Nkansah-Amankra, Stephen

Permanent URI for this collectionhttps://hdl.handle.net/20.500.11875/4658

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    “Gateway hypothesis” and early drug use: Additional findings from tracking a population-based sample of adolescents to adulthood
    (Elsevier (Preventive Medicine Reports), 2016) Nkansah-Amankra, Stephen; Minelli, Mark
    To evaluate the consistency of the relationship between early drug use in adolescence and illegal drug use in adulthood as proposed in the“gateway theory”and to determine whether pre-existing depressive symptoms modifies this relationship. We used contractual data from the National Longitudinal Study of Adolescent to Adult health data spanning a 14 year period. We assessed the relationship between gateway drugs at baseline(age 11–20 years) and drug use in adulthood using generalized estimating equation (GEE) regression models.Gateways drugs used in early adolescence were significantly associated with marijuana use, illegal drugs and cocaine in older adolescence, but over time these relationships were not consistent in adulthood. Changes in the pattern of psychoactive drug use were important predictors of drug use in adulthood. A history of higher depressive symptoms was associated with higher frequencies of psychoactive drug use over time. Users of mental health services in adolescence were less likely to use drugs in older adolescence and in adulthood. Relation-ships between early drug use and later drug use in adulthood cannot be solely explained by the gateway hypothesis. Collectively, adolescent drug prevention and treatment programs should apply theory-based and evidence-proven multisectoral intervention strategies rather than providing a brief counseling on individual's behaviors. This evidence should include understanding that changes in behavior should involve broader analyses of the underlying social context for drug use and in particular the role of the community social norms in driving a group's behaviors.
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    Association between depressive symptoms in adolescence and birth outcomes in early adulthood using a population-based sample
    (Elsevier (Preventive Medicine Reports), 2015) Nkansah-Amankra, Stephen; Tettey, Grace
    Background Adolescent female depressive symptomatology is an unrecognized mood disorder that impairs health in adolescence or adulthood. However, the long-term effects of pre-pregnancy depressive symptoms on birth outcomes in adulthood have not been given adequate empirical assessments. Results Exposure to elevated depressive symptoms in late adolescence, but not in adulthood, was associated with increased odds of LBW by more than 2-fold in early and young adulthoods (adjusted odds ratio [aOR]=2.19; 95% confidence interval, CI: 1.56, 3.08). Depressive symptoms in early adulthood were independently associated with increased odds of PTB and were higher for black mothers. Maternal race modified the relationship between consistent reporting of depressive symptoms in adolescence and LBW or PTB in adulthood. Conclusion This study provides compelling evidence that effects of elevated depressive symptomatology on LBW or PTB appear to be linked to a specific development period in adolescence. National policies to address social inequalities and stratification particularly in health at all stages of human development, will provide an important step in reducing depressive symptoms prior to early adulthood and in pregnancy and childbirth.
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    Adolescent suicidal behaviors, self rated health and multiple health risk behaviors: Exploring new perspectives in suicide prevention research
    (Academic Journals (Journal of Public Health and Epidemiology), 2010) Nkansah-Amankra, Stephen; Diedhiou, Abdoulaye; Walker, Ashley Dawn; Agbanu, Harry; Clark, Alena
    We sought to evaluate the extent to which self-rating of health, gender, and the co-occurrence of other health risk behaviors were related to suicidal behaviors among adolescents. Cross-sectional survey data of Colorado middle and high school students aged 12 to 18 years were analyzed using logistic regression. Main outcome variables were suicide ideation, suicide planning, and suicide attempt. Predictors included self-rated health, self-reported health behaviors, perception of body image, expression of sadness and hopelessness, self-reported sexual abuse, self-reported access to lethal weapon, and expression of school safety concerns. Adjusted results showed respondents with poor health rating had significantly higher odds of suicidal ideation (OR: 2.22), suicidal planning (OR: 1.35), and suicide attempt (OR: 2.23). Reporting of hopelessness was the most consistent predictor of suicidal behaviors with odds ratios ranging from 5.57 (for suicidal ideation) to 17.40 (for suicidal attempt). Factors associated with different adolescents’ suicidal behaviors were different for boys and girls. Findings suggest the need to consider gender differences as regards self assessment of health in order to improve the effectiveness of suicide interventions among adolescents.
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    Elaborating on Population Health Inequalities in the United States: Maternity Care in the Era of Free Market System of Neoliberalization
    (MedCrave (International Journal of Pregnancy and Child Birth), 2018) Nkansah-Amankra, Stephen; Diedhiou, Abdoulaye; Mendoza, Justin
    While there is an extensive array of literature examining the impacts of neoliberal markets on population health and social outcomes, few studies have focused on the impact of neoliberalism on maternity care and women’s health in the United States. We provided a critical review of the literature by examining mechanisms linking the emergent neoliberal market systems to maternity care, infant health and women’s health outcomes while assessing the population-wide shifts in risk exposures associated with contexts of emergent neoliberalized markets in the country over the last thirty years. The findings from studies showed a correlated pattern of increasing poor health outcomes among women in the United States compared with other industrialized countries over the past three decades. Overall, the health system in the country does not make provisions for some of the most important determinants occurring prior to pregnancy, and often fails to place these concerns in the context of women’s health across the life course. Increasing medicalization of pregnancy and birthing processes reflect a dominance of the market-oriented approach of the country’s health system. We conclude that many aspects of the emergent neoliberal market influences bear greatly on maternity care and women’s health in particular. We further propose that it is only the collective decisions of society (particularly governments at different levels) that can consciously redirect and modify policy interventions to benefit women over the life course rather than on specific periods of pregnancy and childbirth.