![]() ![]() However, the notion of “pathway” is itself problematic, adding a layer of largely unresolved complexity to any discussion of contextual influences on health status and outcomes. This is an important lacuna as a better understanding of those pathways could facilitate the design of better interventions. Although these associations are well established, the evidence is chequered regarding the pathways through which contexts influence health. There is considerable evidence of associations between risky environments and increased risk behaviour. Here we explore: (a) aspects of why prevalence of risk behaviours is higher among people living in adverse environments, and (b) why the relationship between socio-economic status and risk behaviour is not linear. These relationships arise from direct health risks, stress from being at the lower end of the income/wealth distribution, and higher levels of risk behaviour. Relationships between poor socio-economic conditions and a wide range of adverse health outcomes have been observed in numerous contexts. ![]() Introduction: Pathways, interventions and emergent properties ![]() More work is needed to take further the task of identifying emergent properties capable of distilling the influence of lower level variables into single measures useful for analysis and policy purposes. Improving our measurement of emergent properties is perhaps the biggest challenge facing this approach. This result is cause for optimism regarding the potential use of emergent properties in explaining variations in risk behaviour. We found that among adolescents living in similar contexts, there was enough variance in reported levels of hope, that an association with alcohol use could be identified. We apply a mixed methods approach to examine the association of an example emergent property, hope, and alcohol consumption among adolescents in a rural South African site. `Emergent properties’ arise from the interaction of factors or items in a high-level system which, as a result, has qualities possessed by none of the individual factors. We investigate the use of the concept of emergent properties in explaining the link and its non-linear nature. The causes of this link are, however, poorly understood, making it difficult to explain why the association is often not linear and why there is so much variability between groups and individuals facing similar adversity. A link between adversity, including low socio-economic status, and behaviours which carry health risks, such as alcohol consumption, has often been observed. ![]()
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