Social capital, social cohesion, and health of Syrian refugee working children living in informal tented settlements in Lebanon: A cross-sectional study
Social capital, social cohesion, and health of Syrian refugee working children living in informal tented settlements in Lebanon: A cross-sectional study
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DOI：
10.1371/journal.pmed.1003283
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发表时间：
2020-09-01
期刊：
影响因子：
15.8
通讯作者：
El Asmar, Khalil
中科院分区：
文献类型：
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作者：
Habib, Rima R.;El-Harakeh, Amena;El Asmar, Khalil
自2011年以来，旷日持久的叙利亚战争给叙利亚人民的生活带来了悲惨的后果，威胁到他们的稳定、健康和福祉。最脆弱的是儿童，他们面临中断学业和童工的问题。本研究探讨了社会资本与黎巴嫩农村地区叙利亚难民童工的身体健康和情感幸福之间的关系。在这项横断面研究中，我们调查了2017年在黎巴嫩贝卡谷地工作的4,090名叙利亚难民儿童。儿童（8-18岁）在面对面的访谈中就其生活和社会环境提供了直接证词。Logistic回归评估了社会资本和社会凝聚力与叙利亚难民童工的健康和情感幸福的关系;具体而言，自我评估健康状况不佳，报告健康问题，从事危险的健康行为，感到孤独，感到乐观，对生活感到满意。在研究中的4，090名童工中，11%报告健康状况不佳，16%报告有健康问题，13%从事危险行为。大多数人（67.5%）表示感到孤独，而大约53%的人乐观，59%的人对生活感到满意。研究结果表明，积极的社会资本结构与更好的健康有关。社会凝聚力水平较低（例如，不花时间与朋友在一起）与自我评价的健康状况不佳，报告身体健康问题，以及感到更孤独有显著相关性（校正比值比（AOR），2.4; CI 1.76- 3.36，p < 0.001），[AOR，1.9; CI 1.44- 2.55，p < 0.001]，[AOR，0.5; CI 0.38- 0.76，p < 0.001]）。更高水平的社会支持（例如，拥有良好的社会关系），家庭社会资本（例如，与父母讨论个人问题），以及邻里依恋（例如，有一个亲密的朋友）都与更乐观有着显著的联系（AOR分别为1.5; CI 1.2- 1.75，p < 0.001），[AOR为1.3; CI 1.11- 1.52，p < 0.001]，[AOR为1.9; CI 1.58- 2.29，p < 0.001]），对生活更满意[AOR，1.3; CI 1.01- 1.54，p = 0.04]、[AOR，1.2; CI 1.01- 1.4，p = 0.04]和[AOR，1.3; CI 1.08- 1.6，p = 0.006]。这项研究的主要局限性是它的横截面设计，以及其他设计问题（使用自我报告的健康措施，使用未经验证研究的问卷，并给予健康和情绪幸福指标的所有组成部分同等权重）。结论本研究强调了社会资本，社会凝聚力和难民打工儿童的身体和情绪健康之间的关联。尽管叙利亚难民儿童的生活和工作条件很差，但拥有一个紧密的家庭和朋友网络与更好的健康有关。考虑社会资本层面的干预措施可能有助于改善健康的叙利亚难民儿童在非正式的帐篷住区（ITSs.Author summary为什么这项研究？叙利亚的战争导致大量人口流离失所到邻国黎巴嫩，许多脆弱的流离失所家庭生活在非正式的帐篷定居点（ITS），无法获得生计和资源，这些流离失所家庭中的童工人数很高。本研究旨在调查社会资本和凝聚力与叙利亚难民儿童的健康和情感幸福之间的关联。研究人员做了什么，发现了什么？我们对生活在黎巴嫩农村地区ITSs的1，902户叙利亚流离失所家庭进行了横断面研究，并采访了4，090名8至18岁的叙利亚难民儿童。大约11%的童工认为他们的健康状况很差，16%的童工报告有身体健康问题，13%的童工从事危险的健康行为。较低的社会凝聚力与报告健康状况不佳显著相关，较低的社会支持水平与从事危险健康行为显著相关。更高水平的邻里依恋、家庭社会资本和社会支持与更大的乐观和生活满意度显著相关，更高水平的邻里依恋和社会凝聚力与不那么孤独的感觉显著相关。这些发现意味着什么？据报告，在黎巴嫩工作和生活的叙利亚难民儿童的健康和情感状况有所改善，这与社会资本和社会凝聚力有关。旨在促进叙利亚难民儿童身心健康的政策应考虑采取旨在维持这些人口的社会资本的干预措施。
Background Since 2011, the protracted Syrian war has had tragic consequences on the lives of the Syrian people, threatening their stability, health, and well-being. The most vulnerable are children, who face interruption of schooling and child labor. This study explored the relationship between social capital and the physical health and emotional well-being of Syrian refugee working children in rural areas of Lebanon. Methods and findings In this cross-sectional study, we surveyed 4,090 Syrian refugee children working in the Bekaa Valley of Lebanon in 2017. Children (8-18 years) gave direct testimony on their living and social environment in face-to-face interviews. Logistic regressions assessed the association of social capital and social cohesion with the health and emotional well-being of Syrian refugee working children; specifically, poor self-rated health, reporting a health problem, engaging in risky health behavior, feeling lonely, feeling optimistic, and being satisfied with life. Of the 4,090 working children in the study, 11% reported poor health, 16% reported having a health problem, and 13% were engaged in risky behaviors. The majority (67.5%) reported feeling lonely, while around 53% were optimistic and 59% were satisfied with life. The study findings suggest that