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Introduction
Skills and Expertise
Publications
Publications (58)
Objectives
Recent studies have demonstrated that parental imprisonment (PI) is associated with cardiometabolic risk later in life. However, underlying risk factors for these associations have not previously been explored. The present study examines how early childhood behaviors and parental imprisonment may be associated with cardiometabolic risk i...
Children who experience parental imprisonment report greater mental and physical health adversities in adolescence and adulthood relative to comparable individuals whose parents did not serve time in prison. Research has linked BMI gain with parental imprisonment among females, but other studies have shown null or negative associations between pare...
Objectives
Parental imprisonment is linked with child health in later life. The present study provides the first prospective cohort analysis and non-U.S. based study examining parental imprisonment and cardiometabolic risk factors in adolescence and adulthood.
Methods
The study followed 7,223 children born from live, singleton births from 1981-198...
Background
Sub-Saharan African settings are experiencing dual epidemics of HIV and hypertension. We investigate effects of each condition on mortality and examine whether HIV and hypertension interact in determining mortality.
Methods
Data come from the 2010 Ha Nakekela population-based survey of individuals ages 40 and older (1,802 women; 1,107 m...
Objectives
There is a scarcity of longitudinal cohort studies in sub-Saharan Africa to understand the epidemiology of cardiovascular disease as a basis for intervention. We estimated incident hypertension and associated sociodemographic, health and behavioural risk factors in a population aged 40 years and older over a 5-year period.
Design
We ass...
Why do some people adapt successfully to change while others do not? We examine this question in the context of a severe HIV/AIDS epidemic in South Africa, where adapting (or not) to social change has borne life and death consequences. Applying an age-period-cohort lens to the analysis of qualitative life history interviews among middle-aged and ol...
Background:
Thoughts of self-harm (TSH) are an important marker of mental health risk, and risk for attempted and completed suicide. While there is increasing attention being paid to mental health problems in pregnancy in South Africa (SA), TSH have received less attention despite some cross-sectional studies suggesting that prevalence may be high...
Objectives
One in six young adults in the USA experiences parental imprisonment in childhood. Prior studies have associated parental imprisonment with risk of sexually transmitted infection (STI); however, potential data and methodological issues may have limited the reliability and accuracy of prior findings. Examining cumulative and longitudinal...
Background
The effect of the period before a mother’s death on child survival has been assessed in only a few studies. We conducted a comparative investigation of the effect of the timing of a mother’s death on child survival up to age five years in rural South Africa.
Methods
We used discrete time survival analysis on data from two HIV-endemic po...
Understanding how sexual behaviors cluster in distinct population subgroups along the life course is critical for effective targeting and tailoring of HIV prevention messaging and intervention activities. We examined interrelatedness of sexual behaviors and variation between men and women across a wide age range in a rural South African setting wit...
Background
: Depression and anxiety in pregnancy have negative consequences for women and their offspring. High adversity places pregnant women at increased mental health risk, yet there is a dearth of longitudinal research in these settings. Little is known about the pathways by which these problems emerge or persist in pregnancy.
Methods
: Women...
Introduction:
In South Africa evidence shows high HIV prevalence in older populations, with sexual behavior consistent with high HIV acquisition and transmission risk. However, there is a dearth of evidence on older people's HIV incidence.
Methods:
We used a 2010-11 cohort of HIV negative adults in rural South Africa who were 40 years or older a...
One-in-six young adults in the U.S. have experienced parental imprisonment. While prior cross-sectional studies associate parental imprisonment and increased risk of STI infection, methodological issues restrict inference of parental imprisonment as a risk factor for general STI infection along the life course. Using data from the National Longitud...
Background:
Evidence on cognitive function in older South Africans is limited, with few population-based studies. We aimed to estimate baseline associations between cognitive function and cardiometabolic disease risk factors in rural South Africa.
Methods:
We use baseline data from "Health and Aging in Africa: A Longitudinal Study of an INDEPTH...
Background:
Evidence on the association between breastfeeding and later childhood obesity and blood pressure (BP) is inconsistent, especially in HIV-prevalent areas where, until recently, HIV-infected women were discouraged from breastfeeding, but obesity is increasingly prevalent.
Methods and findings:
The Siyakhula cohort (2012-2014), a popula...
BACKGROUND: Alcohol use in South Africa (SA) is increasing. The World Health Organization (WHO) states that SA is the third-largest drinking population in Africa, with the highest rate of fetal alcohol syndrome in the world. Internationally, parental drinking during childhood is a risk factor for poor child mental health, behavioural problems and w...
Background:
Alcohol use in South Africa (SA) is increasing. The World Health Organization (WHO) states that SA is the third-largest drinking population in Africa, with the highest rate of fetal alcohol syndrome in the world. Internationally, parental drinking during childhood is a risk factor for poor child mental health, behavioural problems and...
