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How much stress is too much? A psychiatrist explains the links between toxic stress and poor health − and how to get help

<p><a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">La<em>wson R. Wulsin</em></a><em>, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati </a></em></p> <p>COVID-19 taught most people that the line between tolerable and toxic stress – defined as persistent demands that lead to disease – varies widely. But some people will age faster and die younger from toxic stressors than others.</p> <p>So how much stress is too much, and what can you do about it?</p> <p>I’m a <a href="https://researchdirectory.uc.edu/p/wulsinlr">psychiatrist specializing in psychosomatic medicine</a>, which is the study and treatment of people who have physical and mental illnesses. My research is focused on people who have psychological conditions and medical illnesses as well as those whose stress exacerbates their health issues.</p> <p>I’ve spent my career studying mind-body questions and training physicians to treat mental illness in primary care settings. My <a href="https://www.cambridge.org/core/books/toxic-stress/677FA62B741540DBDB53E2F0A52A74B1">forthcoming book</a> is titled “Toxic Stress: How Stress is Killing Us and What We Can Do About It.”</p> <p>A 2023 study of stress and aging over the life span – one of the first studies to confirm this piece of common wisdom – found that four measures of stress all speed up the pace of biological aging in midlife. It also found that persistent high stress ages people in a comparable way to the <a href="https://doi.org/10.1097/PSY.0000000000001197">effects of smoking and low socioeconomic status</a>, two well-established risk factors for accelerated aging.</p> <figure><iframe src="https://www.youtube.com/embed/yiglpsqv5ik?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Children with alcoholic or drug-addicted parents have a greater risk of developing toxic stress.</span></figcaption></figure> <h2>The difference between good stress and the toxic kind</h2> <p>Good stress – a demand or challenge you readily cope with – is good for your health. In fact, the rhythm of these daily challenges, including feeding yourself, cleaning up messes, communicating with one another and carrying out your job, helps to regulate your stress response system and keep you fit.</p> <p>Toxic stress, on the other hand, wears down your stress response system in ways that have lasting effects, as psychiatrist and trauma expert Bessel van der Kolk explains in his bestselling book “<a href="https://www.penguinrandomhouse.com/books/313183/the-body-%20keeps-the-score-by-bessel-van-der-kolk-md/">The Body Keeps the Score</a>.”</p> <p>The earliest effects of toxic stress are often persistent symptoms such as headache, fatigue or abdominal pain that interfere with overall functioning. After months of initial symptoms, a full-blown illness with a life of its own – such as migraine headaches, asthma, diabetes or ulcerative colitis – may surface.</p> <p>When we are healthy, our stress response systems are like an orchestra of organs that miraculously tune themselves and play in unison without our conscious effort – a process called self-regulation. But when we are sick, some parts of this orchestra struggle to regulate themselves, which causes a cascade of stress-related dysregulation that contributes to other conditions.</p> <p>For instance, in the case of diabetes, the hormonal system struggles to regulate sugar. With obesity, the metabolic system has a difficult time regulating energy intake and consumption. With depression, the central nervous system develops an imbalance in its circuits and neurotransmitters that makes it difficult to regulate mood, thoughts and behaviors.</p> <h2>‘Treating’ stress</h2> <p>Though stress neuroscience in recent years has given researchers like me <a href="https://doi.org/10.1097/PSY.0000000000001051">new ways to measure and understand stress</a>, you may have noticed that in your doctor’s office, the management of stress isn’t typically part of your treatment plan.</p> <p>Most doctors don’t assess the contribution of stress to a patient’s common chronic diseases such as diabetes, heart disease and obesity, partly because stress is complicated to measure and partly because it is difficult to treat. In general, doctors don’t treat what they can’t measure.</p> <p>Stress neuroscience and epidemiology have also taught researchers recently that the chances of developing serious mental and physical illnesses in midlife rise dramatically when people are exposed to trauma or adverse events, especially during <a href="https://www.cdc.gov/violenceprevention/aces/ace-brfss.html">vulnerable periods such as childhood</a>.