Social harms and social class in Iranian youth and adolescents living in slums in the suburbs: a systematic review.

BACKGROUND: Socioeconomic and environmental factors can affect the health of the people living in slums in the suburbs. In these areas, the youth and adolescents are the main age groups susceptible to a multitude of harms such as addiction, AIDS, delinquency, aggressive behavior, and prostitution. The present study was conducted to investigate the state of social harms and social class in Iranian youth and adolescents living in slums in the suburbs. METHODS: In the present systematic review, the researchers searched for observational and qualitative papers published in Persian or English languages during 2010-2020 timespan in the following databases: Embase, PubMed, Scopus, Web of Science, Irandoc databases, Google Scholar, SID, and Magiran. Based on MESH, the keywords of "social class", "social harm", "youth", "adolescent", and "slum" were chosen. Papers were assessed according to the inclusion criteria, and the quality of the papers was evaluated using the Newcastle-Ottawa scale for quantitative articles and the COREQ scale for qualitative ones. RESULTS: Of 491 articles assessed, 11 (eight cross-sectional and three qualitative papers) were deemed suitable. According to the results, social harms reported were: drug abuse (two studies), female sex workers (two studies), poverty (two studies), AIDS (two studies), social insecurity (two studies), psychedelic substances (one study), alcohol (one study), delinquency (one study), divorce (one study), physical problems (one study), prostitution because of poverty (one study), unemployment (one study), and adolescents' forced labor due to destitution (one study). Moreover, the assessed papers used education (three studies), economic status (three studies), occupation (two studies), income (two studies), place of residence (two studies), social status (two studies), and cultural status (one study) as indicators of the social class in the individual and their parents, and categorized them in three groups of high (one study), middle (three studies), and low classes (seven studies). CONCLUSION: The present systematic review investigated, for the first time in Iran, social harms and social class in the youth and adolescents living in slums in the suburbs. The results showed that social harm is high among the youth and adolescents in outskirt slums of Iranian cities. Therefore, any attempt to empower the youth and adolescents living in these parts will have direct effects on the health of the residents of these areas.

The Association Between Anhedonia, Suicide Ideation, and Suicide Attempts: A Replication in a Persian Student Sample.

Research suggests that anhedonia, a common symptom of depression, may be uniquely associated with suicidal behavior. However, little research has examined this association across cultures. To address this limitation, this study attempted to replicate a recent anhedonia and suicide study (conducted in a western culture) in a Persian sample using the Specific Loss of Interest and Pleasure Scale, Persian version. Participants consisted of 404 students who were recruited from a Persian university. Surprisingly, our results indicated that anhedonia levels were more than double those found in similar American student sample. Despite this marked difference in anhedonia symptoms, we found that anhedonia was associated with suicide risk, even when it was statistically accounting for other depressive symptoms. These findings suggest that anhedonia is a robust predictor of suicide risk across these two cultures. Further, anhedonia may be a particularly important treatment target among Persian students.

The Association of Poor Mental Health Status and Sociocultural Factors in Men: A Population-Based Study in Tehran, Iran.

