Welfare babies: poor children's experiences informing healthy peer relationships in Canada

Positive peer relationships among children living in poverty are important for their well-being, resiliency and mental and physical health. This paper explicates the 'felt experience' of children living in poverty, and the implications of these experiences for healthy peer relationships, from a re-analysis of two qualitative research studies in Canada examining children living in food insecure circumstances. Poor children feel deprived, part of the 'poor group', embarrassed, hurt, picked on, inadequate and responsible. Poor children internalize their own lack of social resources in feelings of deprivation. They experience negative feelings relative to their peers-inadequacy, embarrassment and hurt. Children do identify group membership but it is not used as a social resource, as it could be, but rather as a symbol of social segregation. Children also feel responsible for ameliorating some of the effects of their poverty and this seems to strengthen their relationship with their mothers. This could equally be translated into peer-related support, such as standing up to poor bashing, or engaging constructively with higher social class peers. Health promotion strategies that seek to foster positive peer relationships and enhance children's sense of belonging should offer novel social environments in which poor children can engage a variety of peers.     

The social and economic consequences of childhood asthma across the lifecourse: a systematic review

BACKGROUND: Asthma prevalence rates are high, and may be increasing in the Western world, particularly among children. The aim of this study was to evaluate the longer-term social and economic consequences of having asthma as a child and to determine whether adverse consequences are more severe for poorer children. METHODS: Results from published and unpublished, quantitative and qualitative studies were synthesized narratively to examine the impact of childhood-onset asthma on school attendance, academic achievement and employment in adulthood. The question of whether the impact differed for different social groups was also examined. FINDINGS: Twenty-nine good quality studies were identified, including in total 12 183 children with asthma or wheeze. Compared with asymptomatic children, those with asthma missed more days of school (additional absence as a result of asthma ranged from 2.1 to 14.8 days). Studies of academic achievement found that children with asthma performed as well as their healthy peers. The existing evidence on labour market performance is sparse, but there is an indication that people with asthma during childhood experience disadvantage in later employment. In an examination of consequences by social position, children with asthma from deprived areas were more likely to miss school than their more affluent peers, and minority ethnic children were also more likely to have poor school attendance. The only qualitative study suggested that children with asthma strove to participate fully in every aspect of their daily lives. INTERPRETATION: Although asthma limits children's daily activities and affects their social activities, this research synthesis found little evidence of major, adverse long-term social and economic consequences in studies reviewed. Further longitudinal research using comparison groups is needed to fill key gaps in the existing evidence base.     

A Review of Cross-Cultural Studies of Observed Peer Interaction

In the Western peer interaction literature, children's observable social functioning is often causally related to peer acceptance and psychosocial well-being. In the present review, cross-cultural empirical support for such a relationship was investigated. By means of a PsycLIT search, cross-cultural studies of peer interaction-published in article-format-were collected that used observational methods and focused on interaction between children up to 12 years of age. The 18 studies that met these criteria could be categorized as focusing on social motives, on characteristics of social interaction, or on sex-specific behaviors. A diversity of theoretical orientations was encountered and discussed. It was concluded that in the studies reviewed here the focus was not on the analysis of observational findings in relation to peer acceptance and the quality of children's psychosocial functioning. Clearly, such cross-cultural research is badly needed.     

‘Faking til you make it’: Social capital accumulation of individuals on low incomes living in contrasting socio-economic neighbourhoods and its implications for health and wellbeing

