Brian Houle
Biographic Data
| ID | 215889 |
|---|---|
| NAME | Brian Houle |
| GIVEN NAMES | Brian |
| FAMILY NAME | Houle |
| SIGNATURE | HOULE B |
| AFFILIATIONS | Australian National University |
| ORCID | 0000-0003-2157-3118 |
| VERIFIED | Yes |
| TOTAL WORKS | 32 |
| TOTAL CITATIONS | 67 |
| AUTHOR COUNT | 32 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2009 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 5 |
Mortality differentials between self-settled refugees and South Africans in rural South Africa
Low- and middle-income countries (LMICs) host most of the world’s refugees but often have limited mortality information systems. Consequently, evidence on the long-term mortality trajectories of self-settled refugees and the contribution of socioeconomic disadvantage to mortality inequalities remains scarce. To examine long-term mortality patterns, cause-specific mortality and the contribution of socioeconomic status (SES) to mortality differenti…
Parental imprisonment, childhood behavioral problems, and adolescent and young adult cardiometabolic risk
The Strength of Long-Distance Ties for Aging Healthy With HIV
Objectives In lower-income settings with limited government-funded care, personal social networks are often the primary means by which older persons access resources and support. We tested the association between long-distance ties—ties that span greater geographical and network distances—and HIV treatment outcomes in a rural South African community with one of the largest aging populations with HIV. Methods We used data from the “Health and Agin…
Unpacking the black box of latent class analysis using qualitative life history interviews
BACKGROUNDSexual behaviors are determined by present-day factors and past/future considerations.Previous work utilizing latent class analysis on a population-based cross-sectional survey of rural South Africans aged 15-plus showed how sexual behaviors cluster in distinct population subgroups (Class 1: Single with consistent protective behaviors; Class 2: Risky behaviors; Class 3: In union with lack of protective behaviors) and their associations …
Mortality variability and differentials by age and causes of death in rural South Africa, 1994–2018
INTRODUCTION: Understanding mortality variability by age and cause is critical to identifying intervention and prevention actions to support disadvantaged populations. We assessed mortality changes in two rural South African populations over 25 years covering pre-AIDS and peak AIDS epidemic and subsequent antiretroviral therapy (ART) availability. METHODS: Using population surveillance data from the Agincourt Health and Socio-Demographic Surveill…
Understanding Household Dynamics From the Ground Up
Investigations into household structure in low- and middle-income countries (LMICs) provide important insight into how families manage domestic life in response to resource allocation and caregiving needs during periods of rapid sociopolitical and health-related challenges. Recent evidence on household structure in many LMICs contrasts with long-standing viewpoints of worldwide convergence to a Western nuclearized household model. Here, we adopt …
Parental imprisonment, delinquent behavior, and BMI gain in a U.S. nationally representative cohort study of adolescents and adults ages 12-32
Children who experience parental imprisonment report greater mental and physical health adversities in adolescence and adulthood relative to comparable individuals whose parents did not serve time in prison. Research has linked BMI gain with parental imprisonment among females, but other studies have shown null or negative associations between parental imprisonment and weight increases for their offspring. Using longitudinal data from the Nationa…
Care arrangements of older persons in rural Indonesia
This study explores the provision of care for older persons in rural areas of ageing Indonesia. Using data from Ageing in Rural Indonesian Study, we examine who needs care, who provides care, and how care operates across socio-demographic settings. We found that one contributing factor to gender inequality in old age is the disproportionate amount of unpaid care that older women provide to their families. Older women are often both care recipient…
Comparative evidence of years lived with reproductive-age morbidity in sub-Saharan Africa (2010-2019)
Despite remarkable progress in reducing maternal mortality, maternal morbidities remain high, particularly in sub-Saharan Africa (SSA). This study estimates the life years that women of reproductive ages spend in poor health due to indirect maternal morbid
Parental imprisonment as a risk factor for cardiovascular and metabolic disease in adolescent and adult offspring
Using prospective cohort data, our results support research showing that parental imprisonment, particularly in early childhood, is associated with increased BMI, blood pressure, sedentary hours, and waist circumference in females in early adulthood. These findings implicate parental imprisonment as a risk factor for cardiometabolic health issues in later life among females
