Search Results (36)

The COVID-19 pandemic has illuminated and intensified pre-existing structural vulnerabilities among older adults living with HIV/AIDS in sub-Saharan Africa, particularly Nigeria. Within already overstretched healthcare infrastructures, these individuals faced heightened economic precarity, disrupted HIV care, and pronounced psychosocial distress. Exploring their lived experiences critically advances an understanding of resilience and informs contextually responsive interventions that can mitigate future health crises. This study employed a narrative qualitative approach to explore the lived experiences of older adults (aged 50 and above) attending the Infectious Diseases Institute (IDI) clinic in Ibadan, Nigeria, during the pandemic lockdown. Purposive sampling guided by maximum variation principles enabled the selection of 26 participants who provided detailed accounts through in-depth interviews. Reflective thematic analysis identified complex narratives illustrating intensified financial hardships, disrupted access to antiretroviral therapy (ART), and heightened psychological distress, including anxiety, depression, and profound isolation. Conversely, participants also articulated experiences of resilience, manifesting in improved medication adherence, strengthened family bonds, and introspective growth fostered by enforced isolation. These nuanced findings highlights the necessity of developing an adaptive, integrated healthcare interventions that addresses economic vulnerabilities, psychosocial wellbeing, and ART continuity, thereby better preparing resource-constrained health systems to support older adults with HIV/AIDS in future public health crises. Full article

A robust body of research examines the association between socioeconomic status (SES), particularly its economic dimension, income poverty, and child maltreatment rates. However, several key questions regarding this relationship remain underexplored. Utilizing a critical literature review, this article finds that some forms of child maltreatment (i.e., sexual abuse) do not correlate with income poverty. Moreover, evidence about the effects of other dimensions of SES, including employment and education is not monolithic. The complexity of this relationship is further influenced by the data source and unit of analysis. Studies using administrative data and analyzing SES at the family or household level frequently report a strong correlation between SES and child maltreatment. However, this relationship weakens (or in some cases disappears) when examined at the neighborhood or regional level using self-report data. Our findings also suggest that the overrepresentation of minority groups in child maltreatment statistics can be, at least in part, attributed to economic disadvantages. Furthermore, social cohesion appears to buffer the effects of income poverty and material hardship, highlighting the role of inequality in weakening social networks and exacerbating socioeconomic stressors. A developing body of literature demonstrates the link between income inequality and child maltreatment rates and indicates that policies aimed at addressing the impact of SES on child maltreatment should not only focus on alleviating poverty-related factors, such as material hardship, unemployment, and housing instability, but also target broader class disparities as the common root of many social problems. Full article

Background/Objectives: Financial distress from the direct and indirect costs of cancer treatment is a critical issue for many patients with breast cancer, particularly those from underserved populations who may be more vulnerable to financial hardship and its negative impacts on quality of life and clinical outcomes (i.e., financial toxicity). Few investigations, however, focus on protective factors that safeguard against financial toxicity. This study explores how social support might reduce financial toxicity among patients with breast cancer who are at high risk for financial hardship. Methods: We analyzed interviews with 41 adult women treated for stage I-IV breast cancer that had been conducted between December 2021 and March 2022. Our study specifically sampled women considered to be at elevated risk for financial toxicity: young adults aged 18–40 years old, Black women, women with lower incomes, and those residing in rural communities. We used deductive and inductive coding to identify themes related to social support. Results: Interviewees reported receiving support from family, friends, and their communities during their treatments. They noted how this social support helped with direct and indirect costs, encouraged emotional wellbeing, and safeguarded against economizing behaviors that offset spending (e.g., financial tradeoffs that jeopardize their treatment plan). Conclusions: Patients with breast cancer from groups vulnerable to financial toxicity often rely on the support of family, friends, and their communities to help buffer financial distress from the costs of treatment. These data highlight social support as an area for future studies exploring strategies to mitigate financial toxicity. Full article

