A latent class analysis of young women’s co-occurring health risks in urban informal settlements in Durban, South Africa
In South Africa, substance use, violence, and HIV risk disproportionately affect young poor Black women. Few studies have explicitly measured the co-occurrence of these health risks or the impact on mental health and wellbeing for this population. To this aim, we use a person-centred approach to exp...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-12-01
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| Series: | SSM - Mental Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666560323000889 |
| _version_ | 1797385007390523392 |
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| author | Laura J. Brown Tarylee Reddy Jenevieve Mannell Rochelle Burgess Nwabisa Shai Laura Washington Rachel Jewkes Andrew Gibbs |
| author_facet | Laura J. Brown Tarylee Reddy Jenevieve Mannell Rochelle Burgess Nwabisa Shai Laura Washington Rachel Jewkes Andrew Gibbs |
| author_sort | Laura J. Brown |
| collection | DOAJ |
| description | In South Africa, substance use, violence, and HIV risk disproportionately affect young poor Black women. Few studies have explicitly measured the co-occurrence of these health risks or the impact on mental health and wellbeing for this population. To this aim, we use a person-centred approach to explore the clustering of health risks among young Black women from urban informal settlements in Durban, South Africa, enrolled in an intervention trial. Latent class analysis identified three health risk subgroups with increasing levels of health risk co-occurrence: while all three subgroups had high rates of emotional/economic intimate partner violence, they differed in their levels of the other health risks, with one (“lower-risk”) subgroup defined by experiencing violence against women (VAW), another by the co-occurrence of VAW with problematic alcohol use (i.e. “mid-risk”), and the last (“high-risk”) subgroup by the co-occurrence of VAW, problematic alcohol use and sexual risk behaviour. Descriptive analyses showed that lower education and food insecurity were associated with greater health risk co-occurrence and that this in turn was associated with increased chances of depression and suicidal ideation. Between subgroup differences persisted over time - after two years, the chances of experiencing violence, problematic alcohol use, transactional sex and depression remained elevated for the women who initially experienced more health risks. Persistent yet differing levels of risk suggest the need for urgent structural interventions that address these health risks synergistically while taking account of individual differing primary and secondary prevention needs. Our analyses highlight that social epidemics such as poverty, racism and gender inequality play into the production of poor health outcomes, including poor mental health. These are the underlying structural issues that need to be addressed in order to protect women’s health and reduce harm. |
| first_indexed | 2024-03-08T21:47:55Z |
| format | Article |
| id | doaj.art-3a9a862b8c9d4919aefef4542781d74e |
| institution | Directory Open Access Journal |
| issn | 2666-5603 |
| language | English |
| last_indexed | 2024-03-08T21:47:55Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM - Mental Health |
| spelling | doaj.art-3a9a862b8c9d4919aefef4542781d74e2023-12-20T07:39:10ZengElsevierSSM - Mental Health2666-56032023-12-014100273A latent class analysis of young women’s co-occurring health risks in urban informal settlements in Durban, South AfricaLaura J. Brown0Tarylee Reddy1Jenevieve Mannell2Rochelle Burgess3Nwabisa Shai4Laura Washington5Rachel Jewkes6Andrew Gibbs7Institute for Global Health, University College London, London, UK; Corresponding author. Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.Biostatistics Unit, South African Medical Research Council, Durban, South AfricaInstitute for Global Health, University College London, London, UKInstitute for Global Health, University College London, London, UKGender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa; School of Public Health, University of Witwatersrand, Johannesburg, South AfricaProject Empower, Durban, South AfricaGender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa; South African Medical Research Council, Pretoria, South Africa; School of Public Health, University of Witwatersrand, Johannesburg, South AfricaInstitute for Global Health, University College London, London, UK; Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa; Department of Psychology, University of Exeter, Exeter, UKIn South Africa, substance use, violence, and HIV risk disproportionately affect young poor Black women. Few studies have explicitly measured the co-occurrence of these health risks or the impact on mental health and wellbeing for this population. To this aim, we use a person-centred approach to explore the clustering of health risks among young Black women from urban informal settlements in Durban, South Africa, enrolled in an intervention trial. Latent class analysis identified three health risk subgroups with increasing levels of health risk co-occurrence: while all three subgroups had high rates of emotional/economic intimate partner violence, they differed in their levels of the other health risks, with one (“lower-risk”) subgroup defined by experiencing violence against women (VAW), another by the co-occurrence of VAW with problematic alcohol use (i.e. “mid-risk”), and the last (“high-risk”) subgroup by the co-occurrence of VAW, problematic alcohol use and sexual risk behaviour. Descriptive analyses showed that lower education and food insecurity were associated with greater health risk co-occurrence and that this in turn was associated with increased chances of depression and suicidal ideation. Between subgroup differences persisted over time - after two years, the chances of experiencing violence, problematic alcohol use, transactional sex and depression remained elevated for the women who initially experienced more health risks. Persistent yet differing levels of risk suggest the need for urgent structural interventions that address these health risks synergistically while taking account of individual differing primary and secondary prevention needs. Our analyses highlight that social epidemics such as poverty, racism and gender inequality play into the production of poor health outcomes, including poor mental health. These are the underlying structural issues that need to be addressed in order to protect women’s health and reduce harm.http://www.sciencedirect.com/science/article/pii/S2666560323000889South AfricaViolence against womenSexual risk behaviourProblematic alcohol usePoor mental health |
| spellingShingle | Laura J. Brown Tarylee Reddy Jenevieve Mannell Rochelle Burgess Nwabisa Shai Laura Washington Rachel Jewkes Andrew Gibbs A latent class analysis of young women’s co-occurring health risks in urban informal settlements in Durban, South Africa SSM - Mental Health South Africa Violence against women Sexual risk behaviour Problematic alcohol use Poor mental health |
| title | A latent class analysis of young women’s co-occurring health risks in urban informal settlements in Durban, South Africa |
| title_full | A latent class analysis of young women’s co-occurring health risks in urban informal settlements in Durban, South Africa |
| title_fullStr | A latent class analysis of young women’s co-occurring health risks in urban informal settlements in Durban, South Africa |
| title_full_unstemmed | A latent class analysis of young women’s co-occurring health risks in urban informal settlements in Durban, South Africa |
| title_short | A latent class analysis of young women’s co-occurring health risks in urban informal settlements in Durban, South Africa |
| title_sort | latent class analysis of young women s co occurring health risks in urban informal settlements in durban south africa |
| topic | South Africa Violence against women Sexual risk behaviour Problematic alcohol use Poor mental health |
| url | http://www.sciencedirect.com/science/article/pii/S2666560323000889 |
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