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A latent class analysis of young women's co-occurring health risks in urban informal settlements in Durban, South Africa

Brown, LJ; Reddy, T; Mannell, J; Burgess, R; Shai, N; Washington, L; Jewkes, R; (2023) A latent class analysis of young women's co-occurring health risks in urban informal settlements in Durban, South Africa. SSM - Mental Health , 4 , Article 100273. 10.1016/j.ssmmh.2023.100273. Green open access

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Abstract

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.

Type: Article
Title: A latent class analysis of young women's co-occurring health risks in urban informal settlements in Durban, South Africa
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ssmmh.2023.100273
Publisher version: http://dx.doi.org/10.1016/j.ssmmh.2023.100273
Language: English
Additional information: © 2023 The Authors. Published by Elsevier Ltd. under a Creative Commons license (http://creativecommons.org/licenses/by/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10184300
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