今早為Asian Medical Students Association Hong Kong (AMSAHK)的新一屆執行委員會就職典禮作致詞分享嘉賓,題目為「疫情中的健康不公平」。
感謝他們的熱情款待以及為整段致詞拍了影片。以下我附上致詞的英文原稿:
It's been my honor to be invited to give the closing remarks for the Inauguration Ceremony for the incoming executive committee of the Asian Medical Students' Association Hong Kong (AMSAHK) this morning. A video has been taken for the remarks I made regarding health inequalities during the COVID-19 pandemic (big thanks to the student who withstood the soreness of her arm for holding the camera up for 15 minutes straight), and here's the transcript of the main body of the speech that goes with this video:
//The coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, continues to be rampant around the world since early 2020, resulting in more than 55 million cases and 1.3 million deaths worldwide as of today. (So no! It’s not a hoax for those conspiracy theorists out there!) A higher rate of incidence and deaths, as well as worse health-related quality of life have been widely observed in the socially disadvantaged groups, including people of lower socioeconomic position, older persons, migrants, ethnic minority and communities of color, etc. While epidemiologists and scientists around the world are dedicated in gathering scientific evidence on the specific causes and determinants of the health inequalities observed in different countries and regions, we can apply the Social Determinants of Health Conceptual Framework developed by the World Health Organization team led by the eminent Prof Sir Michael Marmot, world’s leading social epidemiologist, to understand and delineate these social determinants of health inequalities related to the COVID-19 pandemic.
According to this framework, social determinants of health can be largely categorized into two types – 1) the lower stream, intermediary determinants, and 2) the upper stream, structural and macro-environmental determinants. For the COVID-19 pandemic, we realized that the lower stream factors may include material circumstances, such as people’s living and working conditions. For instance, the nature of the occupations of these people of lower socioeconomic position tends to require them to travel outside to work, i.e., they cannot work from home, which is a luxury for people who can afford to do it. This lack of choice in the location of occupation may expose them to greater risk of infection through more transportation and interactions with strangers. We have also seen infection clusters among crowded places like elderly homes, public housing estates, and boarding houses for foreign domestic helpers. Moreover, these socially disadvantaged people tend to have lower financial and social capital – it can be observed that they were more likely to be deprived of personal protective equipment like face masks and hand sanitizers, especially during the earlier days of the pandemic. On the other hand, the upper stream, structural determinants of health may include policies related to public health, education, macroeconomics, social protection and welfare, as well as our governance… and last, but not least, our culture and values. If the socioeconomic and political contexts are not favorable to the socially disadvantaged, their health and well-being will be disproportionately affected by the pandemic. Therefore, if we, as a society, espouse to address and reduce the problem of health inequalities, social determinants of health cannot be overlooked in devising and designing any public health-related strategies, measures and policies.
Although a higher rate of incidence and deaths have been widely observed in the socially disadvantaged groups, especially in countries with severe COVID-19 outbreaks, this phenomenon seems to be less discussed and less covered by media in Hong Kong, where the disease incidence is relatively low when compared with other countries around the world. Before the resurgence of local cases in early July, local spread of COVID-19 was sporadic and most cases were imported. In the earlier days of the pandemic, most cases were primarily imported by travelers and return-students studying overseas, leading to a minor surge between mid-March and mid-April of 874 new cases. Most of these cases during Spring were people who could afford to travel and study abroad, and thus tended to be more well-off. Therefore, some would say the expected social gradient in health impact did not seem to exist in Hong Kong, but may I remind you that, it is only the case when we focus on COVID-19-specific incidence and mortality alone. But can we really deduce from this that COVID-19-related health inequality does not exist in Hong Kong? According to the Social Determinants of Health Framework mentioned earlier, the obvious answer is “No, of course not.” And here’s why…
In addition to the direct disease burden, the COVID-19 outbreak and its associated containment measures (such as economic lockdown, mandatory social distancing, and change of work arrangements) could have unequal wider socioeconomic impacts on the general population, especially in regions with pervasive existing social inequalities. Given the limited resources and capacity of the socioeconomically disadvantaged to respond to emergency and adverse events, their general health and well-being are likely to be unduly and inordinately affected by the abrupt changes in their daily economic and social conditions, like job loss and insecurity, brought about by the COVID-19 outbreak and the corresponding containment and mitigation measures of which the main purpose was supposedly disease prevention and health protection at the first place. As such, focusing only on COVID-19 incidence or mortality as the outcomes of concern to address health inequalities may leave out important aspects of life that contributes significantly to people’s health. Recently, my research team and I collaborated with Sir Michael Marmot in a Hong Kong study, and found that the poor people in Hong Kong fared worse in every aspects of life than their richer counterparts in terms of economic activity, personal protective equipment, personal hygiene practice, as well as well-being and health after the COVID-19 outbreak. We also found that part of the observed health inequality can be attributed to the pandemic and its related containment measures via people’s concerns over their own and their families’ livelihood and economic activity. In other words, health inequalities were contributed by the pandemic even in a city where incidence is relatively low through other social determinants of health that directly concerned the livelihood and economic activity of the people. So in this study, we confirmed that focusing only on the incident and death cases as the outcomes of concern to address health inequalities is like a story half-told, and would severely truncate and distort the reality.