Somali refugee youth face intersecting stressors related to displacement, economic hardship, and systemic exclusion, yet their coping strategies remain understudied. This study examines the psychosocial distress, coping mechanisms, and help-seeking behaviors of Somali refugee youth in Nairobi’s urban displacement context using a mixed-methods approach. Quantitative analyses assess the prevalence of stressors, coping strategies, and perceived support, while qualitative responses provide insight into lived experiences. Findings reveal that 72% of participants reported distress linked to economic insecurity (15.9%), family separation (16.9%), or refugee-related adversities (13.2%). Religious coping (59.5%) and self-care practices (60.5%) were the most frequently used strategies, while 15.8% relied on avoidance-based methods. Help-seeking patterns showed that 76.7% of participants were willing to seek help in general, but only 40.7% did so for emotional issues, with mothers and same-sex friends being primary sources. Regression analysis (R² = 0.507, p < 0.001) showed that scope of community (β = 0.417, p = 0.001), trust in bonding social capital (β = 0.343, p = 0.012), and perceived community violence (β = 0.346, p = 0.003) were positively associated with perceived support. In contrast, help-seeking intention (β = −0.206, p = 0.049) was negatively associated with perceived support. Other variables—including religious coping, emotional coping, age, gender, and bridging trust—were not significant predictors. These findings underscore the need for community-driven mental health interventions that strengthen existing social structures while integrating culturally adapted service models. Leveraging social capital is essential for fostering sustainable, accessible, and community-based mental health support for displaced Somali youth. Full article

Climate-induced migration is increasingly affecting communities, disrupting livelihoods, and intensifying socio-economic inequalities, particularly in disaster-prone regions. Despite the prevalence of recurring flood hazards, there remains limited research on the multi-dimensional impacts of migration particularly in socio-culturally sensitive and resource-constrained settings like Khyber Pakhtunkhwa (KPK), Pakistan. This study seeks to bridge this gap by exploring the post-migration challenges of flood-affected communities in District Nowshera. Using a qualitative methodology, we conducted in-depth interviews with 25 diverse key informants. The study results revealed profound socioeconomic instability, inadequate access to essential services, and cultural disruptions. Key findings include significant challenges such as inadequate housing, the loss of traditional livelihoods, persistent financial hardships, health issues, and the breakdown of social support networks. Moreover, displaced families face marginalization and language barriers, which hinder integration into host communities, amplifying feelings of isolation and identity loss. Environmental degradation in resettlement areas further intensifies these challenges, prolonging poor living conditions and heightened vulnerability. To address these issues, the study recommends community-based interventions such as developing resilient, culturally appropriate housing, implementing targeted skills training programs to restore livelihoods, promoting climate-smart agricultural practices, and enacting inclusive social policies to promote integration and cohesion to address climate-induced migration in disaster-prone regions. Full article

The literature provides empirical evidence that family economic hardship can increase the likelihood of adolescents engaging in non-suicidal self-injury (NSSI). However, the mechanisms underlying this relationship remain unclear. Guided by the risky families model, this study aimed to investigate whether relative deprivation mediates the link between family economic hardship and adolescent NSSI, and whether self-esteem moderates this indirect link. A combined 673 adolescents (45.9% female; M_age = 12.81 years) completed measures of family economic hardship, relative deprivation, self-esteem, and NSSI. The results verified that relative deprivation mediated the positive link between family economic hardship and NSSI. Additionally, self-esteem moderated the effect of family economic hardship on relative deprivation. Adolescents possessing high self-esteem reported lower relative deprivation compared to those possessing low self-esteem, regardless of their level of family economic hardship. Notably, the mitigating effect of high self-esteem diminished with high family economic hardship. These findings provide deeper insights into the mechanisms by which family economic hardship affect adolescent NSSI, and have practical implications for prevention and intervention strategies targeting this behavior. Full article

