Pathways from family disadvantage via abusive parenting and caregiver mental health to adolescent health risks in South Africa

Franziska Meinck*, Lucie Dale Cluver, Frederick Mark Orkin, Caroline Kuo, Amogh Dhar Sharma, Imca Sifra Hensels, Lorraine Sherr

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: Adolescent health is a major concern in low- and middle-income countries, but little is known about its predictors. Family disadvantage and abusive parenting may be important factors associated with adolescent psychological, behavioral, and physical health outcomes. This study, based in South Africa, aimed to develop an empirically based theoretical model of relationships between family factors such as deprivation, illness, parenting, and adolescent health outcomes.

Methods: Cross-sectional data were collected in 2009–2010 from 2,477 adolescents (aged 10–17) and their caregivers using stratified random sampling in KwaZulu-Natal, South Africa. Participants reported on sociodemographics, psychological symptoms, parenting, and physical health. Multivariate regressions were conducted, confirmatory factor analysis employed to identify measurement models, and a structural equation model developed.

Results: The final model demonstrated that family disadvantage (caregiver AIDS illness and poverty) was associated with increased abusive parenting. Abusive parenting was in turn associated with higher adolescent health risks. Additionally, family disadvantage was directly associated with caregiver mental health distress which increased adolescent health risks. There was no direct effect of family disadvantage on adolescent health risks but indirect effects through caregiver mental health distress and abusive parenting were found.

Conclusions: Reducing family disadvantage and abusive parenting is essential in improving adolescent health in South Africa. Combination interventions could include poverty and violence reduction, access to health care, mental health services for caregivers and adolescents, and positive parenting support. Such combination packages can improve caregiver and child outcomes by reducing disadvantage and mitigating negative pathways from disadvantage among highly vulnerable families.
Original languageEnglish
Pages (from-to)57-64
Number of pages8
JournalJournal of Adolescent Health
Issue number1
Early online date25 Oct 2016
Publication statusPublished - 1 Jan 2017


  • adolescent abuse
  • adolescent behavior
  • adolescent health
  • AIDS
  • mental health
  • parenting
  • risk factors
  • South Africa


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