People on low-income living in low socio-economic neighbourhoods have poorer health in comparison with those living in advantaged neighbourhoods. To explore neighbourhood effects on health and social capital creation, the experiences of low-income people living in contrasting socio-economic neighbourhoods were compared, in order to examine how low-income status and differing levels of neighbourhood resources contributed to perceived health and wellbeing. Quantitative and qualitative data were analysed: survey data from 601 individuals living in contrasting socio-economic areas and in-depth interviews with a new sample of 24 individuals on low-incomes. The study was guided by Bourdieu's theory of practice, which examines how social inequalities are created and reproduced through the relationship between individuals' varying resources of economic, social and cultural capital. This included an examination of individual life histories, cultural distinction and how social positions are reproduced. Participants' accounts of their early life experience showed how parental socio-economic position and socially patterned events taking place across the life course, created different opportunities for social network creation, choice of neighbourhood and levels of resources available throughout life, all of which can influence health and wellbeing. A definition of poverty by whether an individual or household has sufficient income at a particular point in time was an inadequate measure of disadvantage. This static measure of ‘low income’ as a category disguised a number of different ways in which disadvantage was experienced or, conversely, how life course events could mitigate the impact of low-income. This study found that the resources necessary to create social capital such as cultural capital and the ability to socially network, differed according to the socio-economic status of the neighbourhood, and that living in an advantaged area does not automatically guarantee access to potentially beneficial social networks.     

Contrasting lives,contrasting views? Understandings of health inequalities from children in differing social circumstances

Children's differing socio-economic, cultural and familial circumstances and experiences are part of the pathways implicated in health and illness in adulthood. However, in the existing, mainly survey based, work children's own voices tend to be absent and adult-defined data about health and illness accumulated. Little is known about the social and cultural processes, in children's very different childhoods, which underpin and ultimately constitute these epidemiological findings. This paper reports findings from a qualitative study examining the socio-economic and cultural contexts of children's lifestyles and the production of inequalities in health, carried out in a large Scottish city. Two rounds of semi-structured interviews, using a range of child-friendly techniques (photographs, drawings, vignettes), were carried out with 35 girls and boys aged 9-12 years living in two contrasting but contiguous areas, one relatively advantaged and one relatively disadvantaged. Thirty of their parents were also interviewed and community profiling and observational work undertaken. Children and parents described often starkly contrasting lives and opportunities, regularly involving material differences. However, children appeared to locate inequalities as much in relationships and social life as in material concerns; in this their direct experiences of relationships and unfairness were central to their making sense of inequality and its impact on health. Although children from both areas highlighted several different inequalities, including those related to material resources, they also spoke of the importance of control over their life world; of care and love particularly from parents; of friendship and acceptance by their peer group. Many children challenged straightforward causal explanations for future ill-health, privileging some explanations, such as psychological or lifestyle factors. The accounts of children from both areas displayed considerable resilience to and downplaying of the effects of both relationship and material inequalities; also showing how familial and personal challenges, such as bullying, divorce, learning difficulties, cut across structurally based differences.     

Effective services to support children in special circumstances

BACKGROUND: Children living in special circumstances, defined as those who are at risk of achieving poorer outcomes than their peers, have a particular need of good quality, accessible services to promote their health and well-being, yet may be least likely to receive them. AIMS: This review considers the evidence for effective services to support children living in five kinds of special circumstances: (1) those at risk of offending; (2) teenage parents; (3) children whose parents have drug, alcohol or mental health problems; (4) children living with domestic violence; and (5) children who have been abused or neglected. In practice, there is often considerable overlap between these groups, and many children face multiple disadvantage. The review also aims to identify effective strategies for making support services more accessible to hard-to-reach groups. METHODS: Relevant literature was identified through searches of databases and websites, and consultation with experts. Given the broad scope of the topic, the aim was to provide an overview of best evidence rather than to undertake a systematic review. RESULTS: Similar themes underpin the most promising approaches to supporting children in special circumstances. These include: (1) a holistic, multi-agency approach addressing the needs of the whole child rather than compartmentalising children's social, educational, health and care needs; (2) the importance of links between adults' and children's services so that children who are in need because of their parents' circumstances can be identified and supported; and (3) the value of providing children in special circumstances with intensive, targeted support within a framework of universal provision. CONCLUSIONS: Overall, there is a lack of well-designed evaluations of the effectiveness of UK services and programmes for children in special circumstances. The existing evidence base would be strengthened by the development of better outcome measures, by exploring the characteristics of effective services from the perspective of different stakeholders (including children and young people themselves) and by extending the current problem-oriented approach to consider the factors that promote resilience and coping.     

