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
new school for social research 在 浩爾譯世界 Facebook 的最佳貼文
週五早晨,大家早,今天來讀 #華爾街日報
求職時穿戴奢侈品,是助攻還是敗筆?
When Job Applicants Should—and Shouldn’t—Wear Luxury Brands
📑People who wear luxury brands are judged as having higher status, but less warmth and kindness, new research shows.
最新研究顯示,人們認為穿著奢侈品牌服裝的人社會地位較高,但熱情和友善度較低。因此,在面試不同崗位時,穿戴奢侈品的功效會大相徑庭。
🤔Let’s say you’re hiring a publicist for your new nightclub. One candidate carries a Louis Vuitton handbag; another, an unidentifiable bag. You might feel the candidate with the luxury-brand bag is better connected and more able to promote the business.
假設你要為自家新開的夜店招聘一名宣傳公關。一位應聘者拿著路易威登(Louis Vuitton)手袋,另一位應聘者的背包看不出品牌。你可能會覺得背奢侈品牌包的應聘者,更適合這個崗位、更有能力推進業務發展。
Now imagine you’re interviewing kindergarten teachers for your school. Which candidate will better care for youngsters?
現在再想像一下,你要為一所學校面試幼兒園老師,哪個應聘者看起來更會照顧孩子呢?
🛍A large body of research has shown that luxury brands convey wealth, high social standing and power. Status is a central core of luxury-goods marketing. But two researchers at Northwestern University’s Kellogg School of Management recently asked if wearing luxury brands can ever backfire. That is, might there be a social cost to flashing a Gucci or Burberry logo?
大量研究表明,奢侈品牌代表財富、權力和較高的社會地位。身份地位是精品行銷的核心。不過,西北大學凱洛格商學院的兩位研究人員最近卻提出了一個問題:奢侈品牌是否會產生反效果。也就是說,亮出Gucci或Burberry的標誌會有社會成本嗎?
👠“The brands we choose to adorn ourselves with signal rank,” says Derek Rucker, a Kellogg marketing professor. However, high status isn’t desirable for every job. “There’s a dark side,” he says. “You have to ask, what am I wearing and in front of whom?”
「我們選擇品牌來妝點自身,展示地位。」凱洛格商學院的市場營銷學教授魯克說。然而,未必所有工作都需要較高的社會地位。「它也會有負面影響,」他說,「你一定要問問自己,我穿的是什麼,面對的是誰?」
要怎麼決定要不要穿戴奢侈品?
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⛔ LUYỆN READING NÀO ⛔
THE IMPORTANCE OF CHILDREN'S PLAY
Brick by brick, six-year-old Alice is building a magical kingdom. Imagining fairy-tale turrets and fire-breathing dragons, wicked witches and gallant heroes, she's creating an enchanting world. Although she isn't aware of it, this fantasy is helping her take her first steps towards her capacity for creativity and so it will have important repercussions in her adult life.
Minutes later, Alice has abandoned the kingdom in favour of playing schools with her younger brother. When she bosses him around as his 'teacher', she's practising how to regulate her emotions through pretence. Later on, when they tire of this and settle down with a board game, she's learning about the need to follow rules and take turns with a partner.
'Play in all its rich variety is one of the highest achievements of the human species,' says Dr David Whitebread from the Faculty of Education at the University of Cambridge, UK. 'It underpins how we develop as intellectual, problem-solving adults and is crucial to our success as a highly adaptable species.'
Recognising the importance of play is not new: over two millennia ago, the Greek philosopher Plato extolled its virtues as a means of developing skills for adult life, and ideas about play-based learning have been developing since the 19th century.
But we live in changing times, and Whitebread is mindful of a worldwide decline in play, pointing out that over half the people in the world now live in cities. 'The opportunities for free play, which I experienced almost every day of my childhood, are becoming increasingly scarce,' he says. Outdoor play is curtailed by perceptions of risk to do with traffic, as well as parents' increased wish to protect their children from being the victims of crime, and by the emphasis on 'earlier is better' which is leading to greater competition in academic learning and schools.
