Adolescent mental and physical health in the English-speaking Caribbean.
OBJECTIVE
Bronfenbrenner's ecological systems theory, a multisystem framework, was used to identify risk and protective factors associated with adolescent mental and physical health (AMPH) in the English-speaking Caribbean.


METHODS
A structured literature review, using the online databases of Medline, PsychInfo, and Scopus, was conducted to identify peer-reviewed studies published between January 1998 and July 2011 focused on adolescents ages 10-19 years.


RESULTS
Sixty-eight articles were examined: 40 on adolescent mental health (AMH), 27 on adolescent physical health (APH), and 1 on both topics. Key individual factors included gender and age. Religiosity and engagement in other risk behaviors were associated with AMH, while the presence of other chronic illnesses affected APH. Significant determinants of AMH in the microsystem included family and school connectedness, family structure, and socioeconomic status. Maternal obesity, parental education, and school environment influenced APH. Studies that investigated macrosystem factors reported few consistent findings related to AMPH. A history of family mental health problems and physical and sexual abuse was significantly associated with AMH in the chronosystem, while a family history of diabetes and low birth weight were associated with APH. Studies did not examine the exosystem or the mesosystem.


CONCLUSIONS
AMPH in the English-speaking Caribbean is affected by a variety factors in developing adolescents and their surroundings. Gender, family, and early exposure to negative environments are salient factors influencing AMPH and present potential avenues for prevention and intervention. A fuller understanding of AMPH in this region, however, requires scientifically rigorous studies that incorporate a multisystem approach.
Johns Hopkins Bloomberg School of Public Health, Population, Family and Reproductive Health, Baltimore, Maryland, USA.
Nanlesta A
NA
Pilgrim
Robert W
RW
Blum
D000293:Adolescent; D000294:Adolescent Behavior; D017691:Caribbean Region / Q000453:epidemiology; D002648:Child; D016206:Databases, Bibliographic; D003863:Depression / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005190:Family; D001068:Feeding and Eating Disorders / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D000297:Psychology, Adolescent; D012107:Research Design; D012309:Risk-Taking; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D014754:Violence; D055815:Young Adult