Interventions to improve psychosocial well-being for children affected by HIV and AIDS: a systematic review

In addition to its contribution to child mortality, HIV/AIDS has a substantial impact on the psychosocial well-being of children. We conducted a systematic review to identify studies that assess the effectiveness of interventions developed to improve the psychosocial well-being of children affected by HIV/AIDS, published between January 2008 and February 2016. Studies were eligible for the review if they included children under the age of 18 years, who had lost a parent to HIV/AIDS, were living with a parent with HIV/AIDS, or were vulnerable because of other factors and living in communities of high HIV/AIDS prevalence. Studies documented any intervention to improve the psychosocial well-being of children including psychological, psychosocial, medical, and social interventions, with psychological and/or social factors as outcomes. We identified 17 interventions to improve the psychosocial well-being of children affected by HIV/AIDS. Of these, 16 studies took place in 8 different low- and middle-income countries (LMIC), and 6 in Southern and Eastern Africa. Of the total, 15 showed some significant benefits of the intervention, while 2 showed no difference to psychosocial outcomes. The content of interventions, dosage and length of follow-up varied substantially between studies. There were few studies on children under 7 years and several focused mostly on girls. Due to the variability between interventions, it was not possible to make consolidated recommendations for programming based on the results of this review. However, we note that efforts to improve evaluation of interventions to improve the psychosocial well-being of children affected by HIV/AIDS have resulted in a number of new studies which met the inclusion criteria for the review. Most were research projects and not evaluations of existing services. We call for increased partnerships between policymakers, practitioners, and researchers in order to design evaluation studies that can feed into the growing evidence base.     

Parenting support in the context of poverty: a meta-synthesis of the qualitative evidence

From the outset, providing support for parents has been a key feature of New Labour's policy agenda, but 'good' parenting, and child health and well-being are often undermined by the stresses associated with poverty. Moreover, there may be a gap between policy aims, and the perceptions and motivations of those intended to benefit. Drawing on a systematic review of qualitative studies of low-income parents, the present paper explores their experiences of informal and formal support networks, considering their strengths and weaknesses in the context of poverty. Traditional systematic review methods were used to locate and critically appraise 12 UK qualitative studies, which took as their focus parents' subjective experiences of caring for children in impoverished circumstances. Meta-ethnographic methods were then used to produce a qualitative meta-synthesis of findings. Exploring the similarities and differences in parents' accounts across studies identified positive and negative aspects of social support as a resource for poor parents. The review suggests that naturally occurring support systems do provide both material and emotional help to parents, but that such support has certain inherent drawbacks. It is not universally available and, in some circumstances, carries negative associations for poor families. Low-income lone mothers in particular enjoy smaller support networks, and are more reliant on mutual support than those in two-parent families. Paradoxically, it is the most socially isolated women who are least willing to seek professional help. Overall, low-income parents' experiences of formal health and social welfare agencies are mixed, and not invariably positive. In conclusion, this paper suggests that formal support services have the potential to fill gaps in informal support systems for poor families, but only if these are provided in ways which are sensitive to their needs. Therefore, parents' perspectives are essential to informing service design, development and evaluation in health and social care.     

The impact of support network substitution on low-income women's health: Are minor children beneficial substitutes?

Poor women have elevated stress but also face deficits in their social networks to provide help. Consequently, they may substitute their minor children as a support source in place of more traditional ties. Support substitution and compensation theory suggest this form of substitution may not lead to compensatory benefits. We hypothesized that low-income mothers experiencing high levels of acute and network stress would be more likely to rely on their minor children, and this reliance on minor children would be related to worse health outcomes through its impact on minor children's well-being. In an interview-based community study of 116 low-income mothers from Northeast Ohio, USA we found that acute stress (but not network stress) was related to greater reliance on minor children for support and the impact on minor children's well-being mediated the link with low-income mothers' worse health outcomes. These results suggest that the reason for and type of social network substitution may determine whether compensatory benefits are realized.     