</p> <p>Over the past 40 years in the U.S., the alarming rise in <a href="https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html">rates of diabetes</a>, <a href="https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf">obesity</a>, depression, PTSD, <a href="https://www.cdc.gov/nchs/products/databriefs/db433.htm">suicide</a> and addictions points to one contributing factor that these different illnesses share: toxic stress.</p> <p>Toxic stress increases the risk for the onset, progression, complications or early death from these illnesses.</p> <h2>Suffering from toxic stress</h2> <p>Because the definition of toxic stress varies from one person to another, it’s hard to know how many people struggle with it. One starting point is the fact that about 16% of adults report having been exposed to <a href="https://www.cdc.gov/violenceprevention/aces/fastfact.html">four or more adverse events in childhood</a>. This is the threshold for higher risk for illnesses in adulthood.</p> <p>Research dating back to before the COVID-19 pandemic also shows that about 19% of adults in the U.S. have <a href="https://doi.org/10.7249/TL221">four or more chronic illnesses</a>. If you have even one chronic illness, you can imagine how stressful four must be.</p> <p>And about 12% of the U.S. population <a href="https://blogs.worldbank.org/opendata/introducing-second-edition-world-banks-global-subnational-atlas-poverty">lives in poverty</a>, the epitome of a life in which demands exceed resources every day. For instance, if a person doesn’t know how they will get to work each day, or doesn’t have a way to fix a leaking water pipe or resolve a conflict with their partner, their stress response system can never rest. One or any combination of threats may keep them on high alert or shut them down in a way that prevents them from trying to cope at all.</p> <p>Add to these overlapping groups all those who struggle with harassing relationships, homelessness, captivity, severe loneliness, living in high-crime neighborhoods or working in or around noise or air pollution. It seems conservative to estimate that about 20% of people in the U.S. live with the effects of toxic stress.</p> <figure><iframe src="https://www.youtube.com/embed/WuyPuH9ojCE?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Exercise, meditation and a healthy diet help fight toxic stress.</span></figcaption></figure> <h2>Recognizing and managing stress and its associated conditions</h2> <p>The first step to managing stress is to recognize it and talk to your primary care clinician about it. The clinician may do an assessment involving a <a href="https://doi.org/10.1097/PSY.0000000000001051">self-reported measure of stress</a>.</p> <p>The next step is treatment. Research shows that it is possible to retrain a dysregulated stress response system. This approach, <a href="https://lifestylemedicine.org/">called “lifestyle medicine</a>,” focuses on improving health outcomes through changing high-risk health behaviors and adopting daily habits that help the stress response system self-regulate.</p> <p>Adopting these lifestyle changes is not quick or easy, but it works.</p> <p>The <a href="https://www.cdc.gov/diabetes/prevention/index.html">National Diabetes Prevention Program</a>, the <a href="https://www.ornish.com/">Ornish “UnDo” heart disease program</a> and the <a href="https://www.ptsd.va.gov/understand_tx/tx_basics.asp">U.S. Department of Veterans Affairs PTSD program</a>, for example, all achieve a slowing or reversal of stress-related chronic conditions through weekly support groups and guided daily practice over six to nine months. These programs help teach people how to practice personal regimens of stress management, diet and exercise in ways that build and sustain their new habits.</p> <p>There is now strong evidence that it is possible to treat toxic stress in ways that improve health outcomes for people with stress-related conditions. The next steps include finding ways to expand the recognition of toxic stress and, for those affected, to expand access to these new and effective approaches to treatment.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222245/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655"><em>Lawson R. Wulsin</em></a><em>, Professor of Psychiatry and Family Medicine, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-stress-is-too-much-a-psychiatrist-explains-the-links-between-toxic-stress-and-poor-health-and-how-to-get-help-222245">original article</a>.</em></p>

Mind

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Poor Prince Harry taken to the cleaners on live TV