The present study investigates the geographic distribution patterns of the responsiveness of four safety net programs during the significant economic downturn triggered by the 2020 pandemic: Unemployment Insurance, the Supplemental Nutrition Assistance Program, Medicaid, and Temporary Assistance for Needy Families. An analysis of each state’s enrollment changes in these safety net programs from the pre-pandemic to the pandemic period relative to labor-market performance, using a responsiveness index, revealed which programs were most responsive to the pandemic recession in specific states or regions. Consistent with national findings, the present study suggests that Unemployment Insurance responded the most to the economic downturn of 2020, followed by the Supplemental Nutrition Assistance Program, Medicaid, and Temporary Assistance for Needy Families. Findings also show that Arizona and New Mexico responded highly across all four programs relative to labor-market performance. We used exploratory spatial data analysis to determine whether the spatial patterns of the responsiveness index identified in the study are statistically significant globally and locally within a given neighborhood structure. Our findings suggest that spatial distribution patterns are not random for the Supplemental Nutrition Assistance Program and Temporary Assistance for Needy Families at the global level. Moreover, statistically low-low clusters were found in different areas of these two programs: the Supplemental Nutrition Assistance Program in northern states and Temporary Assistance for Needy Families in southern states. Our analyses of the four safety nets’ responsiveness to labor market performance are consistent with the underlying social sustainability principles, particularly livelihood security and social well-being. Our findings can help policymakers make data-driven and better-informed decisions to assist those facing financial hardship, paving the way for improved policies and new opportunities for prosperity. Full article

The association between poverty and maltreatment is well established, and numerous studies show the detrimental effects of economic and material hardship on maltreatment, child welfare involvement, and family well-being. In turn, an increasing body of literature suggests the value of programs and services that provide economic and concrete support in stabilizing and supporting families and, ultimately, reducing occurrences of maltreatment. In this article, we examine the effectiveness of economic and concrete support in reducing primary outcomes of child maltreatment and child welfare involvement and in improving secondary outcomes of child and adult well-being through a systematic review of the literature. We review studies published between 1990 and 2023 through searches of scholarly databases, child welfare websites, and evidence-based clearinghouses. We used a two-stage review process to identify a final sample of articles for data extraction. Twenty-four studies with low risk of bias were included in the synthesis. Regardless of delivery mechanism, we found consistent, favorable evidence of the impact of economic and concrete support as a prevention strategy to reduce child maltreatment and child welfare entry and to a lesser extent, improvements in child and adult well-being across these studies. Implications for policy, practice, and racial equity are discussed. Full article

Background/Objectives: This study aims to explore family dynamics and the economic hardships experienced by families during the COVID-19 pandemic and their associations with adolescents’ health risk behaviours (HRBs). Methods: Based on a representative study of adolescents aged 11–16 conducted in Bulgaria during the COVID-19 pandemic and HBSC data from the pre-pandemic period, logistic regression models were applied, assessing cigarette smoking, vaping, alcohol use, drunkenness, and cannabis use. The independent variables included demographics, Family Affluence Scale (FAS III), family structure, ease of communication with parents, and the authors’ developed questions on parents’ income and economic status change, family conflicts, and missing contact with extended family due to the pandemic. Results: Material status of the family showed increasing differentials in adolescents’ HRBs during the pandemic. Parental unemployment, income reduction, and temporary lay-offs were associated with a higher risk of substance use. Family conflicts, missing contact with extended family, and difficulties in communication with the mother were related to a higher risk of substance use. Communication with the father was significantly associated with alcohol use and drunkenness. Boys had lower odds of vaping and higher odds of alcohol use, drunkenness, and cannabis use. Higher age and minority status were associated with an increase in adolescents’ HRBs. Conclusions: This study highlights the need for special family-focused interventions in times of health and economic crises. Full article