International bodies like the United Nations and the European Union have begun to develop policies concerned with children's right to play, and to consider implications for leisure facilities and educational programmes. But what they often lack is the evidence to base policies on.
'The type of play we are interested in is child-initiated, spontaneous and unpredictable- but, as soon as you ask a five-year-old "to play", then you as the researcher have intervened,' explains Dr Sara Baker. 'And we want to know what the long-term impact of play is. It's a real challenge.'
Dr Jenny Gibson agrees, pointing out that although some of the steps in the puzzle of how and why play is important have been looked at, there is very little data on the impact it has on the child's later life.
Now, thanks to the university's new Centre for Research on Play in Education, Development and Learning (PEDAL), Whitebread, Baker, Gibson and a team of researchers hope to provide evidence on the role played by play in how a child develops.
'A strong possibility is that play supports the early development of children's self-control,' explains Baker. 'This is our ability to develop awareness of our own thinking processes - it influences how effectively we go about undertaking challenging activities.'
In a study carried out by Baker with toddlers and young pre-schoolers, she found that children with greater self-control solved problems more quickly when exploring an unfamiliar set-up requiring scientific reasoning. 'This sort of evidence makes us think that giving children the chance to play will make them more successful problem-solvers in the long run.'
If playful experiences do facilitate this aspect of development, say the researchers, it could be extremely significant for educational practices, because the ability to self-regulate has been shown to be a key predictor of academic performance.
Gibson adds: 'Playful behaviour is also an important indicator of healthy social and emotional development. In my previous research, I investigated how observing children at play can�give us important clues about their well-being and can even be useful in the diagnosis of neurodevelopmental disorders like autism.'
Whitebread's recent research has involved developing a play-based approach to supporting children's writing. 'Many primary school children find writing difficult, but we showed in a previous study that a playful stimulus was far more effective than an instructional one.' Children wrote longer and better-structured stories when they first played with dolls representing characters in the story. In the latest study, children first created their story with Lego*, with similar results. 'Many teachers commented that they had always previously had children saying they didn't know what to write about. With the Lego building, however, not a single child said this through the whole year of the project.'
Whitebread, who directs PEDAL, trained as a primary school teacher in the early 1970s, when, as he describes, 'the teaching of young children was largely a quiet backwater, untroubled by any serious intellectual debate or controversy.' Now, the landscape is very different, with hotly debated topics such as school starting age.
'Somehow the importance of play has been lost in recent decades. It's regarded as something trivial, or even as something negative that contrasts with "work". Let's not lose sight of its benefits, and the fundamental contributions it makes to human achievements in the arts, sciences and technology. Let's make sure children have a rich diet of play experiences.'
⛔ CÂU HỎI:
Do the following statements agree with the information given in Reading Passage 1?
In boxes 9-13 on your answer sheet, write
TRUE if the statement agrees with the information
FALSE if the statement contradicts the information
NOT GIVEN if there is no information on this
1. Children with good self-control are known to be likely to do well at school later on.
2. The way a child plays may provide information about possible medical problems.
3. Playing with dolls was found to benefit girls’ writing more than boys’ writing.
4. Children had problems thinking up ideas when they first created the story with Lego.
5. People nowadays regard children’s play as less significant than they did in the past.
(Trích Cam 14)
⛔ HIGHLIGHT TỪ VỰNG
Possibility (n): Khả năng
Self-control (n): Tự kiểm soát
Toddler (n): Trẻ mới biết đi
Pre-schooler (n): Trẻ nhỏ tuổi
Unfamiliar (adj): Không quen thuộc
Facilitate (v): Tạo điều kiện cho
Diagnosis (n): Chẩn đoán
Autism (n): Tự kỷ
Approach (n): Phương pháp
Stimulus (n): Sự kích thích
Serious (adj): Nghiêm túc
Debate (v): Tranh luận
Trivial (adj): Tầm thường
Fundamental (adj): Cơ bản
Contribution (n): Sự đóng góp
Các bạn làm đề nhé, cô chia sẻ đáp án dưới cmt nha!