City Life at Shutter Speed

A boy chews tobacco in Delhi. An open dumping area spoils a Shanghai neighborhood. In Baltimore, an overweight adolescent girl smokes a cigarette.

The striking images are the work of young people who took on an assignment to photograph images of health—good and bad—in the cities that they call home.

Researchers from the Bloomberg School will use the more than 10,000 pictures snapped by approximately 60 teens in six study sites—Baltimore; Delhi; Ibadan, Nigeria; Johannesburg; Shanghai; and Rio de Janeiro—to gain insights into the lives and health of disadvantaged adolescents as part of the Well-Being of Adolescents in Vulnerable Environments (WAVE) study.

Led by the School’s Center for Adolescent Health and the University’s Urban Health Institute, the research is funded by AstraZeneca’s Young Health Programme.

Photovoice, a component of the WAVE study, uses “participatory photography” to give marginalized communities the opportunity to tell their stories through pictures.

“It gives them a different way to express themselves versus us sitting and asking them questions about health issues,” says Beth Marshall, DrPH ’10, MPH, assistant director of the Center for Adolescent Health.

Marshall spent four days last July in East Baltimore with 11 teens taking photos with digital cameras provided by the study. The youths first met with a photojournalist who gave them a crash course in photography basics. And before the kids trained their cameras on the neighborhood, study investigators posed some general questions about health. What do health and well-being look like? What are threats to it? How do young people stay healthy?

After each photo session, the group reviewed the day’s pictures on a laptop and discussed the images. The teens wrote captions for the pictures they selected for inclusion in the study, Marshall says.

In the analysis phase of the project, researchers will review the photos and code the captions and discussions to identify themes. The next step is to develop questions based on the collected data to survey approximately 2,400 adolescents—400 from each study site—on their health needs. The answers will help design more effective health interventions for young people in vulnerable environments.

“So many conceptual frameworks start with identifying a need, making the assumption that we know about young people and their health needs,” Marshall says. “We have to understand how they see health before putting an intervention in place.”

Lashira Darby, 18, who took pictures of the Baltimore neighborhood where she’s lived her entire life, says that she came away from the project with basic photography skills and a broader understanding of what health means.

“The best thing was learning how to use the camera better,” says Darby. “It also taught us to help the neighborhood. We have to set an example for the younger kids and not smoke and drink but do positive things.”