Household Versus Neighborhood Socio-Economic Status and Their Effects on Adolescent Health in Urban Johannesburg and Soweto: What Can Neighborhood Members Tell Us?

Zoe A. Sheppard, Loughborough University
Paula Griffiths, Loughborough University
Shane Norris, University of the Witwatersrand
John M. Pettifor, University of the Witwatersrand and Chris Hani Baragwanath Hospital
Noel Cameron, Loughborough University

To identify those at risk of ill-health and target public health resources accordingly, it is important to understand the role of neighborhood versus household socio-economic effects on health. Because of the magnitude of income inequalities, South Africa is an ideal setting to study health inequalities. Birth to Twenty (Bt20) is a birth cohort study in Johannesburg-Soweto and its longitudinal design brings an opportunity to analyze the changing role of socio-economic status (SES) on health. However, Bt20 has focussed on measuring SES at the household level, meaning little is known about neighborhood SES. Therefore this paper uses focus groups with adolescents aged 15 years and their caregivers, and key informant in-depth interviews, to establish lay knowledge and perceptions of the importance of neighborhood/school SES for health. Findings suggest that both economic and social support factors are equally important in understanding the role of neighborhood SES for adolescent health in this context.