Black pregnant women in Chicago are disproportionately affected by maternal morbidity and mortality and are more likely to reside in neighborhoods that experience greater economic hardships and food apartheid than any other race/ethnicity. Addressing social determinants of health such as structural inequities, economic environment, and food apartheid issues may provide insights into eliminating Black maternal morbidity and mortality disparities. This study explores food choice determinants and dietary perspectives of young, urban, Black pregnant women. Two audio-recorded focus groups were conducted in Chicago, IL between March 2019 and June 2019 to discuss pregnancy experiences and factors affecting maternal nutrition. Thematic analysis was used to identify the codes, themes, and subthemes of the data. Data analysis was guided by the Social Ecological Model (SEM) as a theoretical framework. Eleven, young, Black women were recruited. Three major themes were discussed across the SEM levels that influenced food choice including food access, stress and family influences on eating, and the need for nutritional education during pregnancy. These choices were primarily rooted in the detrimental effects of food apartheid experienced within the participants’ neighborhoods. Therefore, acknowledging, understanding, and addressing food apartheid and its impact on Black maternal health disparities is needed in clinical practice, research, and policy change. Full article

Background: During the COVID-19 pandemic, reduced access to care services and fear of infection prompted families to increase home care for their older relatives with long-term care needs. This had negative effects on both members of the caring dyad, impacting their quality of life (QoL) and mental well-being. This study investigated the factors that influenced the mental well-being and QoL of 239 dyads, before and after the first pandemic wave in Italy. Methods: Data were collected through a survey on the use of health and social care services and interventions by older care recipients living in the community and their family caregivers. Factors associated with deterioration of mental well-being and QoL in older care recipients (mean age 86.1 years old) and their family caregivers after the pandemic were studied. Results: The importance attached by family caregivers to the skills and training of healthcare professionals was a protective factor against the deterioration in the well-being of older care recipients. Similarly, the importance associated by family caregivers to the help received from healthcare professionals was a protective factor for QoL. Financial hardship of older care recipients was a risk factor for deterioration in caregivers’ mental well-being, while support from other family members was a protective factor for QoL. Conclusions: The presence of attentive healthcare professionals, a supportive family environment, and economic support can reduce the burden on both the caregiver and the older care recipient. These aspects need to be considered in any future emergency situation and when planning care services for community-dwelling older people. Full article

Poultry diseases pose major constraints on smallholder production in Africa, causing high flock mortality and economic hardship. Infectious diseases, especially viral diseases like Newcastle disease and highly pathogenic avian influenza (HPAI) and bacterial diseases, especially colibacillosis and salmonellosis, are responsible for most chicken losses, with downstream effects on human nutrition and health. Beyond production impacts, poultry diseases directly harm public health if zoonotic, can give rise to epidemics and pandemics, and facilitate antimicrobial resistance through treatment attempts. HPAI, campylobacteriosis, and salmonellosis are the priority zoonoses. Sustainable solutions for poultry health remain elusive despite recognition of the problem. This review summarises current knowledge on major poultry diseases in smallholder systems, their impacts, and options for prevention and control. We find biosecurity, vaccination, good husbandry, and disease-resistant breeds can reduce disease burden, but practical limitations exist in implementing these measures across smallholder systems. Treatment is often inefficient for viral diseases, and treatment for bacterial diseases risks antimicrobial resistance. Ethnoveterinary practices offer accessible alternatives but require more rigorous evaluation. Multisectoral collaboration and policies that reach smallholder poultry keepers are essential to alleviate disease constraints. Successful control will improve livelihoods, nutrition, and gender equity for millions of rural families. This review concludes that sustainable, scalable solutions for smallholder poultry disease control remain a critical unmet need in Africa. Full article

