Das-Munshi, J; Lund, C; Mathews, C; Clark, C; Rothon, C; Stansfeld, S
(2016)
Mental Health Inequalities in Adolescents Growing Up in Post-Apartheid South Africa: Cross-Sectional Survey, SHaW Study.
PLoS One, 11 (5).
e0154478.
ISSN 1932-6203
https://doi.org/10.1371/journal.pone.0154478
SGUL Authors: Clark, Charlotte Elizabeth Sarah
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Abstract
BACKGROUND: South Africa is one of the most 'unequal' societies in the world. Despite apartheid ending more than 20 years ago, material inequalities remain interwoven with ethnic/racial inequalities. There is limited research on the prevalence/predictors of common mental disorders (CMD) among young people. Adolescence is a unique time-point during which intervention may lead to improved mental health and reduced social problems later. The study objective was to assess mental health disparities in a representative sample of adolescents growing up in South Africa. METHODS: Cross-sectional associations of race/ethnicity and material disadvantage with CMD and Post Traumatic Stress Disorder (PTSD) were assessed in a stratified random sample representative of school-attendees, aged 14-15 years, in a large metropolitan area of Cape Town. Validated instruments assessed mental disorders; these included: Harvard Trauma Questionnaire (PTSD); Short Moods and Feelings Questionnaire (depression); Zung self-rated anxiety scale (anxiety). Self-ascribed ethnicity was determined using procedures similar to the South African census and previous national surveys. RESULTS: Response rate was 88% (1034 of 1169 individuals). Adolescents experienced a high prevalence of depression (41%), anxiety (16%) and PTSD (21%). A gradient between material disadvantage and CMD/ PTSD was evident across all ethnic/racial groups. Respondents self-identifying as 'black' or 'coloured' were disadvantaged across most indicators. After adjusting for confounders, relative to white children, relative risk (RR) of CMD in black children was 2.27 (95% CI:1.24, 4.15) and for PTSD was RR: 2.21 (95% CI:1.73, 2.83). Relative risk of CMD was elevated in children self-identifying as 'coloured' (RR: 1.73, 95% CI:1.11, 2.70). Putative mediators (violence, racially motivated bullying, social support, self-esteem) partially accounted for differences in CMD and fully for PTSD. CONCLUSIONS: Adolescent mental health inequalities in Cape Town are associated with material disadvantage and self-identification with historically disadvantaged groups.
Item Type: | Article | |||||||||
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Additional Information: | © 2016 Das-Munshi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | |||||||||
Keywords: | Adolescent, Apartheid, Cross-Sectional Studies, Female, Humans, Male, Mental Disorders, Mental Health, Self Concept, Social Support, Socioeconomic Factors, South Africa, Stress Disorders, Post-Traumatic, Surveys and Questionnaires, Humans, Cross-Sectional Studies, Self Concept, Mental Health, Mental Disorders, Stress Disorders, Post-Traumatic, Social Support, Socioeconomic Factors, Adolescent, South Africa, Female, Male, Surveys and Questionnaires, Apartheid, General Science & Technology, MD Multidisciplinary | |||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Population Health Research Institute (INPH) | |||||||||
Journal or Publication Title: | PLoS One | |||||||||
ISSN: | 1932-6203 | |||||||||
Language: | eng | |||||||||
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Publisher License: | Creative Commons: Attribution 4.0 | |||||||||
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PubMed ID: | 27139456 | |||||||||
Go to PubMed abstract | ||||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/113935 | |||||||||
Publisher's version: | https://doi.org/10.1371/journal.pone.0154478 |
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