BACKGROUND Sierra Leone in sub-Saharan Africa had one of the highest under-five mortality rates in the world in 2016: 114 deaths per 1000 live births. Previous studies have mainly focused on examining individual risk factors of child mortality in the country, without examining micro and macro levels of risk factors simultaneously. OBJECTIVE This st...
Despite being home to a large population of vulnerable children there is a dearth of population-based evidence on childhood mental disorders in sub-Saharan Africa. Parent and child mental health are rarely measured concurrently, despite potential for confounding with other risk factors, including parental HIV. Using the parent-report Child Behaviou...
Aims:
Fieldworkers capturing reports of sensitive behaviors, such as substance use, may influence survey responses and represent an important factor in response validity. We explored the effects and interaction of fieldworker and respondent characteristics (age and gender) in substance (tobacco and alcohol) use reporting. We aim to further the lit...
There is limited information about sexual behavior among older Africans, which is problematic given high HIV rates among older adults. We use a population-based survey among people aged 15-80+ to examine the prevalence of sexual risk and protective behaviors in the context of a severe HIV epidemic. We focus on variation across the life course, gend...
Background: The pre-pubertal socioeconomic environment may be an important determinant of age at menarche, adult height, body proportions and adiposity: traits closely linked to adolescent and adult health.
Aims: This study explored differences in age at menarche, adult height, relative leg-length and waist circumference between rural and urban bla...
In Figure 3, in both Model 1 and Model 2, the second and third boxes on the left were incorrectly labelled. They should read KABC Planning Index rather than KABC Learning Index.
Objective:
The African HIV epidemic is aging, yet HIV testing behavior studies either exclude older persons or include too few to say much about age differences.
Method:
Strategically combining focus group interviews (participants in 40s/50s/60s-plus age groups) and survey data from rural South Africa (where HIV prevalence peaks in the late 30s,...
The Kaufman Assessment Battery for Children, Second Edition, measures cognitive processing, includes non-verbal sub-tests, and is increasingly used in low- and middle-income countries. While the Kaufman Assessment Battery for Children, Second Edition, has been validated in the United States, a psychometric evaluation has not been conducted in South...
Understanding the distribution of socioeconomic status (SES) and its temporal dynamics within a population is critical to ensure that policies and interventions adequately and equitably contribute to the well-being and life chances of all individuals. This study assesses the dynamics of SES in a typical rural South African setting over the period 2...
Background: Understanding the effects of socioeconomic disparities in health outcomes is important to implement specific preventive actions. We assessed socioeconomic disparities in mortality indicators in a rural South African population over the period 2001–13.
Methods: We used data from 21 villages of the Agincourt Health and socio-Demographic S...
Longitudinal maternal mental health data is needed from high HIV prevalence settings. The Siyakhula Cohort (SC) is a population-based cohort of HIV-positive and negative mothers (n=1506) with HIV-negative children (n=1536) from rural South Africa. SC includes 767 HIV-negative mothers; 465 HIV-positive in pregnancy; 272 HIV-positive since pregnancy...
Introduction:
In South Africa, older adults make up a growing proportion of people living with HIV. HIV programmes are likely to reach older South Africans in home-based interventions where testing is not always feasible. We evaluate the accuracy of self-reported HIV status, which may provide useful information for targeting interventions or offer...
Background
Virtually all low- and middle-income countries are undergoing an epidemiological transition whose progression is more varied than experienced in high-income countries. Observed changes in mortality and disease patterns reveal that the transition in most low- and middle-income countries is characterized by reversals, partial changes and t...
Objective
To identify the unmet needs for HIV prevention among older adults in rural South Africa.
Methods
We analyzed data from a population-based sample of 5059 men and women aged 40 years and older from the study Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities (HAALSI), which was carried out in the Agincourt health and s...
This paper contributes evidence documenting the continued decline in all-cause mortality and changes in the cause of death distribution over time in four developing country populations in Africa and Asia. We present levels and trends in age-specific mortality (all-cause and cause-specific) from four demographic surveillance sites: Agincourt (South...
Exclusive breastfeeding (EBF) is associated with early child health; longer-term benefits for child development remain inconclusive. We examine associations between EBF, HIV exposure, and other maternal/child factors, with cognitive and emotional-behavioural development in children aged 7-11 years.
Methods and findings
The Vertical Transmission S...
Literature is limited on the effects of high prevalence HIV on fertility in the absence of treatment, and the effects of the introduction of sustained access to antiretroviral therapy (ART) on fertility. We summarize fertility patterns in rural northeast South Africa over 21 years during dynamic social and epidemiological change.
We use data for fe...
To inform health care and training, resource and research priorities, it is essential to establish how non-communicable disease risk factors vary by HIV-status in high HIV burden areas; and whether long-term anti-retroviral therapy (ART) plays a modifying role.
As part of a cohort initiation, we conducted a baseline HIV/cardiometabolic risk factor...
Receiving an education is essential for children living in poverty to fulfil their potential. Success in the early years of schooling is important as children who repeat grade one are particularly at risk for future dropout. We examined early life factors associated with grade repetition through logistic regression and explored reasons for repeatin...