The progress and development of society in every sense is possible by raising healthy individuals. To do so, it is necessary to ensure the physical and mental development of children in a healthy way. There are many variables that affect the physical and mental development of children. These variables are affected by individual factors, social structure, social interactions and cultural values. In addition, when these factors interact with each other, their effect on behavior and well-being may increase. Undoubtedly, one of the primary factors negatively affecting a child’s physical and psychological development is the adverse economic conditions and hardships experienced by his/her family and consequently, by the child. Increasing poverty hinders children’s access to resources, and thus negatively affects their mental health as well as their physical development. Furthermore, positive economic conditions pave the way for an improved environment, better nutrition, higher-quality education, elevated social status, more friends, reduced feelings of loneliness, and increased social support and trust and all of these positively contribute to psychological well-being. Therefore, based on the conviction that early interventions can be protective and screening is needed to determine the proper intervention, this study aims to investigate the relationship between psychological well-being, loneliness, social support and social trust, all of which affect the psychological health of children living in economically disadvantaged families. To this end, answers to the following questions were sought. Is there a significant relationship between the loneliness, social support, social trust and psychological well-being of the children from low-income families? Do the feelings of loneliness, social support and social trust of the children from low-income families significantly predict their psychological well-being? Full article

The frequency of natural disasters is exacerbated by the escalating impacts of climate change with the need for effective relief shelters for victims and displaced individuals. Providing accessible and easy-to-assemble relief shelters is essential in addressing these needs. Due to climate-related challenges and the need for sustainable solutions, the integration of circularity principles in shelter design has become imperative. Circular economy principles promote the efficient use of resources, minimising waste generation and the cost of shelters. Moreover, a considerable number of people usually suffer from homelessness, and an increasing number of families live in slums in every part of the globe. All such people are entitled to be housed in affordable, safe, and appropriate shelters for at least several months after a disaster until they can either rebuild their former houses or find somewhere decent to settle after recovering from the hardship. With the aim of investigating the immediate housing needs of people after a disaster, this paper identifies the essential factors that must be taken into account during shelter design. The paper also presents the prototype developed on the basis of theoretical criteria and the identified factors. The paper’s main objectives were to design an easy-to-assemble emergency shelter on circular economy principles, identify critical factors for the circularity and buildability of the shelter, and present a proposed smart shelter acceptance model. The methodology behind the research involves conducting an intensive literature review and creating a novel prototype of a smart disaster relief shelter on the basis of long-run laboratory work and various prototype iterations. The paper presents the details of the novel prototype and shows materials that enhance the circularity of the shelter, according to a unique architectural design strategy of ‘reusing’ materials to enhance circularity practice in the design and construction sectors. The prototype was developed in a workshop after 6 months of reiterations using plastic water bottles, basic pipes, and other reusable materials. Then, by incorporating the essential factors, a set of criteria was designed that can be used as a guide for the architectural design of shelters. The criteria offered in this paper are useful to evaluate each factor’s importance in shelter design. In total, 51 effective factors in designing and constructing such accommodation are presented, clustered into five design strategy groups: social–cultural, physical–technical, environmental, economic, and organisational. Full article

The COVID-19 pandemic highlighted the existing inequalities in education and mental health. The aim of this study was to examine socioeconomic disadvantages and mental well-being inequalities among Slovenian adolescents in October 2020. The study used nationally representative data from 3052 adolescents aged 14 and 18 (M_age = 14.4 and 18.4). The WHO-5 Well-Being Index (WHO-5) was used to measure mental well-being and risk for depression. Multinomial logistic regression was used to identify differences in the pattern of associations regarding sociodemographic characteristics and experiences during the pandemic with poor well-being and risk for depression. Our study found that adolescents from socially disadvantaged families faced poorer conditions as regards academic performance, had fewer opportunities to socialise with friends online, and were more likely to feel lonely; they reported lower levels of mental well-being and were at a higher risk for depression. The unemployment of both parents and adolescents’ perceptions of family wealth were found to be the most important predictors of depression risk. In addition, experiencing deprivation and economic hardship during the pandemic was also identified as a significant predictor. The study concludes that social and economic conditions were critical determinants of adolescents’ mental health during the pandemic and that effective intervention is needed to promote their well-being and reduce inequalities. Full article