<p>The Duke of Sussex engaged in a thrilling penalty shootout with Germany's defence minister, Boris Pistorius, during a live television broadcast to promote the 2023 Invictus Games – however, Prince Harry's quest for victory ended in disappointment as he failed to score a single goal in six attempts.</p> <p>This friendly (yet competitive!) soccer challenge took place as part of the promotion for the 2023 Invictus Games, which Prince Harry attended in Düsseldorf, Germany. The Duke, aged 38, appeared on the popular German TV show, <em>Das Aktuelles Sportstudio</em>, following the opening ceremony of the Invictus Games.</p> <p>In a clip shared on social media, Prince Harry, alongside Pistorius, Angelo Anderson, and Jens Niemeyer, took turns attempting to kick a soccer ball through one of two holes in a wall on the studio set. The game, known as a shootout, has been a long-standing tradition on the show.</p> <p>Prince Harry jokingly inquired about the consequences of a zero score before being informed that he'd have to don a German jersey if he lost. Undeterred, he stepped up to take his shots, but his first three attempts missed the mark.</p> <p>Pistorius then managed to score twice during his turn, and after other participants took their shots, Harry missed three more times.</p> <p>In the end, rather than a German jersey, Prince Harry was presented with a scarf from the local German club, FSV Mainz 05, which he sportingly wore to the applause of the audience.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="de">Prinz Harry, Bundesverteidigungsminister Boris Pistorius, Angelo Anderson und Jens Niemeyer stellen sich der Herausforderung an der <a href="https://twitter.com/hashtag/sportstudio?src=hash&amp;ref_src=twsrc%5Etfw">#sportstudio</a>-Torwand. <a href="https://t.co/liwmkz0zg0">pic.twitter.com/liwmkz0zg0</a></p> <p>— ZDF (@ZDF) <a href="https://twitter.com/ZDF/status/1700637221273862535?ref_src=twsrc%5Etfw">September 9, 2023</a></p></blockquote> <p>During the show, Prince Harry also discussed the profound impact of founding the Invictus Games, describing it as a lifeline. He reflected on the shared experiences and stories within the veterans' community, something that resonated deeply with him due to his own military service in the British Army, which included two tours in Afghanistan.</p> <p>The Invictus Games, created by Prince Harry in 2014, are a global sporting event for veterans and service personnel, and this year's edition marked the first time it was hosted in Germany. Previous events were held in London (2014), Orlando (2016), Toronto (2017), Sydney (2018), and The Hague (2022). The 2025 Invictus Games are scheduled to take place in Vancouver and Whistler, Canada.</p> <p>This year's event, running from September 9 to September 16, featured over 500 athletes from 21 countries competing in 10 different sports, representing six continents.</p> <p>In a video message ahead of the event, Prince Harry expressed his excitement about having participants from every continent except Antarctica, humorously adding that they were still working on getting representation from there.</p> <p>At the opening ceremony, Prince Harry gave a speech touching on self-discovery, teamwork, and family life. He welcomed Colombia, Israel, and Nigeria as first-time participants and humorously mentioned that since Meghan Markle discovered her Nigerian ancestry through a genealogy test, the competition might get more competitive in their household.</p> <p>Harry also emphasised the importance of the Invictus Games as a platform for veterans to be part of a supportive community and overcome societal perceptions about disabilities and limitations. He quoted a South Korean competitor, Mr. Na, who shared, "We overcome perceptions of ourselves in society." For Harry, these games were not just about winning medals but about breaking down self-imposed barriers and redefining what's possible.</p> <p><em>Images: Twitter (X) / ZDF</em></p>

TV

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Why are the poor shunned? The reasons are complicated

<p>In a <a href="https://www.cambridge.org/core/journals/central-european-history/article/what-it-means-to-have-nothing-poverty-and-the-idea-of-human-dignity-in-nineteenthcentury-germany/8C8F12F666689B75396E67A212E69EBD">study</a> of 19th century ideas of poverty, the German historian Beate Althammer observes a strange dichotomy. On the one hand, “there existed a deep-rooted tradition of ascribing to the poor a special proximity to God”. </p> <p>As a Hamburg teacher wrote in 1834, "Who obliges us more to sympathy and reverence than he who faces the inescapable blows of an erratic fate with manly steadiness, pious resignation and wise abstinence? What a dignified appearance is the neediness simultaneously ennobled and keenly veiled by an indestructible love of honor, which will bear suffering rather than pity!"