Researchers are often skeptical of sexual behavior surveys: Respondents may lie or forget details of their intimate lives, and interviewers may exercise authority in how they capture responses. We use data from a 2010–2011 cross-sectional sexual behavior survey in rural South Africa to explore who says what to whom about their sexual lives. Results...
Maternal mortality, the HIV/AIDS pandemic, and child survival are closely linked. This study contributes evidence on the impact of maternal death on children's risk of dying in an HIV-endemic population in rural South Africa.
We used data for children younger than 10 years from the Agincourt health and socio-demographic surveillance system (1992 -...
A recent study using Heckman-type selection models to adjust for non-response in the Zambia 2007 Demographic and Health Survey (DHS) found a large correction in HIV prevalence for males. We aim to validate this finding, replicate the adjustment approach in other DHSs, apply the adjustment approach in an external empirical context, and assess the ro...
The HIV pandemic has led to dramatic increases and inequalities in adult mortality, and the diffusion of antiretroviral treatment, together with demographic and socioeconomic shifts in sub-Saharan Africa, has further changed mortality patterns. We describe all-cause and cause-specific mortality patterns in rural South Africa, analyzing data from th...
The prevalence of obesity and overweight is socially patterned, with higher prevalence among women, racial/ethnic minorities, and those with lower socio-economic status. Contextual factors also affect obesity risk. However, an omitted factor has been incarceration, particularly since it disproportionately affects minorities. This study examines the...
Household characteristics are important influences on the risk of child death. However, little is known about this influence in HIV-endemic areas. We describe the effects of household characteristics on children's risk of dying in rural South Africa.
We use data describing the mortality of children younger than 5 years living in the Agincourt healt...
Background:
There is evidence that a young child's risk of dying increases following the mother's death, but little is known about the risk when the mother becomes very ill prior to her death. We hypothesized that children would be more likely to die during the period several months before their mother's death, as well as for several months after...
Abstract A greater knowledge of the burden of HIV in rural areas of Southern Africa is needed, especially among older adults. We conducted a cross-sectional biomarker survey in the rural South African Agincourt Health and Socio-demographic Surveillance site in 2010-2011 and estimated HIV prevalence and risk factors. Using an age-sex stratified rand...
There is increasing evidence that children are at high risk of dying following their mother's death. Little is known about the risks for the child when the mother becomes very ill, prior to her death. Understanding of these risks and their timing in relation to maternal death is critical to guide interventions. Data from a health and socio-demograp...
Obesity prevalence among inmates in the United States is unknown. Since incarceration disproportionately affects minorities, excluding inmates from surveys may bias national obesity estimates. Including inmates may also help explain racial obesity disparities among men. This descriptive study summarizes obesity prevalence among US male inmates and...
Few studies consider obesity inequalities as a distributional property. This study uses relative distribution methods to explore inequalities in body mass index (BMI; kg/m(2)). Data from 1999-2006 from the National Health and Nutrition Examination Survey were used to compare BMI distributions by gender, Black/White race, and education subgroups in...
A marked shift in tobacco-related workplace health promotion intervention involves the adoption of policies barring employment to smokers. We discuss the potential public health consequences of these policies on those affected-smokers, their families, the surrounding community and society at large. We find a lack of published evidence evaluating th...
We used cartograms to visually communicate the state-specific prevalence of obesity and its association with socioeconomic variables over time to benefit and inform decisions by national health policymakers who address geographic and social inequities in health.
We generated density-equalizing maps, known as cartograms (in which geographic regions...
Recently sales of physical music media have declined along with music industry revenues - the reasons are complex and poorly understood. We present three models exploring claims made in the conversation over piracy and the music industry's future. We model stakeholder perspectives rather than the full industry to identify their assumptions and the...
Prescription drug abuse and undertreatment of pain are public health priorities in the United States. Few options to manage these problems are balanced, in simultaneously supporting pain relief and deterring prescription drug abuse. Prescription monitoring programs (PMPs) potentially offer a balanced approach; however, the medical/scientific commun...
Tailored nutrition Web programs constitute an emerging trend in obesity prevention. Initial investment in innovative technology necessitates that the target population be well understood. This pilot study's purpose was to determine the feasibility of a workplace nutrition Web program.
Formative research was conducted with gaming industry employees...
This study describes the development of a systematic approach to the analysis of Internet chatter as a means of monitoring potentially abusable opioid analgesics.
Message boards dedicated to drug abuse were selected using specific inclusion criteria. Threaded discussions containing 48,293 posts were captured. A coding system was created to compare...
Clinicians recognize the importance of monitoring aberrant medication-related behaviors of chronic pain patients while being prescribed opioid therapy. The purpose of this study was to develop and validate the Current Opioid Misuse Measure (COMM) for those pain patients already on long-term opioid therapy. An initial pool of 177 items was developed...
