Jessie Pinchoff

Introduction: Climate change is shaping adolescent and young people’s (AYP) transitions to adulthood with significant and often compounding effects on their physical and mental health. The climate crisis is an intergenerational inequity, with the current generation of young people exposed to more climate events over their lifetime than any previous one. Despite this injustice, research and policy to date lacks AYP’s perspectives and active engagement. Methods: Participatory, youth co-led qualitative focus group discussions were held in Bangladesh, Guatemala and Nigeria in mid-2023. A total of 196 AYP ages 12–25 years participated. Open-ended questions elicited responses regarding AYP knowledge, experiences and perceptions of climate change. Using NVivo software, translated transcripts were coded to explore and synthesise key thematic areas. Results: Respondents discussed varied climate exposures and associated health risks, for example, how flooding events were impeding access to sexual and reproductive health commodities. Acute climate events like flooding and cyclones increased perceived risk of early marriage and gender-based violence in Bangladesh and Guatemala. In Nigeria, respondents discussed health effects of extreme heat, and how droughts were shifting women into more traditionally male roles in agriculture and income-generating activities, increasing the perceived risk of household tensions and gender-based violence. Commonly reported themes included perceived climate impacts on sexual and reproductive health including early marriage or gender-based violence. Another common theme was anxiety about climate change, its effects on economic and food insecurity in communities and feeling hopeless, lacking agency and not feeling supported by local institutions, all linked with worse mental health. Conclusion: Our results summarise how AYP perceive climate change is affecting their physical and mental health, finding similarities and differences across these three settings. Our results can inform the development of policies and programmes that directly address AYP needs in a way that is inclusive and responsive.

Although the globalization of international migration is commonly accepted as a general tendency in contemporary migration patterns (de Haas, Castles, and Miller 2020, 9), the corresponding body of empirical evidence is mixed and fragmented. Our review of global migration patterns over the past half‐century highlights how the theories, expectations, and ultimately findings may vary depending on the specific definitions, vantage points, and measures being used. In this paper, we provide a simpler and integrated account of the globalization of international migration that includes a corresponding empirical template to quantify the relative importance of two processes at work: the intensity and connectivity of international migration. Using recent estimates of country‐to‐country migration flows every five years from 1990–1995 to 2015–2020, our analysis using demographic decomposition and group‐based multitrajectory modeling highlights the dynamic relationship between intensity and connectivity from both the global and country vantage points. Our work in this paper provides a starting point in the form of a much‐needed empirical template, one that is also highly flexible and customizable, for future research on the globalization of international migration to coalesce around and use going forward.

During the early stages of the global COVID-19 pandemic, governments searched for effective means to rapidly disseminate information about how to prevent the disease and care for sick household members. In June 2020, the government of Kenya considered sending text messages, a behavioral nudging approach, to inform and persuade the public to practice home-based care for those who were infected. We conducted a randomized evaluation of simple informational messages compared to messages targeting personal and social benefits for those receiving the messages. We hypothesized that those that received messages tailored around social or personal benefit would be more likely to undertake the promoted behaviors of isolating if infected with COVID-19 and intending to care for an infected family member. While fear and perceptions of stigma were widespread, more than two-thirds of respondents in the control condition expressed an intention to care for an infected family member at home. Despite greater recall of the personal benefit message, which used reciprocity as its key behavioral lever, intentions to provide care at home and perceptions of stigma did not differ across study groups. Rather, capabilities such as wealth and having sufficient room at home were the key determinants. While text messages as behavioral nudges may be useful for some behaviors, policymakers should consider a broader range of tools for behaviors that are influenced by people’s capabilities, since even low-cost interventions may crowd out the time and energy needed for other responses during an emergency.

Background: Internal migration is an important part of the transition to adulthood for many young people in sub-Saharan Africa. This study examines how migration, in relation to marriage and parenthood, impacts modern contraceptive use and health facility visits amongst young urban women. Methods: We draw on Performance Monitoring for Action (PMA) surveys conducted in Burkina Faso, Côte d’Ivoire, Democratic Republic of Congo, Kenya, Nigeria, and Uganda (2019–2022). Our analysis is unique in being able to adjust for whether women wanted to get pregnant soon. Our sample includes women ages 15–24 years currently residing in urban areas (n = 6,225). We conducted logistic regression models clustered by village level identifier to explore the sequence of life events and the timing of migration in relation to current modern contraceptive use and recent health facility visit, a proxy for engagement with formal health services. Results: The timing of migration matters more than the sequence of these life events. Young urban women who experienced both migration and a birth, regardless of the order, had increased contraceptive use and recent health facility visit, compared to women who had only experienced one event or neither. Young women who migrated in the past year had 24% lower odds of using a modern method (Odds Ratio = 0.76; 95% confidence interval 0.63, 0.91), adjusting for demographic factors and adjusting for fertility preference (Wanting to get pregnant soon). Having had a birth was highly significant for health facility visit and among women who had had a birth, those who migrated in the last year had lower odds of a recent visit (OR = 0.68, 95% CI 0.41, 0.89). Results suggest an initially disruptive effect of migration. Discussion: Our results suggest young women who recently migrated to urban areas may need additional support in accessing contraception and formal health services for themselves or their children.