The double-edged role of accessed status on health and well-being among middle- and older-age adults in rural South Africa
Supporting social capital theory, we find that having higher accessed status is associated with better health and well-being for older adults in a setting with limited formal support resources. However, the explanatory power of both theories appears to depending on other key factors, such as gender and network size, highlighting the importance of contextualizing theories in practice
Twin epidemics
Our results indicate that HIV and elevated blood pressure are acting as separate, non-interacting epidemics affecting high proportions of the older adult population. PLWH with unsuppressed viral load were at higher mortality risk compared to those uninfected. Systolic blood pressure was a mortality risk factor independent of HIV status. As antiretroviral therapy becomes more widespread, further longitudinal follow-up is needed to understand how t…
The Meaning of Health in Rural South Africa
This article examines the meaning of health among middle-aged and older adults in a rural South African setting, where 72 percent of adults aged 40 and over are living with a major chronic condition, and 81 percent report good or very good health. We draw on a unique mixed-methods dataset that includes a population-based survey with disease biomarkers (hypertension, diabetes, HIV), self-assessments of health including self-rated health, functiona…
Making Sense of Troubled Livelihoods
When men and women cannot attain idealized gendered forms of economic provision and dependence, how do they make sense of this perceived failure? In this article, we posit that poor health narratives serve as a gendered tool to make sense of inadequate livelihoods, even when that inadequacy is attributable to structural conditions. We draw on survey and life-history interview data from middle-aged and older rural South Africans. The survey data s…
Mortality transition over a quarter century in rural South Africa
BACKGROUND: Mortality burden in South Africa since the mid-1990s has been characterized by a quadruple disease burden: HIV/AIDS and tuberculosis (TB); other communicable diseases (excluding HIV/AIDS and TB), maternal causes, perinatal conditions and nutritional deficiencies; non-communicable diseases (NCDs); and injuries. Causes from these broad groupings have persistently constituted the top 10 causes of death. However, proportions and rankings …
A Nowadays Disease
Why do some people adapt successfully to change while others do not? We examine this question in the context of a severe HIV/AIDS epidemic in South Africa, where adapting (or not) to social change has borne life and death consequences. Applying an age-period-cohort lens to the analysis of qualitative life history interviews among middle-aged and older adults, we consider the role of the life course and gendered sexuality in informing Africans' st…
Clusters of HIV Risk and Protective Sexual Behaviors in Agincourt, Rural South Africa
Cognitive function and cardiometabolic disease risk factors in rural South Africa
We provide an important baseline from rural South Africa on the associations between cardiometabolic disease risk factors and cognitive function in an older, rural South African population using standardized clinical measurements and cut-offs and widely used cognitive assessments. Future studies are needed to clarify temporal associations as well as patterns between the onset and duration of cardiometabolic conditions and cognitive function. As t…
The effects of household and community context on mortality among children under five in Sierra Leone
Sierra Leone in sub-Saharan Africa had one of the highest under-five mortality rates in the world in 2016: 114 deaths per 1000 live births. Previous studies have mainly focused on examining individual risk factors of child mortality in the country, without
Sexual behavior and HIV risk across the life course in rural South Africa
There is limited information about sexual behavior among older Africans, which is problematic given high HIV rates among older adults. We use a population-based survey among people aged 15-80+ to examine the prevalence of sexual risk and protective behaviors in the context of a severe HIV epidemic. We focus on variation across the life course, gender and HIV serostatus to compare the similarities and differences of young, middle aged, and older a…
Rural–urban variations in age at menarche, adult height, leg-length and abdominal adiposity in black South African women in transitioning South Africa
In black South African women, the earlier onset of puberty, and consequently an earlier growth cessation process, may lead to central fat mass accumulation in adulthood
How to “Live a Good Life”
We conclude with recommendations to increase HIV testing uptake among older adults including home testing, couples testing, and HIV testing concurrently with noncommunicable diseases
Confirmatory factor analysis of the Kaufman assessment battery in a sample of primary school-aged children in rural South Africa