Truth be told, health inequality does not only appear after the pandemic outbreak of COVID-19, it is a pre-existing condition in countries and regions around the world, including Hong Kong. My research over the years have consistently shown that people in lower socioeconomic position tend to have worse physical and mental health status. Nevertheless, precisely because health inequality is nothing new, there are always voices in our society trying to dismiss the problem, arguing that it is only natural to have wealth inequality in any capitalistic society. However, in reckoning with health inequalities, we need to go beyond just figuring out the disparities or differences in health status between the poor and the rich, and we need to raise an ethically relevant question: are these inequalities, disparities and differences remediable? Can they be fixed? Can we do something about them? If they are remediable, and we can do something about them but we haven’t, then we’d say these inequalities are ultimately unjust and unfair. In other words, a society that prides itself in pursuing justice must, and I say must, strive to address and reduce these unfair health inequalities. Borrowing the words from famed sociologist Judith Butler, “the virus alone does not discriminate,” but “social and economic inequality will make sure that it does.” With COVID-19, we learn that it is not only the individuals who are sick, but our society. And it’s time we do something about it.
Thank you very much!//
Please join me in congratulating the incoming executive committee of AMSAHK and giving them the best wishes for their future endeavor!
Roger Chung, PhD
Assistant Professor, CUHK JC School of Public Health and Primary Care, @CUHK Medicine, The Chinese University of Hong Kong 香港中文大學 - CUHK
Associate Director, CUHK Institute of Health Equity
同時也有10000部Youtube影片,追蹤數超過2,910的網紅コバにゃんチャンネル,也在其Youtube影片中提到,...
natural factors中文 在 Mrs.Mihuhu 九尾殿 Facebook 的最讚貼文
the ordinary的最愛,
膚質是敏感乾肌夏天都會脫皮的那種乾;
對於酒精、香精都會過敏起小疹子發癢等等。
他們家我從還沒爆紅前就有在做功課跟使用,
也改善了很多原本皮膚上的小問題,這些是我喜歡的以及會再回購的品項。
以下介紹我會把中文英文品名整理出來,方便讓大找產品做比對,跟一些質地的介紹。
看完真的在不懂可以再問我
保濕類:
🎊Hyaluronic Acid2%+B5(玻尿酸+B5):
質地:比較水狀
基本上就是保濕,非常萬用的一瓶可以取代化妝水也可以用完化妝水後上全臉!我偶爾會調和比較液態的粉底液讓底妝更保濕!
🎊Natural Moisturizing Factors(天然保濕因子):
質地:半固態乳霜狀(非常難擠)
可當作整個保養的最後步驟,他擠出來質地蠻噁心但是一上臉就會完全化開很變得很舒服,乾肌會覺得有點不夠力,適合夏天。
🎊100%Plant-Derived Squalane(植物萃取角鯊):
質地:油狀
保養的最後步驟,角鯊脘是人體會自生的一種油脂,所以非常親膚好吸收,有些人會覺皮膚很乾又一直出油那可能是皮膚油水不平衡造成的,所以真的可以試試用保養油,真的會改善!