The climate crisis exacerbates social, economic, and health disparities. This study employs innovative methods to identify distinct groups affected by recent climate events. A mobile phone-based survey was conducted in April 2022 with individuals residing in multiple climate-affected states across three countries: India (n = 1020), Mexico (n = 1020), and Nigeria (n = 1021). Latent class analysis and classification and regression tree analysis were used to identify the groups most exposed to climate events, the effects and responses taken, and then to identify the characteristics associated with group membership. Effects included housing damage or lost work, while responses included actions such as borrowing money or dropping out of school. Findings revealed four distinct groups: Group 1 reported low exposure, no effects, or responses (49% of respondents in India, 43% in Mexico, and 27% in Nigeria); Group 2 experienced multiple hazards with moderate effects and some responses; Group 3 was characterized by drought exposure with more effects and responses taken; Group 4 was affected by heavy flooding and rainfall with varied effects. Notably, India had the largest proportion of respondents in Group 3 (17%), in Mexico over a quarter (29%) were in group 4, while over half of Nigerian respondents were in Group 2 (52%). Characteristics associated with membership in each group varied by country. Overall, men from rural areas with lower incomes and reliant on agriculture experienced the highest levels of exposure and vulnerability, while urban women from higher-income households were the least affected. This study underscores the importance of considering the intersectionality of risk and vulnerability when formulating policies and programs to address the impacts of climate change. Results emphasize the need for multi-sectoral policies that target the needs of different groups, to reduce inequalities and tailor to the context-specific needs of the most vulnerable people and households.

The demographic, ecological and socioeconomic changes associated with urbanisation are linked to changes in disease incidence, health service provision and mortality. These effects are heterogeneous between and within urban areas, yet without a clear definition of what constitutes an ‘urban’ area, their measurement and comparison are constrained. The definitions used vary between countries and over time hindering analyses of the relationship between urbanisation and health outcomes, evaluation of policy actions and results in uncertainties in estimated differences. While a binary urban-rural designation fails to capture the complexities of the urban-rural continuum, satellite data augmented with models of population density and built-up areas offer an opportunity to develop an objective, comparable and continuous measure which captures urbanisation gradient at high spatial resolution. We examine the urban gradient within the context of population health. We compare the categorisation of urban and rural areas (defined by national statistical offices) used in household surveys in sub-Saharan Africa (SSA) to an urban-rural gradient derived from augmented satellite data within a geospatial framework. Using nine Demographic and Health Surveys (DHS) conducted between 2005 and 2019 in six SSA countries, we then assess the extent of misalignment between urbanicity based on DHS categorisation compared with a satellite-derived measure, while discussing the implications on the coverage of key maternal health indicators. The proposed indicator provides a useful supplement to country-specific urbanicity definitions and reveals new health dynamics along the rural-urban gradient. Satellite-derived urbanicity measures will need frequent updates to align with years when household surveys are conducted.

The dual crises of COVID-19 and climate change are impacting the lives of adolescents and young people as they transition to adulthood in an uncertain world, yet they are often excluded from research and political discourse. We surveyed young people about their needs and experiences, critical to engaging them and designing effective programs and policies to address these intersecting harms. The 2022 round of a national online survey through the Violence Outcomes in COVID-19 Epoch (VoCes) Study surveyed 152,088 Mexican youth (15–24 years). Logistic regressions were implemented to identify characteristics associated with four climate responses (economic, work-related, receiving government support, or social network support). Overall, 8.1% of participants experienced a recent climate hazard, with major impacts including housing damage from floods, and crop/livestock losses from drought. Participants who experienced a climate hazard were more likely to have experienced a pandemic-related harm, suggesting a dual impact. Poor youth were more likely to report economic losses from both the pandemic and a climate event but least likely to receive government support. Economic effects from the pandemic are exacerbating climate-related harms, unequally threatening the poorest youth. Engaging young people in decision-making and supporting the most vulnerable youth is critical for the next generation to thrive.

Young people today are predicted to experience more climate change related stressors and harms than the previous generation, yet they are often excluded from climate research, policy, and advocacy. Increasingly, this exposure is associated with experience of common mental health disorders (CMD). The VoCes-19 study collected surveys from 168,407 young people across Mexico (ages 15–24 years) through an innovative online platform, collecting information on various characteristics including CMD and experience of recent climate harms. Logistic regression models were fit to explore characteristics associated with CMD. Structural equation models were fit to explore pathways between exposure, feeling of concern about climate change, and a sense of agency (meaning the respondent felt they could help address the climate crisis) and how these relate to CMD. Of the respondents, 42% (n = 50,682) were categorized as experiencing CMD, higher among those who experienced a climate stressor (51%, n = 4,808) vs those not experiencing climate stressors (41%, n = 43,872). Adjusting for key demographic characteristics, exposure to any climate event increased the odds of CMD by 50% (Odd Ratio = 1.57; 95% Confidence Interval (CI) 1.49, 1.64), highest for heatwaves. Specific climate impacts such as housing damage, loss of or inability to work, damage to family business, leaving school and physical health affected were adversely related to CMD, though for different climate hazards. More concern and less agency were related to CMD through different pathways, particularly for those exposed to recent events. Future research regarding the cumulative exposures to climate change, not just acute events but as an ongoing crisis, and various pathways that influence the mental health and well-being of young people must be clearly understood to develop programs and policies to protect the next generation.