escuela primaria y de alfabetismo corespondeientes a personas jóvenes continúan estando entre los más bajos de Latinoamérica, y persisten otros problemas como el ingreso tardío, la repetición de cursos y el abandono temprano. Se estima que el índice de alfabetismo entre adultos es del 85 por ciento en Latinoamérica en general, comparado con sólo un 70 por ciento en Guatemala. Aunque los pueblos indígenas en Latinoamérica por lo general tienen menos escolaridad que los no …

Les Filles Sont Oubliées : Rediriger Les Interventions En Matière De Vih Vers Les Plus Vulnérables, Judith Bruce

Poverty, Gender, and Youth

Alors que nous entrons dans la troisième décennie de la pandémie de VIH en Afrique subsaharienne, les jeunes femmes, le plus souvent les adolescentes, sont le nouveau visage de la maladie. Le VIH/SIDA menace en particulier les jeunes femmes et les adolescentes qui se trouvent dans des situations sociaux-économiques peu favorables, celles qui ne peuvent éviter, gérer ni échapper à des relations sexuelles à risque au sein même du mariage or hors mariage. Les filles présentant un risque d'être exploitées sexuellement ne représentent pas une petite minorité; on peut les compter par centaines de millions. Promouvoir des transitions vers l'âge …

Las Niñas Rezagadas: Dirigir Las Intervenciones De Vih Hacia Las Más Vulnerables, Judith Bruce

Poverty, Gender, and Youth

Al ingresar en la tercera década de la pandemia del VIH en el África subsahariana, las mujeres jóvenes—a menudo adolescentes—conforman el nuevo rostro de la enfermedad. En especial, el VIH/SIDA amenaza a aquellas niñas y mujeres jóvenes con limitados posibilidades sociales y económicas; quienes que no pueden evitar, controlar o abandonar las relaciones sexuales inseguras, dentro y fuera del matrimonio. Las niñas que están en riesgo de ser explotatas sexualmente no constituyen una pequeña minoría; se calculan en cientos de millones. Promoción de transiciones a la vida adulta: Sanas, seguras y productivas N° 23 explora: los determinantes estructurales de riesgo, …

Biodosepr-2006 Consensus Committee Report On Biodosimetric Methods To Evaluate Radiation Doses At Long Times After Exposure, Steven L. Simon, Ian Bailiff, André Bouville, Paola Fattibene, Ruth A. Kleinerman, David C. Lloyd, Stephen W.S. Mckeever, Alexander Romanyukha, Alexander V, Sevan’Kaev, James D. Tucker, Albrecht Wieser

Uniformed Services University of the Health Sciences

The requirements for biodosimetric techniques used at long times after exposure, i.e., 6 months to more than 50 years, are unique compared to the requirements for methods used for immediate dose estimation. In addition to the fundamental requirement that the assay measures a physical or biologic change that is proportional to the energy absorbed, the signal must be highly stable over time to enable reasonably precise determinations of the absorbed dose decades later. The primary uses of these biodosimetric methods have been to support long-term health risk (epidemiologic) studies or to support compensation (damage) claims. For these reasons, the methods …

Socioeconomic Position And Incident Mobility Impairment In The Cardiovascular Health Study, Cheryl K. Nordstrom, Ana V. Diez Roux, Richard Schulz, Mary N. Haan, Sharon A. Jackson, Jennifer L. Balfour

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

We investigated if personal socioeconomic position (SEP) factors and neighborhood characteristics were associated with incident mobility impairment in the elderly.

Methods

We used data from the Cardiovascular Health Study, a longitudinal, population-based examination of coronary heart disease and stroke among persons aged 65 and older in the United States.

Results

Among 3,684 persons without baseline mobility impairment, lower baseline SEP was associated with increased risk of incident mobility disability during the 10-year follow-up period, although the strengths of these associations varied by socioeconomic indicator and race/sex group.

Conclusion

Among independent-living elderly, SEP affected development of mobility impairment into …

Physical Activity And Physical Activity Adherence In The Elderly Based On Smoking Status., Theodore Cooper, M. Resor, C. Stoever, P. Dubbert

Departmental Papers (Psych)

No abstract provided.

Chronic Care At The Crossroads: Exploring Solutions For Chronic Care Management. Report On The Us Summit., Janice L Clarke

College of Population Health Faculty Papers

Report on the US Summit

The Health Insurance Debate In Canada: Lessons For The United States?, Mary Anne Bobinski

Faculty Articles

This Essay begins with an intentionally ambiguous title. Are comparisons to Canada relevant and useful for policy-makers in the United States and, if so, what lessons can we learn? Part II of this Essay highlights some of the risks and benefits of cross-border comparisons between the United States and Canada. In Part III, I analyze some of the key data points often cited in comparing the two health care systems. Part IV explores the current Canadian debate about private health insurance. Finally, in Part V, I focus on the lessons from Canada for the health insurance debate in the United …

Dead Roses And Blooming Deserts: The Medical History Of A New Deal Icon, Michelle F. Turk

Psi Sigma Siren

Although a memorial plaque at the Hoover Dam sets the number of workers killed during its construction at ninety-six, the real figure was nearly double. In fact, the figure would have been much higher had it not been for the precedent-setting effort by the federal government, contactors, and workers to save as many lives as possible on the project. Aside from its long unrecognized value as a jobs program, much needed stimulus to the fledging Las Vegas economy, and status as one of the “man-made wonders of the world,” Hoover Dam represented a major step forward for the American occupational …

Factors Associated With Atypical Moles In New Hampshire, Usa, L Titus-Ernstoff, J Ding, A. E. Perry, S. K. Spencer, B. F. Cole, M. S. Ernstoff