Parents' labour market participation as predictor of children's well-being: changes from 1984 to 1996 in the Nordic countries

BACKGROUND: This study analysed the influence of parents' labour market participation on their children's well-being in the five Nordic countries, and the changes from 1984 to 1996, during which unemployment rates generally rose in the Nordic countries. METHODS: Parent-reported questionnaire data from two cross-sectional studies, 12 years apart, with 15,354 (in 1984) and 15,255 (in 1996) randomly selected children aged 2-17 years. The response rates were 67.0% (n=10290) and 67.6% (n=10317), respectively. The parents' assessment of their children's well-being was measured by six items, with three items focusing on psychological functioning and three items on social functioning. RESULTS: The association between parents' labour market participation and children's well-being changed from 1984 to 1996. In 1984, more children in families with paid work had low well-being than did children in families without paid work. In 1996, however, the share of children with low well-being was higher among children in families without paid work. This change was most notable in Finland but did not occur in Denmark. The overall level of well-being among children in the Nordic countries remained stable over this period. CONCLUSION: The relationship between parents' labour market participation and well-being among children changed from 1984 to 1996. In 1984 low well-being was most common among children in families with paid work, while in 1996 low well-being was more common in families without participation in the labour market. Social inequality in children's well-being thus increased if parents' labour market participation was used as an indicator of socioeconomic status.     

What do we know about the experience of age related macular degeneration? A systematic review and meta-synthesis of qualitative research

Age Related Macular Degeneration (AMD) is the leading cause of registerable blindness with a high medical and societal cost burden. Much of the research examining experiences of living with AMD has been conducted independently with small sample sizes and has failed to impact on practice. Meta-synthesis of qualitative research can improve the understanding of the experience of living with AMD by drawing together findings of qualitative studies. This article presents a systematic review and meta-synthesis of qualitative studies investigating the experience of AMD (literature searched up to April 2012; published studies identified range from 1996 to 2009). The review highlights themes relating to: functional limitations, adaptation and independence; feelings about the future with vision impairment; interaction with the health service; social engagement; disclosure; and the emotional impacts of living with AMD. Attention to the experience of living with AMD can help us to better understand the needs of patients. This meta-synthesis aimed to bring together the findings of qualitative research studies and highlights important areas for consideration when caring for patients with AMD. Our findings suggest that a holistic approach to service provision and support for AMD is needed which takes into account individuals' needs and experiences when coping with and adjusting to living with AMD. This support should aim to reduce stigma, increase social engagement, and develop the psychological resources of patients with AMD.     

Golden holocaust: Origins of the cigarette catastrophe and the case for abolition

Refugee camps are replete with risk factors for mental health problems among children, including poverty, disruption of family structure, family violence and food insecurity. This study, focused on refugee children from Burma, in Ban Mai Nai Soi camp in Thailand, sought to identify the particular risks children are exposed to in this context, and the impacts on their mental health and psychosocial well-being. This study employed two qualitative methods – free list interviews and key informant interviews – to identify the main problems impacting children in Ban Mai Nai Soi camp and to explore the causes of these problems and their impact on children's well-being. Respondents in free list interviews identified a number of problems that impact children in this context, including fighting between adults, alcohol use by adults and children, and child abuse and neglect. Across the issues, the causes included economic and social conditions associated with living in the camp and changes in family structures. Children are chronically exposed to stressors during their growth and development in the camp environment. Policies and interventions in areas of protracted displacement in camp-based settings should work to address these stressors and their impacts at community, household and individual levels.     

Parents' experiences of caring for a child with a cleft lip and/or palate: a review of the literature

