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,...
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natural medicine中文 在 Q老師的營養教室-張佩蓉營養師 Facebook 的精選貼文
非常非常同意趙強營養師說的!
每次看到這類型的新聞都會很難過.....
這邊Q老師ㄧ說再說
不要再聽隔壁鄰居或朋友的朋友說了啦!
有病趕快去醫院就診,及早治療才不會耽誤黃金就醫時間
用正規醫學好好做治療;要聽醫生、營養師的話!
#醫生營養師在說你有沒有在聽
#誤信偏方
唉...... 這種 #誤信偏方 的例子,似乎從未中斷......
對於癌症治療,目前並沒有哪種食物、植物、草藥、或是飲食模式可以根治癌症!
不論是地瓜、靈芝、牛樟芝、生酮飲食......都不能治癒癌症!
幾年前以《無毒一身輕》一書而聲名大噪的林光常,後來因為癌症病人誤信他的言論而延誤治療,以致死亡!
後來,林光常先生也因而被判刑入獄。
其實,不只是台灣人愛找偏方!美國人也很愛!
根據美國國家輔助與整體健康中心(National Center for Complementary and Integrative Health, NCCIH)的資料,在美國,30%的成人與12%的兒童會使用非主流的健康照顧方式來維持健康。
各式各樣的方法都有:
天然產品(Natural products): 17.7 %
深呼吸(Deep breathing): 10.9 %
瑜伽,太極或氣功(Yoga, tai chi, or qi gong): 10.1 %
按摩治療或整骨治療(Chiropractic or osteopathic manipulation): 8.4 %
冥想(Meditation): 8.0 %
按摩(Massage): 6.9 %
特殊飲食(Special diets): 3.0 %
順勢療法(Homeopathy): 2.2 %
逐步放鬆(Progressive relaxation): 2.1 %
圖像導引Guided imagery): 1.7 %
[以上中文是趙強自己翻譯的,若想查資料,請以英文查詢]
資料來源:https://nccih.nih.gov/health/integrative-health
還有,一定要記得:
目前美國衛生機構(NIH)~國家輔助與整體健康中心(National Center for Complementary and Integrative Health, NCCIH)的名稱,
已經不再是
國家輔助與替代醫學中心(National Center for Complementary and Alternative Medicine, NCCAM)了!
因為~~~
替代療法(Alternative Medicine)問題太多了!
尤其是會造成 #延誤治療 問題!
所以,美國NIH將過去的NCCAM修正為NCCIH。
強調這些非主流療法,應該與 #主流治療方式 "一起(together)" 實施,而非 "替代"主流治療方式。
如果還有人在講述輔助治療時,說資料來自"NCCAM",就表示他的資料 #沒有更新 喔!
natural medicine中文 在 趙強營養師這樣說 Facebook 的最讚貼文
唉...... 這種 #誤信偏方 的例子,似乎從未中斷......
對於癌症治療,目前並沒有哪種食物、植物、草藥、或是飲食模式可以根治癌症!
不論是地瓜、靈芝、牛樟芝、生酮飲食......都不能治癒癌症!
幾年前以《無毒一身輕》一書而聲名大噪的林光常,後來因為癌症病人誤信他的言論而延誤治療,以致死亡!
後來,林光常先生也因而被判刑入獄。
其實,不只是台灣人愛找偏方!美國人也很愛!
根據美國國家輔助與整體健康中心(National Center for Complementary and Integrative Health, NCCIH)的資料,在美國,30%的成人與12%的兒童會使用非主流的健康照顧方式來維持健康。
各式各樣的方法都有:
天然產品(Natural products): 17.7 %
深呼吸(Deep breathing): 10.9 %
瑜伽,太極或氣功(Yoga, tai chi, or qi gong): 10.1 %
按摩治療或整骨治療(Chiropractic or osteopathic manipulation): 8.4 %
冥想(Meditation): 8.0 %
按摩(Massage): 6.9 %
特殊飲食(Special diets): 3.0 %
順勢療法(Homeopathy): 2.2 %
逐步放鬆(Progressive relaxation): 2.1 %
圖像導引Guided imagery): 1.7 %
[以上中文是趙強自己翻譯的,若想查資料,請以英文查詢]
資料來源:https://nccih.nih.gov/health/integrative-health
還有,一定要記得:
目前美國衛生機構(NIH)~國家輔助與整體健康中心(National Center for Complementary and Integrative Health, NCCIH)的名稱,
已經不再是
國家輔助與替代醫學中心(National Center for Complementary and Alternative Medicine, NCCAM)了!
因為~~~
替代療法(Alternative Medicine)問題太多了!
尤其是會造成 #延誤治療 問題!
所以,美國NIH將過去的NCCAM修正為NCCIH。
強調這些非主流療法,應該與 #主流治療方式 "一起(together)" 實施,而非 "替代"主流治療方式。
如果還有人在講述輔助治療時,說資料來自"NCCAM",就表示他的資料 #沒有更新 喔!
natural medicine中文 在 holistic view中文、Holistic synonym在PTT/mobile01評價與討論 的推薦與評價
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natural medicine中文 在 herbal medicine中文2022-在Facebook/IG/Youtube上的焦點 ... 的推薦與評價
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natural medicine中文 在 holistic view中文、Holistic synonym在PTT/mobile01評價與討論 的推薦與評價
holistic medicine中文 在PTT/mobile01評價與討論, 提供holistic view中文、Holistic synonym、holistic doctor中文就來台鐵車站資訊懶人包,有最完整holistic medicine ... ... <看更多>