• Joan Christodoulou, Mary Jane Rotheram-Borus, Panteha Hayati Rezvan, W Scott Comulada, Jackie Stewart, Ellen Almirol, and Mark Tomlinson.
• Palo Alto University, USA. Electronic address: jchristodoulou@paloaltou.edu.
• Prev Med. 2022 Apr 1; 157: 106966106966.

ObjectiveThis is a secondary analysis examining neighborhood factors predicting high rates of child resilience in South African Township neighborhoods.MethodsA population cohort of South African pregnant women (98%; n = 1238), were recruited and assessed across five years with high follow-up rates (83-96%). Resilient children were identified based on consistently meeting global standards for growth, cognitive functioning, and behavior. Community infrastructure, maternal risks, and caretaking behaviors were examined based on neighborhood as predictors of childhood resilience.ResultsThe rate of resilient children varied significantly by neighborhood (9.5% to 27%). Mothers living in high prevalence neighborhoods (HPN) compared to low prevalence neighborhoods (LPN) were older and more likely be living with three or more people in formal housing with access to water and electricity. In the HPN, resilient children had more food security and were less likely to have mothers with depressed mood. Migration to rural areas occurred more frequently among resilient compared to non-resilient children in the HPN.ConclusionThis study applies a novel measure of resilience that is multidimensional and longitudinally defined. Living in formal housing with consistent access to food was associated with resilience. Migration to rural areas among families living in HPN suggests that rural areas could be protective.Trial RegistrationClinicalTrials.gov registration #NCT00996528.Copyright © 2022. Published by Elsevier Inc.

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