</p> <p>Yet the same teacher sounds a dissonant note when writing about the “depraved, ignominious poverty” of the beggar, “who has rid himself of all shame and discipline on the way to impoverishment”. </p> <p>“Where idleness has become a trade and begging a fraudulent art,” he continues, “all human feeling has died.”</p> <p>The idea that the poor are impoverished morally as well as materially, that they lack humanity as well as means, has a long history. It is expressed most mordantly in Jonathan Swift’s <a href="https://www.gutenberg.org/files/1080/1080-h/1080-h.htm">A Modest Proposal</a>, a 1729 satire on British attitudes to Irish poverty. </p> <p>Starvation among large families could be averted with a simple solution, "A young healthy child well nursed, is, at a year old, a most delicious nourishing and wholesome food, whether stewed, roasted, baked, or boiled; and I make no doubt that it will equally serve in a fricassee, or a ragout."</p> <p>Swift’s suggestion that poor children could become a commercial food source is mocking heartless responses to poverty. His “proposal” rests on a dehumanising equation of people with animals or consumer goods. A new book argues that this animus is an enduring feature of contemporary society.</p> <h2>Aporophobia</h2> <p><a href="https://en.wikipedia.org/wiki/Adela_Cortina">Adela Cortina</a> is a distinguished Spanish political philosopher who has written extensively on ethics, justice, civil society and democracy. Around the new millennium, she began to write on the rejection of the poor as an overlooked form of prejudice.</p> <p>Cortina coined the term “aporophobia” – from the Ancient Greek aporos, meaning poor or without means – and published an influential 2017 book on the subject in Spanish. That book has now been published in English as <a href="https://press.princeton.edu/books/hardcover/9780691205526/aporophobia">Aporophobia: Why We Reject the Poor Instead of Helping Them</a>.</p> <p>Cortina does not present aporophobia as a clinical condition or narrowly as a species of fear. Much like other faux-phobias, such as homophobia and xenophobia, she takes it to be a widespread aversion, based on contempt as much as dread, which justifies the ongoing deprecation of the poor.</p> <p>Her primary case for the reality and significance of aporophobia rests on the harsh treatment of immigrants and displaced people. What might first appear to be a xenophobic response, Cortina argues, may not be motivated by their foreignness or race, but by the perception that their poverty leaves them unable to reciprocate the host nation’s beneficence, "Do we reject immigrants because they are foreign or because they are poor and seem to bring problems while offering nothing of value in return?"</p> <p>Cortina observes that some groups of foreigners are welcomed. Tourists, investors and international students, all of whom bring resources, encounter widespread xenophilia. The roots of prejudice towards immigrants, refugees and asylum seekers, Cortina suggests, are therefore to be found in the perception of their indigence rather than their alienness.</p> <p>Having defined and made a theoretical case for aporophobia, Cortina moves on to the problem of hatred, understood as group-based animosity based on the assumed superiority of its perpetrators. </p> <p>Hate crimes against the poor and homeless motivated by aporophobia, which she estimates as constituting around 1% of Spain’s total, must be acknowledged and taken seriously. Even so, she maintains that aporophobic hatred is distinct from other kinds because “involuntary poverty […] is neither a personal identity nor a choice”.</p> <p>Cortina’s prescription for combating hate speech is the cultivation of “active respect” and “mutual recognition of dignity” in civil society. Juridical solutions are insufficient, she maintains. The grounds for objecting to hate speech is a proposed “right to self-esteem”, a right that some might seem to have in excess. </p> <p>Although many examples of hate speech appear to be based on race, religion or ideology, Cortina proposes that poverty is their essential common ingredient. Aporophobia, she argues, “is inevitably at the root of speech acts that target those in subordinate positions”. On this expansive view, any form of subordination or “position of weakness” is interpreted as a form of poverty. </p> <p>Overcoming hatred may be challenging because “our brains are aporophobic”. Cortina explores the neuroscience of social conflict, finding evidence of a “contractualist brain” that is primed to expect reciprocity and respond with moralistic aggression to violations of that principle. To override this brain-based rejection of free riders, she argues, we need a program of “moral bioenhancement”. </p> <p>The ultimate way forward does not involve tinkering with our brains, however. “Economic institutions that eliminate poverty and inequality are the best ways to eradicate aporophobia.” In addition, universal values and “cosmopolitan hospitality” must be taught and practised. Cortina closes her book with suggestions for how a more compassionate citizenry and a more economically fair international order can be created.