A cross-sectional survey of climate and COVID-19 crises in young people in Indian slums: context, psychological responses, and agency.

Background: COVID-19 and the climate crisis have caused unprecedented disruptions across the world. Climate change has affected the mental health and wellbeing of children and adolescent. Young people with a mental illness and without social support are at an increased risk of climate change induced mental ill-health. COVID-19 resulted in a marked increase of psychological distress. Increase in depression, anxiety and insomnia have increased due to the upheavals that people were experiencing including loss of livelihood and breaking of social bonds. Methods: This exploratory study adopted a cross sectional survey design using quantitative methods to understand the perceptions, thoughts, and feelings of young people on both the climate and COVID-19 crises, their concerns, and desires for the future and to understand their sense of agency to contribute to the changes that they want to see. Findings: The findings show that most of the respondents from the sample studied reported nearly similar interference of climate change and COVID-19 on their mental wellbeing. Their climate concern and COVID-19 concern scores were comparable. Tangible experiences of extreme weather events, that were personally experienced or that impacted their family members had a negative impact on their lives, while action around improving the environment had a positive impact.Loss of income, loss of mobility and loss of social contact due to COVID-19 had negative impacts on the respondents, while indulging in leisure activities and bonding with the family had positive impacts. Although the majority of the participants reported having both climate and COVID agency, it did not translate into action to improve the environment. Interpretation: Young people's activism on climate change and COVID-19 has a positive impact on their mental wellbeing hence more opportunities and platforms must be provided to enable young people to take action on both these crises. Funding: None.

COVID-19, adversities and depression among older adolescents in urban slums of India.

PURPOSE: We report findings from a survey on the mental health impact of COVID-19 factoring environmental adversities among older adolescents (15-19 years) living in urban slums in India. METHODS: We report survey results of 3490 older adolescents. Patient Health Questionnaire-9 was used to assess depression, slum adversity questionnaire for slum conditions, and for COVID-19 infection we recorded self-reported positivity status. Sociodemographic details were also collected. Additional sub-group analyses of sample who had depression and tested positive for COVID-19 infection was conducted. We used univariate and multivariate logistic regression models to identify factors and COVID-19 infection that were associated with depression. RESULTS: Adolescents with adversities were three times more likely to report depression. Adolescents who reported COVID-19 infection were about two times more likely to have depression. Sub-group analyses showed that adolescents having experienced adversities and girls were more likely to report depression following COVID-19 infection. CONCLUSIONS: There is a need for an intersectional research framework that incorporates stress arising out of a pandemic, social disadvantage, and systemic inequities. Such a framework will help to assess mental health issues of developmentally vulnerable groups residing in disadvantageous conditions.

The double burden of malnutrition among adults in India: evidence from the National Family Health Survey-4 (2015-16).

OBJECTIVES: India still faces the burden of undernutrition and communicable diseases, and the prevalence of overweight/obesity is steadily increasing. The discourse regarding the dual burden of underweight and overweight/obesity has not yet been widely explored in both men and women. The present study assessed the determinants of underweight and overweight/obesity in India among adult men and women aged 15-49. METHODS: Population-based cross-sectional and nationally representative data from the National Family Health Survey-4 (2015-16), consisting of a sample of men and women, were analyzed. Stratified 2-stage sampling was used in the NFHS-4 study protocol. In the present study, bivariate and adjusted multinomial logistic regression analyses were performed to determine the correlates of underweight and overweight/obesity. RESULTS: The results suggested a persistently high prevalence of underweight coexisting with an increased prevalence of overweight/obesity in India. The risk of underweight was highest in the central and western regions and was also relatively high among those who used either smoking or smokeless tobacco. Overweight/obesity was more prevalent in urban areas, in the southern region, and among adults aged 35-49. Furthermore, level of education and wealth index were positively associated with overweight/obesity. More educated and wealthier adults were less likely to be underweight. CONCLUSIONS: In India, underweight has been prevalent, and the prevalence of overweight/obesity is increasing rapidly, particularly among men. The dual burden of underweight and overweight/obesity is alarming and needs to be considered; public health measures to address this situation must also be adopted through policy initiatives.

Level, Trend and Correlates of Mistimed and Unwanted Pregnancies among Currently Pregnant Ever Married Women in India.

Unintended pregnancy accounts for more than 40% of the total pregnancies worldwide. An Unintended pregnancy can have serious implications on women and their families. With more than one-fourth of the children in India born out of unintended pregnancies such pregnancies are considered to be one of the major public health concerns today. The present study is aimed at determining major predictors of unintended pregnancy among currently pregnant ever-married women in India. The present study has used National Family Health Survey (NFHS) data, conducted by the International Institute for Population Sciences (IIPS), Mumbai, to show the trend, pattern and determinants of mistimed and unwanted pregnancies. Bivariate and multinomial logistic regression model have been used with the help of Stata 13 software. The results show that the likelihood of a mistimed pregnancy is more prevalent among young women whereas the prevalence of unwanted pregnancy is observed more among the women aged 35 years or more. The results also show that the risk of experiencing mistimed pregnancy decreases if the woman belongs to 'other' castes and has higher education. The likelihood of unwanted pregnancy decreases among married women aged 18 years and above, those women having higher education, some autonomy and access to any mode of mass communication. Knowledge of these predictors of mistimed and unwanted pregnancy will be helpful in identifying the most vulnerable group and prioritize the intervention strategies of the reproductive health programmes for the population in need.