Dartmouth Scholarship

Only a few studies, conducted in Sweden, assessed factors associated with the presence of atypical moles in the general population. We conducted a population-based, case-control study in New Hampshire, USA, to identify factors associated with atypical moles. In our study, atypical moles affected 14% of the study population. The adjusted odds ratio (OR) was 0.34 (95% confidence interval (CI)=0.14-0.80) for those with the highest adulthood recreational sun exposure, relative to the lowest. The OR for any freckles, compared to none, was 2.24 (95% CI=1.18-4.25). We found a linear relationship between the number of benign moles and the presence of atypical …

On A Multinational Assessment Of Rotavirus Disease In Europe, David O. Matson

Community & Environmental Health Faculty Publications

Rotaviruses were discovered in the 1960s in animals and in the 1970s in humans; the latter discovery was made by an intrepid group who performed duodenal biopsies on children with acute gastroenteritis (AGE) [1]. By the late 1970s, data already clearly indicated that rotavirus was the cause of the annual winter peak of AGE affecting young children, as well as a frequent cause of severe gastroenteritis in various animal species (e.g., [2–5]). Use of the retrospectroscope clarified or left as tantalizing the suggestion that rotaviruses were the cause of the annual “winter vomiting syndrome” first described in children in 1910 …

Using Concentration Index To Study Changes In Socio-Economic Inequality Of Overweight Among Us Adolescents Between 1971 And 2002, Qi Zhang, Youfa Wang

Community & Environmental Health Faculty Publications

Background: The prevalence of overweight among adolescents continues to increase in the United States. This study examines the changes in socio-economic status (SES) inequality of overweight among US adolescents in the past three decades.

Methods: Concentration Index (CI) was utilized to measure changes in the SES inequality in prevalence of overweight among US adolescents. Data collected from 15286 adolescents in four waves of the National Health and Nutrition Examination Surveys (NHANES) between 1971 and 2002 and Hispanic Health and Nutrition Examination Survey (HHANES) (1982-84) were used.

Results: Changes in the SES inequality of overweight among US adolescents and considerable gender …

Towards Messages That Matter: Understanding And Addressing Hiv And Srh Risks Among Married Young People In India, Armin Jamshedji-Neogi, Renu Kapoor, Jayashree Kumar, Ashwini Bhalerao Gandhi, Lakshmi Murthy, K.G. Santhya, Shireen J. Jejeebhoy, Saswata Ghosh, Vijaya Nidadavolu, Nicole Haberland, Komal Saxena, M.A. Jose

Poverty, Gender, and Youth

Although there is increasing interest in young people's sexual and reproductive health (SRH) situations and needs in India, married young people have received little attention as a vulnerable group with distinct needs because marriage is assumed to be safe and because married youth are assumed to face none of the stigma that their unmarried counterparts experience in accessing SRH services. However, emerging evidence shows that within this subpopulation, married young women and men constitute groups with distinct risks of HIV and other poor SRH outcomes. There remains a need to better understand their unique vulnerabilities and to design programs that …

Changing Transitions To Adulthood In Vietnam's Remote Northern Uplands: A Focus On Ethnic Minority Youth And Their Families, Bussarawan Teerawichitchainan, Hac Van Vinh, Nguyen Thi Phuong Lan

Poverty, Gender, and Youth

Ethnic minorities, who tend to live in remote mountainous areas, account for 15 percent of Vietnam’s 84 million total population and, according to a recent estimate, 61 percent of them are poor. Evidence suggests that despite recent efforts by the Government of Vietnam to promote poverty reduction in remote areas, a majority of ethnic minorities have not yet experienced positive change, contrary to their Kinh (ethnic Vietnamese) neighbors who have enjoyed substantial improvement in living standards. To identify program interventions that promote healthy human development and, in turn, positively affect Vietnam’s economic growth, it is crucial to have a comprehensive …

Hiv-Positive Inmates Released From Nevada’S Prisons In 2001: Results From Matching Health Division And Corrections’ Databases, Paul G. Devereux, Kristen Clements-Nolle, Sharon Clodfelter, Jessey Bargmann-Losche, Miguel Feroro, Wei Yang

Nevada Journal of Public Health

It is estimated that about one quarter of all HIV-infected individuals in the United States are released from a correctional facility each year. To better understand the needs of inmates with HIV exiting the prison system, a partnership with the Nevada State Health Division (NSHD), the Nevada Department of Corrections (DOC), and the University of Nevada, Reno School of Public Health was formed to examine this population using information contained in existing databases. An analysis of DOC data matched with the data from the HIV/AIDS Reporting System (HARS) maintained by the NSHD identified 2,802 HIV-negative inmates (2,451 males and 350 …

The Influence Of Indoor Air Quality (Iaq) On Student Test Performance, Denise M. Hreha

Seton Hall University Dissertations and Theses (ETDs)

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Theorizing Threat: An Investigation Of Contentious Embodiment, Jennifer Musial, Emily Van Der Meulen

Reconstruction: Studies in Contemporary Culture

[First paragraph]

In early summer 2006, we had a phone conversation that generated interest in this topic. Emily was reminiscing about her experiences at the Washington, D.C. March for Women's Lives in April of 2004. The March, a demonstration for reproductive justice, brought out feminists and anti-abortion protestors alike. Emily remembered seeing African-American men holding signs that equated abortion to the airplane attacks in New York City on September 11, 2001. This sparked curiosity: how does abortion become equated with "terrorism"? [1] One answer to this question is that a woman who has an abortion is said to commit "body-terrorism" …