Mental ill-health has increased among Iranian men in the recent years. Mental health is complexly determined by sociocultural, psychological, demographic characteristics, and some health-risk behaviors such as smoking. This study aimed to explore the association(s) between demographic factors, smoking status, social capital, and poor mental health status in a sample of Iranian men. The data were derived from a survey titled "Urban Health Equity Assessment and Response Tool-2" in Tehran, Iran ( n = 11,064). A multistage sampling method was applied in the study. The General Health Questionnaire-28 was used to assess poor mental health status (range = 0-84, scores higher than 23 indicated poor mental health status). The data were analyzed using t test, chi-square test, and multivariate logistic regression. The means of age and family size were 47.14 ± 17.26 years (range = 20-91) and 3.54 ± 1.32 individuals (range = 1-15), respectively. The majority of the participants were employed (57%, n = 6,361). The prevalence of poor mental health was 36.36%, 95% confidence interval (CI) [35.46, 37.26]. The components of social capital were positively associated with poor mental health status. Family size (adjusted odds ratio [AOR] = 0.93; 95% CI [0.90, 0.96]), job status (unemployed vs. employed, AOR = 1.34; 95% CI [1.16, 1.55]), marital status (widowed and divorced vs. single, AOR = 1.09; 95% CI [1.02, 1.17]), education level (illiterate vs. academic, AOR = 1.18; 95% CI [1.09, 1.29]), and smoking status (smokers vs. nonsmokers, AOR = 1.46; 95% CI [1.31, 1.62]) were directly associated with poor mental health status in the logistic regression model. These results suggest that social capital could be an important approach for men to attain suitable mental health and reduce mental disorders. The high prevalence of poor mental health in men merits more attention in mental health policy and program planning.

Identifying associated factors with social capital using path analysis: A population-based survey in Tehran, Iran (Urban HEART-2).

Background: Social capital has been defined as norms, networks, and social links that facilitate collective actions. Social capital is related to a number of main social and public health variables. Therefore, the present study aimed to determine the factors associated with social capital among the residents of Tehran, Iran. Methods: In this large cross-sectional population-based study, 31531 residents aged 20 years and above were selected through multi-stage sampling method from 22 districts of Tehran in 2011. The social capital questionnaire, 28-item General Health Questionnaire (GHQ-28), and Short-Form Health Survey (SF-12) were used. Hypothetical causal models were designed to identify the pathways through which different variables influenced the components of social capital. Then, path analysis was conducted for identifying the determinants of social capital. Results: The most influential variables in 'individual trust' were job status (ß=0.37, p=0.02), marital status (ß=0.32, p=0.01), Physical Component Summary (PCS) (ß=0.37, p=0.02), and age (ß=0.34, p=0.03). On the other hand, education level (ß=0.34, p=0.01), age (ß=0.33, p=0.02), marital status (ß=0.33, p=0.01), and job status (ß=0.32, p=0.01) were effective in 'cohesion and social support'. Additionally, age (ß=0.18, p=0.02), PCS (ß=0.36, p=0.01), house ownership (ß=0.23, p=0.03), and mental health (ß=0.26, p=0.01) were influential in 'social trust/collective relations'. Conclusion: Social capital can be improved in communities by planning to improve education and occupation status, paying more attention to strengthening family bonds, and provision of local facilities and neighborhood bonds to reduce migration within the city.

Survival Analysis of Drug Abuse Relapse in Addiction Treatment Centers.

BACKGROUND: Drug abuse is a chronic and enduring phenomenon, which is among the important challenging public health problems. One of the main aspects in drug abuse is the relapse. OBJECTIVES: The aims of this study were to estimate the time to relapse (survival rate) and to evaluate some of its associated variables by survival analysis. PATIENTS AND METHODS: This research was conducted in four addiction treatment centers on 140 self-referred addicts in Ilam city, Iran, in 2012. Cluster sampling method was used for selecting the samples and data were collected by interview and referring to the subjects' records. The gathered data were analyzed through the life table, Kaplan-Meier analysis, log rank test, and Cox regression. RESULTS: The relapse rate was 30.42%, mean and median of the time to relapse (survival time) were 27.40 ± 1.63 months (CI 95%: 24.19 - 30.60) and 25 ± 2.25 months (CI 95%: 22.5 - 27.5), respectively. In the first six months, the cumulative survival rate was 83%, while in the 24th month it was 46% and the following time was consistent. Job status (OR = 2.64), marital status (OR = 1.55), family size (OR = 1.20) and age (OR = 0.23) were statistically significant in Cox regression model. CONCLUSIONS: In the initial treatment, it seems necessary to supervise and monitor the treatment process through staff in addiction treatment centers together with the company of the addicts' families to reduce relapse rate.