可以滴3~4滴搓熱用按壓的方式上臉。
抗老類:
🎊EUK134 0.1%(無水高效抗氧化精華):
質地:油狀
酸性的抗老化精華,記得晚上使用然後隔天一定要防曬!因為無水的關係所以蠻接近油狀,非常好吸收,我會晚上搭配buffet一起使用。
🎊Buffet(多重技術胜肽精華):
質地:很稠的精華
上完化妝水使用,質地非常黏稠但是好吸收,這是復合型的胜肽配方,我很喜歡拿來妝前使用可以減少一些化妝的自由基傷害。
🎊Argireline Solution 10%(六胜肽精華):
質地:水狀
六胜肽只要是針對動態紋路(ex:魚尾紋、抬頭紋、法令紋、頸紋)我會用buffet上完全臉後局部使用加強,也可以滴入眼霜混合上眼用☺️
🎊Granactive Retinoid 2% Emulsion(活性維他命A):
質地:乳液狀
也就是所謂的A酸是除皺抗老最好的維他命,缺乏皮復會乾燥蠟黃容易脫皮,我剛開始使用會長超大的暗瘡之後爬文很多人有這個現象,持續使用兩週後就沒再漲了,膚質也越來越有光澤脫皮也改善很多!
🎊100%cold-pressed virigin Marula (馬魯拉油)
質地:油狀
很多人對馬魯拉果油很陌生,但他其實在歐美已經紅一陣子了還被稱為「奢華之油」是目前抗氧化劑含量最高的還富有青花素、兒茶素、類黃酮等對於保濕恢復光澤有很好的效果。
我真的覺得這罐非常必買,因為其他品牌出的單價都非常高,他比角鯊更值得入手我個人覺得
酸類:
🎊Salicyliic Acid 2% (水楊酸):
質地:微稠水狀
針對痘痘肌可以加速代謝痘痘,還有溫和去角質的減少粉刺生痘痘生成的功效,我喜歡上完玻尿在擦比較不刺激。
註:記得晚上使用隔天要加強防曬!
🎊Lacitic Acid 10%+HA 2%(乳酸10%):
質地:微稠水狀
如果沒大痘痘的可以選這瓶,他也是加速皮膚代謝溫和去角質,長期使用可以減少粉刺生成比水楊酸刺激一點他有5%的可以做選擇。一樣可以上完玻尿在上減少刺激。
註:記得晚上使用隔天要加強防曬!
🎊Azelaic Acid Suspension10%(杜鵑花or仁王酸)
質地:乳霜狀
因為含矽脂,上完後有霧面皮膚的效果!如果上完油類不喜歡油油的感覺可以再上這罐就不會油膩,杜鵑花酸可以淡化痘疤改善膚色不均,可以局部使用,我自己熱愛上全臉😂😂
註:日夜皆可使用要加強防曬!
🎊AHA30%+BHA30%(去角質型面膜):
質地:黏稠精華狀
如果非常非常怕刺痛真的不建議購入,我自己是敏感肌用完洗掉是沒什麼紅腫發癢的症狀,他是比較高濃度酸類面膜敷上去10分鐘要馬上洗掉不然會過度侵蝕唷!但是敷完皮膚會超亮保養品都超好吸收。
註:記得晚上使用隔天要加強防曬!
美白:
🎊Ascorbyl Tetraisopalmitate solution 20% in Vitamin F(脂溶性維他命C+F精華液):
質地:油狀
他質地是油狀的維他命c,目前剛入手沒多久會回購的原因是因為去小琉球玩黑了兩階,認真的使用它後,膚色有恢復到原本的膚色😂😂😂
我沒有其他美白產品,就只使用它
彩妝跟其他:
🎊Niacinamide 10%+zinc(菸鹼胺+鋅):
質地:水狀微黏
針對閉鎖性粉刺痘痘有很好的功效,我配合著酸類讓我的粉刺幾乎消失完全不太需要妙鼻貼這種東西了!也機乎不用去做臉😂😂😂
🎊High-spreadaability Fluid Primer(保濕妝前液):
質地:稠水狀
我冬天超愛用他,根本超越我原本熱愛的專櫃妝前乳!一整天都超保濕,我只要有化妝妝前不夠保濕下午會開始脫皮尤其冬天,這個完全解救了我這個狀態😂😂
🎊High-adherence silicone primer(含矽妝前乳):
質地:乳霜狀
我會跟另一款交替使用,這款其實比較主推油肌,但是因為他上完有一層霧面感,有點像毛孔隱形霜的效果超霧面😍所以我超愛的!
#mihuhumakeup