This review brings together for the first time the existing quantitative and qualitative research evidence about the experiences of parents caring for a child with a cleft. It summarizes salient themes on the emotional, social and service-related experiences of parents and critiques the literature to date, comparing it with wider, selected literature from the field of children's long-term conditions, including disability. The review suggests that there are similarities and differences between the literatures, in terms of research focus and approach. Similarities are found across children's conditions in the perspectives of parents on emotional, social and service-related aspects, although much of the cleft literature is focused on the early stages of children's lives. However, the quality of cleft research to date about parents' experiences has also been variable, with a narrow emphasis on cross-sectional, deficit-orientated psychological approaches focused mainly on mothers. Despite a substantial literature, little qualitative research has examined parents' perspectives in-depth, particularly about their child's treatment journey. This contrasts with the wider children's literature, which has traditionally drawn not only on psychological approaches but also on the broader perspectives of sociology, social policy, nursing and health services research, using both qualitative and quantitative methods, often in integrated ways. Such approaches have been able to highlight a greater range of experiences from both mothers and fathers, about caring for a child with a long-term condition and views about treatment. The review identifies a lack of comparable research in the cleft field to examine parents' experiences and needs at different stages of their children's lives. Above all, research is needed to investigate how both mothers and fathers might experience the long-term and complex treatment journey as children become older and to elicit their views about decision making for cleft treatments, particularly elective surgeries.     

Adolescent mothers' subjective well-being and mothering challenges in a Yoruba community, southwest Nigeria

Well-being varies within cultures and context. Studies on the well-being and mothering challenges of adolescents in Nigeria have focused on the general poor well-being of adolescent mothers rather than exploring their agency and subjective well-being within specific context. This study explores adolescent mothers' (13-20 years) subjective well-being by focusing on their childbirth, mothering experiences, and available network of supports. Thirty face-to-face in-depth interviews were conducted through the support of four informants and peer referrals. Content analysis was used to identify salient themes and patterns. Findings showed that a high proportion of the adolescent mothers had stigmatizing experiences among which include dropping out of school, and lack of supports from families, friends, and the society. Where available, supports were perceived as inadequate in contributing to their well-being and that of their children. Some of the adolescent mothers were apprehensive of losing their children to ill health while emphasizing that their present challenges could affect their children's future. However, the adolescent mothers invoked their agency by subtly using strategies such as petty trading and apprenticeship to reduce the social consequences of unintended pregnancy and earn a living. Recognizing adolescent mothers' agency in policies targeted toward their empowerment would be of benefit.     

"I used to worry about what other people thought but now I just think ... well I don't care": shifting accounts of learning difficulties in public places

This paper will explore the ways in which mothers of children with learning difficulties account for their children's behaviour when they are in public places. Children with learning difficulties may demonstrate unconventional behaviour without having any apparent sign of impairment. This may lead others, unfamiliar with the children, to make inappropriate judgements about both the children and their mothers. An exploration of the ways in which mothers account for their children's behaviour illustrates both the ways in which the mothers make sense of their children's learning difficulties and how they attempt to facilitate their children's participation in social life in public places. This paper draws upon the findings of a qualitative research project involving 18 mothers of children with moderate to severe learning difficulties. I begin by presenting a brief overview of the contextual and theoretical framework for the analysis focusing upon public places and disability. This section includes a discussion about the sociological concept of accounts and account making. The next section discusses the methods used in the study and this is followed by a section presenting the research findings. Finally, a discussion of these findings highlights how mothers shift in their approach to accounting for their children's behaviour over time and I conclude by suggesting that the exploration of the use of accounts in public places is a useful tool for highlighting changes in perceptions of disability.     

Paths to child social adjustment: parenting quality and children's processing of social information

BaCKGROUND: The purpose of this research was to examine the manner in which multiple influences on child social adjustment operated together to predict differential outcomes for young children. Specifically, this study was designed to (i) examine the role of social cognitive and emotional factors in parents' observed and self-reported behaviour towards their children, and (ii) investigate the impact of parenting and children's social information processing (SIP) patterns on children's subsequent social adjustment in the school setting. METHODS: A model of children's peer social adjustment was evaluated using a group of 166 children, over-sampled for history of physical child abuse. Assessment of constructs was multi-method, including parent and child self-reports as well as teacher reports of child adjustment and observations of parent-child and child-peer interactions. RESULTS: Using structural equation modelling, support was found for our theoretical model. Specifically, parents' negative child-related beliefs and clinical elevations in emotional distress were predictors of harsh, insensitive parenting, which in turn predicted children's SIP operations and social maladjustment 6 months later. However, children's SIP did not significantly predict their social adjustment above and beyond the impact of parenting. CONCLUSIONS: Results indicated that the quality of parenting that children received was more central to subsequent adjustment in peer interactions than were children's SIP operations. Furthermore, the quality of parenting children experienced was closely linked to parents' beliefs about their children and parents' mental health status. Directions for future research and potential implications for clinical practice are discussed.     