The Kaufman Assessment Battery for Children, Second Edition, measures cognitive processing, includes non-verbal sub-tests, and is increasingly used in low- and middle-income countries. While the Kaufman Assessment Battery for Children, Second Edition, has been validated in the United States, a psychometric evaluation has not been conducted in Southern Africa. This study aims to establish the reliability and validity of the Kaufman Assessment Batt…
Progression of the epidemiological transition in a rural South African setting
This typical rural South African population is experiencing a protracted epidemiological transition. The intersection and interaction of HIV/AIDS and antiretroviral treatment, non-communicable disease risk factors and complex social and behavioral changes will impact on continued progress in reducing preventable mortality and improving health across the life course. Integrated healthcare planning and program delivery is required to improve access…
Assessing Changes in Household Socioeconomic Status in Rural South Africa, 2001-2013
Assessing Changes in Household Socioeconomic Status in Rural South Africa, 2001-2013
The Effect of Incarceration on Adult Male BMI Trajectories, USA, 1981-2006
Let's Talk about Sex, Maybe
Researchers are often skeptical of sexual behavior surveys: Respondents may lie or forget details of their intimate lives, and interviewers may exercise authority in how they capture responses. We use data from a 2010-2011 cross-sectional sexual behavior survey in rural South Africa to explore who says what to whom about their sexual lives. Results show an effect of fieldworker age across outcomes: Respondents report "safer," more "responsible" s…
The Meaning of Health in Rural South Africa
This article examines the meaning of health among middle-aged and older adults in a rural South African setting, where 72 percent of adults aged 40 and over are living with a major chronic condition, and 81 percent report good or very good health. We draw on a unique mixed-methods dataset that includes a population-based survey with disease biomarkers (hypertension, diabetes, HIV), self-assessments of health including self-rated health, functiona…
A Nowadays Disease
Why do some people adapt successfully to change while others do not? We examine this question in the context of a severe HIV/AIDS epidemic in South Africa, where adapting (or not) to social change has borne life and death consequences. Applying an age-period-cohort lens to the analysis of qualitative life history interviews among middle-aged and older adults, we consider the role of the life course and gendered sexuality in informing Africans' st…
How to “Live a Good Life”
We conclude with recommendations to increase HIV testing uptake among older adults including home testing, couples testing, and HIV testing concurrently with noncommunicable diseases
Obesity disparities among disadvantaged men
Making Sense of Troubled Livelihoods
When men and women cannot attain idealized gendered forms of economic provision and dependence, how do they make sense of this perceived failure? In this article, we posit that poor health narratives serve as a gendered tool to make sense of inadequate livelihoods, even when that inadequacy is attributable to structural conditions. We draw on survey and life-history interview data from middle-aged and older rural South Africans. The survey data s…
Unpacking the black box of latent class analysis using qualitative life history interviews
BACKGROUNDSexual behaviors are determined by present-day factors and past/future considerations.Previous work utilizing latent class analysis on a population-based cross-sectional survey of rural South Africans aged 15-plus showed how sexual behaviors cluster in distinct population subgroups (Class 1: Single with consistent protective behaviors; Class 2: Risky behaviors; Class 3: In union with lack of protective behaviors) and their associations …
Understanding Household Dynamics From the Ground Up
Investigations into household structure in low- and middle-income countries (LMICs) provide important insight into how families manage domestic life in response to resource allocation and caregiving needs during periods of rapid sociopolitical and health-related challenges. Recent evidence on household structure in many LMICs contrasts with long-standing viewpoints of worldwide convergence to a Western nuclearized household model. Here, we adopt …
Clusters of HIV Risk and Protective Sexual Behaviors in Agincourt, Rural South Africa
Smoker-free workplace policies
A marked shift in tobacco-related workplace health promotion intervention involves the adoption of policies barring employment to smokers. We discuss the potential public health consequences of these policies on those affected-smokers, their families, the surrounding community and society at large. We find a lack of published evidence evaluating the effectiveness and consequences of these policies. By developing a model of policy effects, we outl…