</p> <h2>Impoverished emotions</h2> <p>Cortina’s work is a philosophically rich and sometimes rousing call to end poverty and secure human dignity. Whether the concept of aporophobia can bear the interpretive load she places on it is another matter. The concept is both too narrow and too ambitious to serve its intended explanatory function. Its diagnosis of the source of antipathy to the poor is questionable in three respects.</p> <p>First, the concept of aporophobia asserts that the ingredients of antipathy to the poor are fear and contempt. The poor are dreaded from a position of threat and scorned from a position of imagined superiority. These emotional elements may be present in responses to the poor, but indifference and neglect are at least equally powerful. The poor suffer as much from a cold lack of concern, reinforced by spatial separation, as they do from heated aversion. Residential segregation and national borders help to keep poverty out of sight and out of mind, but this motivated ignorance is invisible in Cortina’s account.</p> <p>Second, the concept of aporophobia overlooks a key aspects of the rejection of the poor. By centring fear and contempt, Cortina omits the moral dimension of that aversion. The poor are not merely dreaded and scorned, but are also believed to have transgressed rules of fairness. This dynamic is evident in the dichotomous reactions to the virtuous and vicious poor characters mentioned at the beginning of this review. Polarised responses to people viewed as deserving and undeserving of their impoverished state are common. Those seen as not responsible for their condition are judged worthy, whereas those who are thought to have brought it on themselves are reviled. Attitudes to the poor hinge on moral evaluations of deservingness, which ideas of amoral aversion fail to capture.</p> <p>Third, if our views of the poor are indeed polarised by judgements of deservingness, is there a powerful aversion to the poor as a class, as Cortina suggests, or only to its undeserving variety? The poor are sometimes stereotyped as lacking in warmth and capability – though <a href="https://spssi.onlinelibrary.wiley.com/doi/10.1111/josi.12208">not invariably</a>. But it is unclear whether that perception reveals attitudes to poverty per se or only to that demonised form. </p> <p><a href="https://spssi.onlinelibrary.wiley.com/doi/pdf/10.1111/asap.12313">Recent Australian research</a> suggests that evaluations of poverty may be quite benevolent. The study examined how public attitudes are influenced by poverty, unemployment and receipt of income support. It found that poverty itself carries little stigma. Members of the working poor were judged no less sympathetically than other workers. </p> <p>Being unemployed, however, carried a negative charge, and receiving unemployment benefits an additional one. Benefit recipients were perceived as less disciplined, emotionally stable and warm than other unemployed people. </p> <p>These findings are consistent with the well established phenomenon of <a href="https://www.cambridge.org/core/journals/journal-of-social-policy/article/abs/stigma-of-claiming-benefits-a-quantitative-study/AF30092AE7D5B7C659798228B219F02C">benefit stigma</a>, related to a stereotype of recipients as lazy, parasitic, and undeserving. They are not consistent with an aversion to poor people that is directly attributable to their poverty. Any account that invokes an amoral generalised aversion to the poor rather than a moralised aversion to the supposedly undeserving poor is incomplete.</p> <h2>Is aporophobia primary?</h2> <p>In addition to querying Cortina’s characterisation of the emotions underlying our views of the poor, we can also quibble with her argument for the primacy of aporophobia over xenophobia in the rejection of immigrants and displaced people. </p> <p>It is unquestionably true that attitudes to outsiders are rarely monolithically negative, and that wealthy foreigners are welcomed in ways that refugees are not. But the argument that xenophobia can be reduced to aporophobia – not to mention the more general claim that aporophobia is at the root of all forms of subordination – is entirely far-fetched. </p> <p>Our tendency to show an ethnocentric preference for our own kind – to value and favour in-group over out-group – is very <a href="https://spssi.onlinelibrary.wiley.com/doi/abs/10.1111/0022-4537.00126">well established</a> and even wealthy outsiders are not immune to it. We routinely denigrate and distrust foreign nationals, even – and sometimes especially – when they are rich and powerful. </p> <p>The fact that poverty is one reason for our rejection of immigrants or displaced persons does not make it the only one. Any rejection based on lack of means or reciprocity is compounded by rejection based on foreignness (xenophobia), on race, and potentially on other factors, such as religion or gender. </p> <p>To reduce the hostility of rich European nations to immigrants from North Africa and beyond to aporophobia, as Cortina does, or to racism, as others prefer to do, is to oversimplify. Single-barrelled explanations overlook the fact that prejudice is layered.