Kinship Care Placement and Children's Academic Performance

Very little consideration has been given to the impact children's living situations can have on their educational performance. The relationship of family environment to the children's educational performance depends in part upon the experiences and intent of the mediating adults who frame, select, focus and interpret the experiences children have in ways that produce an appropriate attitude toward education. Because of changing family patterns, along with significant social and economic factors plaguing many families today, particularly African American families, a substantial number of children continue to grow up in circumstances that put them at risk for unstable family environments, low achievement, and school failure. These unstable family environments often lead to placements in families other than their biological families. Often times these placements are within the state foster care system and for some the placement is with a relative, known as kinship care. Kinship placement is seen as an alternative in maintaining some type of stable family environment for these children at risk. In view of the relatively high incidence of low school performance and other social issues of children at risk, the role of minority families in the education of their children has become a national interest. The issue being addressed in this article centers around specific family processing factors in kinship care environments and its impact on children's academic performance. doi:10.1300/J045v22n03_03.     

HIV-related stigma and the psychosocial well-being of children orphaned by AIDS: a systematic review

The study aimed to systematically review existing literature reporting on the effects of HIV-related stigma on the psychosocial well-being of children orphaned by AIDS. A systematic review methodology was used to search electronic databases and journals, including Academic Search Complete, AIDS Care, PsychArticles, PubMed and SA ePublications from January 2006 to December 2016. Included studies were required to be peer reviewed, full-text, English medium, embody a quantitative, qualitative or mixed methodology and focus on HIV-related stigma and its impact on the psychosocial well-being of children orphaned by AIDS. Findings were extracted in four steps: (1) identification; (2) screening; (3) eligibility; (4) inclusion. A meta-synthesis was used for the extraction and amalgamation of findings. Thirteen studies were included in the final review and consistently indicated that HIV-related stigma inhibited the psychosocial functioning and well-being of children orphaned by AIDS. This study sheds light on the impact of HIV-related stigma on the psychosocial well-being of children orphaned by AIDS, but has been limited by a culture of non-disclosure of parental HIV infection or death or failing to report on parental cause of death.     

Social Class or Deprivation? Structural Factors and Children’s Limiting Longstanding Illness in the 1990s

This paper investigates inequalities in children's reported morbidity by parental social class compared with indicators of material disadvantage, using data for children aged 0 to 16 years from the British General Household Surveys for 1991–94. Family structure, employment status and receipt of benefit are more closely associated with differentials in health for children than parental social class. Children in lone parent families living on Income Support are most likely to report chronic illness, whereas for children living with two parents the unemployment of the family head is most clearly associated with reported morbidity. These health inequalities are more pronounced in children under 10 years than children aged 10–16 years. Children living in local authority housing were significantly more likely to report chronic illness. South Asian children were less likely to have a longstanding limiting illness compared to the white population. This research shows that the economic position of the family, and especially material deprivation, is more closely associated with children's health status than social class.     

Mothers with HIV/AIDS and their children: disclosure and guardianship issues

For many mothers living with HIV/AIDS, whether, when, and how to disclose their HIV diagnosis to their children and arranging for future care are important although agonizing issues. Due to the increasing number of children who lose their mothers to AIDS and the dearth of empirical information about them, these issues are increasingly important to research. This study of 188 HIV-positive mothers and their 267 children of minor age in New York City revealed that only half the mothers had disclosed their HIV diagnosis to at least one of their children and only 57% had made formal plans for the children's care. As expected, older children were more likely to be informed than younger children. Contrary to some previous research, maternal disclosure was not related to ethnicity, advanced illness, improved psychological well-being, or greater or more satisfying social support resources. Implications for future research and provision of services to this group of women are discussed.