Use of Density-Equalizing Cartograms to Visualize Trends and Disparities in State-Specific Prevalence of Obesity
Objectives. We used cartograms to visually communicate the state-specific prevalence of obesity and its association with socioeconomic variables over time to benefit and inform decisions by national health policymakers who address geographic and social inequities in health. Methods. We generated density-equalizing maps, known as cartograms (in which geographic regions are sized in proportion to some variable), that illustrate indicators of popula…
Obesity disparities among disadvantaged men
Prevalence of HIV among those 15 and older in rural South Africa
A greater knowledge of the burden of HIV in rural areas of Southern Africa is needed, especially among older adults. We conducted a cross-sectional biomarker survey in the rural South African Agincourt Health and Socio-demographic Surveillance site in 2010-2011 and estimated HIV prevalence and risk factors. Using an age-sex stratified random sample of ages 15+, a total of 5037 (65.7%) of a possible 7662 individuals were located and 4362 (86.6%) c…
The Effect of Incarceration on Adult Male BMI Trajectories, USA, 1981-2006
Cardiometabolic disease risk and HIV status in rural South Africa
Sub-Saharan Africa is facing intersecting epidemics of HIV and hypertension. In this setting, around half the adult population require long-term care for at least one of HIV, hypertension or diabetes. Together with the adverse effects that HIV and its treatment have on lipids, this may have serious implications for the South African health care system. Monitoring of the interaction of HIV, ART use, and cardiometabolic disease is needed at both in…
Let's Talk about Sex, Maybe
Researchers are often skeptical of sexual behavior surveys: Respondents may lie or forget details of their intimate lives, and interviewers may exercise authority in how they capture responses. We use data from a 2010-2011 cross-sectional sexual behavior survey in rural South Africa to explore who says what to whom about their sexual lives. Results show an effect of fieldworker age across outcomes: Respondents report "safer," more "responsible" s…
Progression of the epidemiological transition in a rural South African setting
This typical rural South African population is experiencing a protracted epidemiological transition. The intersection and interaction of HIV/AIDS and antiretroviral treatment, non-communicable disease risk factors and complex social and behavioral changes will impact on continued progress in reducing preventable mortality and improving health across the life course. Integrated healthcare planning and program delivery is required to improve access…
Assessing Changes in Household Socioeconomic Status in Rural South Africa, 2001-2013
Sexual behavior and HIV risk across the life course in rural South Africa
There is limited information about sexual behavior among older Africans, which is problematic given high HIV rates among older adults. We use a population-based survey among people aged 15-80+ to examine the prevalence of sexual risk and protective behaviors in the context of a severe HIV epidemic. We focus on variation across the life course, gender and HIV serostatus to compare the similarities and differences of young, middle aged, and older a…
Rural–urban variations in age at menarche, adult height, leg-length and abdominal adiposity in black South African women in transitioning South Africa
In black South African women, the earlier onset of puberty, and consequently an earlier growth cessation process, may lead to central fat mass accumulation in adulthood
How to “Live a Good Life”
We conclude with recommendations to increase HIV testing uptake among older adults including home testing, couples testing, and HIV testing concurrently with noncommunicable diseases
Confirmatory factor analysis of the Kaufman assessment battery in a sample of primary school-aged children in rural South Africa
The Kaufman Assessment Battery for Children, Second Edition, measures cognitive processing, includes non-verbal sub-tests, and is increasingly used in low- and middle-income countries. While the Kaufman Assessment Battery for Children, Second Edition, has been validated in the United States, a psychometric evaluation has not been conducted in Southern Africa. This study aims to establish the reliability and validity of the Kaufman Assessment Batt…
Cognitive function and cardiometabolic disease risk factors in rural South Africa
We provide an important baseline from rural South Africa on the associations between cardiometabolic disease risk factors and cognitive function in an older, rural South African population using standardized clinical measurements and cut-offs and widely used cognitive assessments. Future studies are needed to clarify temporal associations as well as patterns between the onset and duration of cardiometabolic conditions and cognitive function. As t…
The effects of household and community context on mortality among children under five in Sierra Leone