positive social capital constructs were associated with better health. Lower levels of social cohesion (e.g., not spending time with friends) were significantly associated with poor self-rated health, reporting a physical health problem, and feeling more lonely ([adjusted odds ratio (AOR), 2.4; CI 1.76-3.36,p< 0.001], [AOR, 1.9; CI 1.44-2.55,p< 0.001], and [AOR, 0.5; CI 0.38-0.76,p< 0.001], respectively). Higher levels of social support (e.g., having good social relations), family social capital (e.g., discussing personal issues with parents), and neighborhood attachment (e.g., having a close friend) were all significantly associated with being more optimistic ([AOR, 1.5; CI 1.2-1.75,p< 0.001], [AOR, 1.3; CI 1.11-1.52,p< 0.001], and [AOR, 1.9; CI 1.58-2.29,p< 0.001], respectively) and more satisfied with life ([AOR, 1.3; CI 1.01-1.54,p= 0.04], [AOR, 1.2; CI 1.01-1.4,p= 0.04], and [AOR, 1.3; CI 1.08-1.6,p= 0.006], respectively). The main limitations of this study were its cross-sectional design, as well as other design issues (using self-reported health measures, using a questionnaire that was not subject to a validation study, and giving equal weighting to all the components of the health and emotional well-being indicators). Conclusions This study highlights the association between social capital, social cohesion, and refugee working children's physical and emotional health. In spite of the poor living and working conditions that Syrian refugee children experience, having a close-knit network of family and friends was associated with better health. Interventions that consider social capital dimensions might contribute to improving the health of Syrian refugee children in informal tented settlements (ITSs).Author summaryWhy was this study done? The war in Syria has resulted in a large displacement of the population to neighboring Lebanon, where many vulnerable displaced families are living in informal tented settlements (ITSs) with no access to means of livelihood and resources, and child labor among these displaced families is high. This study aimed to investigate the associations between social capital and cohesion and the health and emotional well-being of Syrian refugee children. What did the researchers do and find? We conducted a cross-sectional study of 1,902 households of Syrian displaced families living in ITSs in a rural area in Lebanon and interviewed 4,090 working Syrian refugee children aged between 8 and 18 years. Around 11% of the working children rated their health as poor, 16% reported having a physical health problem, and 13% were engaged in risky health behaviors. Lower social cohesion was significantly associated with reporting poor health, and a lower level of social support was significantly associated with engaging in risky health behaviors. Higher levels of neighborhood attachment, family social capital, and social support were significantly associated with greater optimism and life satisfaction, and higher levels of neighborhood attachment and social cohesion were significantly associated with feeling less lonely. What do these findings mean? Social capital and social cohesion are associated with reporting better health and emotional well-being among Syrian refugee children working and living in Lebanon. Policies aimed at promoting the physical and emotional well-being of Syrian refugee children should consider interventions that aim to maintain social capital among these populations.