8 : Everyday Life In Poor Health
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In 2019, 280 million people were living with depression, including 23 million children and adolescents (1). Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. During a depressive\\r\\n episode, the person experiences depressed mood (feeling sad, irritable, empty) or a loss of pleasure or interest in activities, for most of the day, nearly every day, for at least two weeks. Several other symptoms are also present, which may include\\r\\n poor concentration, feelings of excessive guilt or low self-worth, hopelessness about the future, thoughts about dying or suicide, disrupted sleep, changes in appetite or weight, and feeling especially tired or low in energy. People with depression\\r\\n are at an increased risk of suicide. Yet, effective psychological treatment exists, and depending on the age and severity, medication may also be considered.
Neurodevelopmental disorders include disorders of intellectual development, autism spectrum disorder, and attention deficit hyperactivity disorder (ADHD) amongst others. ADHD is characterised by a persistent pattern of inattention and/or hyperactivity-impulsivity\\r\\n that has a direct negative impact on academic, occupational, or social functioning. Disorders of intellectual development are characterised by significant limitations in intellectual functioning and adaptive behaviour, which refers to difficulties\\r\\n with everyday conceptual, social, and practical skills that are performed in daily life. Autism spectrum disorder (ASD) constitutes a diverse group of conditions characterised by some degree of difficulty with social communication\\r\\n and reciprocal social interaction, as well as persistent restricted, repetitive, and inflexible patterns of behaviour, interests, or activities.
Health systems have not yet adequately responded to the needs of people with mental disorders and are significantly under resourced. The gap between the need for treatment and its provision is wide all over the world; and is often poor in quality\\r\\n when delivered. For example, only 29% of people with psychosis (5) and only one third of people with depression receive formal mental health care (6).
WHO's Mental Health Gap Action Programme (mhGAP) uses evidence-based technical guidance, tools and training packages to expand services in countries, especially in resource-poor settings. It focuses on a prioritized set of conditions, directing capacity\\r\\n building towards non-specialized health-care providers in an integrated approach that promotes mental health at all levels of care. The WHO mhGAP Intervention Guide 2.0 is part of this Programme, and provides guidance for doctors, nurses, and\\r\\n other health workers in non-specialist health settings on assessment and management of mental disorders.
In 2019, 280 million people were living with depression, including 23 million children and adolescents (1). Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. During a depressiveepisode, the person experiences depressed mood (feeling sad, irritable, empty) or a loss of pleasure or interest in activities, for most of the day, nearly every day, for at least two weeks. Several other symptoms are also present, which may includepoor concentration, feelings of excessive guilt or low self-worth, hopelessness about the future, thoughts about dying or suicide, disrupted sleep, changes in appetite or weight, and feeling especially tired or low in energy. People with depressionare at an increased risk of suicide. Yet, effective psychological treatment exists, and depending on the age and severity, medication may also be considered.
Neurodevelopmental disorders include disorders of intellectual development, autism spectrum disorder, and attention deficit hyperactivity disorder (ADHD) amongst others. ADHD is characterised by a persistent pattern of inattention and/or hyperactivity-impulsivitythat has a direct negative impact on academic, occupational, or social functioning. Disorders of intellectual development are characterised by significant limitations in intellectual functioning and adaptive behaviour, which refers to difficultieswith everyday conceptual, social, and practical skills that are performed in daily life. Autism spectrum disorder (ASD) constitutes a diverse group of conditions characterised by some degree of difficulty with social communicationand reciprocal social interaction, as well as persistent restricted, repetitive, and inflexible patterns of behaviour, interests, or activities.
Health systems have not yet adequately responded to the needs of people with mental disorders and are significantly under resourced. The gap between the need for treatment and its provision is wide all over the world; and is often poor in qualitywhen delivered. For example, only 29% of people with psychosis (5) and only one third of people with depression receive formal mental health care (6).
WHO's Mental Health Gap Action Programme (mhGAP) uses evidence-based technical guidance, tools and training packages to expand services in countries, especially in resource-poor settings. It focuses on a prioritized set of conditions, directing capacitybuilding towards non-specialized health-care providers in an integrated approach that promotes mental health at all levels of care. The WHO mhGAP Intervention Guide 2.0 is part of this Programme, and provides guidance for doctors, nurses, andother health workers in non-specialist health settings on assessment and management of mental disorders.
Of course, survey data like these cannot prove that believing certain actions are obligatory for Christians actually causes Christians to behave in particular ways. The causal arrow could point in the other direction: It may be easier for those who regularly engage in particular behaviors to cite those behaviors as essential to their faith. Conversely, it may be harder for those who do not regularly engage in particular activities (such as helping the poor) to describe those activities as essential to their faith. Nevertheless, the survey data suggest that Christians are more likely to live healthy lives, work on behalf of the poor and behave in environmentally conscious ways if they consider these things essential to what it means to be a Christian.
For kids, getting the recommended amount of sleep on a regular basis is linked with better health, including improved attention, behavior, learning, memory, the ability to control emotions, quality of life, and mental and physical health.