Sierra Leone in sub-Saharan Africa had one of the highest under-five mortality rates in the world in 2016: 114 deaths per 1000 live births. Previous studies have mainly focused on examining individual risk factors of child mortality in the country, without
Clusters of HIV Risk and Protective Sexual Behaviors in Agincourt, Rural South Africa
Mortality transition over a quarter century in rural South Africa
BACKGROUND: Mortality burden in South Africa since the mid-1990s has been characterized by a quadruple disease burden: HIV/AIDS and tuberculosis (TB); other communicable diseases (excluding HIV/AIDS and TB), maternal causes, perinatal conditions and nutritional deficiencies; non-communicable diseases (NCDs); and injuries. Causes from these broad groupings have persistently constituted the top 10 causes of death. However, proportions and rankings …
A Nowadays Disease
Why do some people adapt successfully to change while others do not? We examine this question in the context of a severe HIV/AIDS epidemic in South Africa, where adapting (or not) to social change has borne life and death consequences. Applying an age-period-cohort lens to the analysis of qualitative life history interviews among middle-aged and older adults, we consider the role of the life course and gendered sexuality in informing Africans' st…
Parental imprisonment as a risk factor for cardiovascular and metabolic disease in adolescent and adult offspring
Using prospective cohort data, our results support research showing that parental imprisonment, particularly in early childhood, is associated with increased BMI, blood pressure, sedentary hours, and waist circumference in females in early adulthood. These findings implicate parental imprisonment as a risk factor for cardiometabolic health issues in later life among females
The double-edged role of accessed status on health and well-being among middle- and older-age adults in rural South Africa
Supporting social capital theory, we find that having higher accessed status is associated with better health and well-being for older adults in a setting with limited formal support resources. However, the explanatory power of both theories appears to depending on other key factors, such as gender and network size, highlighting the importance of contextualizing theories in practice
Twin epidemics
Our results indicate that HIV and elevated blood pressure are acting as separate, non-interacting epidemics affecting high proportions of the older adult population. PLWH with unsuppressed viral load were at higher mortality risk compared to those uninfected. Systolic blood pressure was a mortality risk factor independent of HIV status. As antiretroviral therapy becomes more widespread, further longitudinal follow-up is needed to understand how t…
The Meaning of Health in Rural South Africa
This article examines the meaning of health among middle-aged and older adults in a rural South African setting, where 72 percent of adults aged 40 and over are living with a major chronic condition, and 81 percent report good or very good health. We draw on a unique mixed-methods dataset that includes a population-based survey with disease biomarkers (hypertension, diabetes, HIV), self-assessments of health including self-rated health, functiona…
Making Sense of Troubled Livelihoods
When men and women cannot attain idealized gendered forms of economic provision and dependence, how do they make sense of this perceived failure? In this article, we posit that poor health narratives serve as a gendered tool to make sense of inadequate livelihoods, even when that inadequacy is attributable to structural conditions. We draw on survey and life-history interview data from middle-aged and older rural South Africans. The survey data s…
Parental imprisonment, delinquent behavior, and BMI gain in a U.S. nationally representative cohort study of adolescents and adults ages 12-32
Children who experience parental imprisonment report greater mental and physical health adversities in adolescence and adulthood relative to comparable individuals whose parents did not serve time in prison. Research has linked BMI gain with parental imprisonment among females, but other studies have shown null or negative associations between parental imprisonment and weight increases for their offspring. Using longitudinal data from the Nationa…
Care arrangements of older persons in rural Indonesia
This study explores the provision of care for older persons in rural areas of ageing Indonesia. Using data from Ageing in Rural Indonesian Study, we examine who needs care, who provides care, and how care operates across socio-demographic settings. We found that one contributing factor to gender inequality in old age is the disproportionate amount of unpaid care that older women provide to their families. Older women are often both care recipient…
Medicine (25 works) · Demography (19 works) · Population (18 works) · Psychology (16 works) · Environmental health (15 works) · Gerontology (15 works) · Geography (14 works) · Sociology (13 works) · Public health (12 works) · HIV/AIDS Research and Interventions (10 works)