For adults, getting less than seven hours of sleep a night on a regular basis has been linked with poor health, including weight gain, having a body mass index of 30 or higher, diabetes, high blood pressure, heart disease, stroke, and depression.
A report from the Institute of Medicine indicates that nearly half of the American adult population may have difficulties in acting on health information [8]. This finding has been referred to as the \"health literacy epidemic\" [9]. In response, measures have been taken to ensure better health communication through establishing health literacy guidelines [10], and a trans-disciplinary approach has been encouraged to improve health literacy [11]. To support this approach, the American Medical Association recommends four areas for research: health literacy screening; improving communication with low-literacy patients; costs and outcomes of poor health literacy; and causal pathways of how poor health literacy influences health [12, 13]. The research literature on health literacy has expanded exponentially, with nearly 5,000 PubMed-listed publications to date (Primo November 2011), the majority of which have been published since 2005 [5, 14] and is evident that health literacy is being explored within different disciplines and with different approaches, e.g. looking at the role of health educators in promoting health literacy [15]; public health literacy for lawyers [16], health communication [17], the prevalence of limited health literacy [18], and health literacy as an empowerment tool for low-income mothers [19].
However, with the proliferation of health literacy research and policy measures, it becomes clear that there is no unanimously accepted definition of the concept. Moreover, the constituent dimensions of health literacy remain disputed, and attempts to operationalize the concept vary widely in scope, method and quality. As a result, it is very difficult to compare findings with regard to health literacy emerging from research in different countries.
Health literacy is linked to literacy and entails people's knowledge, motivation and competences to access, understand, appraise, and apply health information in order to make judgments and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve quality of life during the life course.
Proponents of the population health literacy view, on the other hand, extend the concept to include dimensions which go beyond individual competences and the medical context. The prototypical model is that of Nutbeam [36], which distinguishes between three typologies of health literacy: (1) Functional health literacy refers to the basic skills in reading and writing that are necessary to function effectively in everyday situations, broadly comparable with the content of \"medical\" health literacy referred to above; (2) Interactive health literacy refers to more advanced cognitive and literacy skills which, together with social skills, can be used to actively participate in everyday situations, extract information and derive meaning from different forms of communication, and apply this to changing circumstance; and (3) Critical health literacy refers to more advanced cognitive skills which, together with social skills, can be applied to critically analyze information and use this to exert greater control over life events and situations. The different typologies represent levels of knowledge and skills that progressively support greater autonomy and personal empowerment in health related decision-making, as well as engagement with a wider range of health knowledge that extends from personal health management to the social determinants of health [52]. Manganello [50] adds media literacy as the ability to critically evaluate media messages. Zarcadoolas et al. [38] distinguish between fundamental literacy (skills and strategies involved in reading, speaking, writing and interpreting numbers); science literacy (the levels of competence with science and technology); civic literacy (abilities that enable citizens to become aware of public issues and become involved in the decision-making process); and cultural literacy (the ability to recognize and use collective beliefs, customs, world-view and social identity in order to interpret and act on health information). In a similar vein, Freedman et al. [35] identify three dimensions of public health literacy, each of which involves corresponding competences: (1) Conceptual foundations includes the basic knowledge and information needed to understand and take action on public health concerns; individuals and groups should be able to discuss core public health concepts, public health constructs and ecologic perspectives. (2) Critical skills relates to the skills necessary to obtain, process, evaluate, and act upon information that is needed to make public health decisions that benefit the community; an individual or group should be able to obtain, evaluate, and utilize public health information, identify public health aspects of personal and community concerns, and access who is naming and framing public health problems and solutions. (3) Civic orientation includes the skills and resources necessary to address health concerns through civic engagement; an individual or group should be able to articulate the uneven distribution of burdens and benefits of the society, evaluate who benefits and who is harmed by public health efforts, communicate current public health problems, and address public health problems through civic action, leadership, and dialogue. Mancuso [43] emphasizes that health literacy is a process that evolves over a person's lifetime and identify the attributes of health literacy to be capacity, comprehension and communication. (1) The Capacity skills related to health literacy include gathering, analyzing, and evaluating health information for credibility and quality, working together, managing resources, seeking guidance and support, developing and expressing a sense of self, creating and pursuing a vision and goals, and keeping pace with change. Oral language skills are also considered essential. Social skills and credentials such as reading, listening, analytical, decision-making, and numerical abilities are important as well to advocate for oneself, to act on health information, and to negotiate and navigate within the health-care system. (2) Comprehension is a complex process based on the effective interaction of logic, language, and experience and is crucial to the accurate interpretation of a myriad of information that is provided to the modern patient, such as discharge instructions, consent forms, patient education materials, and medication directions. (3) Communication is how thoughts, messages or information are exchanged through speech, signals, writing or behavior. Communication involves inputs, decoding, encoding output, and feedback. Essential communication skills are reading with understanding, conveying ideas in writing, speaking so others can understand, listening actively, and observing critically. 59ce067264