</p> <p>Consider Australia’s historically unwelcoming attitude to many immigrants and displaced persons. It has been popular to view this rejection through a racism or xenophobia monocle. If that were the whole story, public attitudes would be equally antagonistic to immigrants, refugees admitted through the humanitarian program, and undocumented asylum seekers. But those attitudes are decidedly unequal.</p> <p>Attitudes towards immigrants are typically warmer and more compassionate than those towards refugees, with special scorn reserved for undocumented boat arrivals. Aporophobia may help to account for some of these differences: immigrants are assumed to be skilled and economically self-sufficient, whereas refugees and asylum seekers are assumed to require substantial welfare supports. </p> <p>However, much of the animus towards asylum seekers focuses not on their race, foreignness, or lack of resources, but on moralistic reactions to their mode of entry, as the shrill language of “illegals” and “queue-jumpers” attests. To reduce popular attitudes towards displaced people to racism, xenophobia or aporophobia is to bulldoze several tiers of aversion into one flattened explanation.</p> <h2>A confluence of factors</h2> <p>Social rejection can take many forms and have many determinants. The idea of “<a href="https://en.wikipedia.org/wiki/Intersectionality">intersectionality</a>” offers one perspective. How we evaluate and respond to a person may reflect the unique intersection of their identities. The stereotype of “Asian woman” is not a simple sum of the stereotypes of “Asian” and “woman” but may call up a distinct configuration of perceptions. </p> <p>Sometimes, though, it helps to remember that some attitudes are not so much intersectional as additive, at least in their virulence. How negatively we perceive groups such as asylum seekers may reflect a confluence of factors: their outsider status, their race, their poverty, their officially sanctioned versus unsanctioned means of entering the country, and so on. </p> <p>“Additivity” doesn’t have the same ring as “intersectionality”, but it might help to warn us off simplifying accounts of social exclusion.</p> <p>Aporophobia is nevertheless a valuable addition to the social scientist’s conceptual arsenal. Cortina’s work draws welcome attention to a form of prejudice that is too often shunted aside by our identitarian focus on race, gender and sexuality. </p> <p>We might quibble with some inflated claims for the primacy of aporophobia, with the imperfect analysis of its emotional signature, and with the omission of social class from Cortina’s discussion of economic inequality. Her emphasis on the rejection of displaced people within European nations – understandable given the book’s original publication in 2017 when a refugee crisis was convulsing the continent – can also be faulted. Examining public responses to the domestic poor might afford a clearer view of aporophobia than one complicated by displacement and ethnic differences.</p> <p>Despite these reservations, Cortina has written a significant work of social philosophy that deserves close attention in the Anglophone world. Aporophobia is a provocative book that will stimulate discussion, argument and investigation.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/why-are-the-poor-shunned-the-reasons-are-complicated-194808" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Caring

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Social media use and poor wellbeing feed into each other in a vicious cycle

<p>We often hear about the negative impacts of social media on our wellbeing, but we don’t usually think of it the other way round – whereby how we feel may impact how we use social media.</p> <p>In a <a href="https://link.springer.com/article/10.1007/s00127-022-02363-2" target="_blank" rel="noopener">recent study</a>, my colleagues and I investigated the relationship between social media use and wellbeing in more than 7,000 adults across four years, using survey responses from the longitudinal <a href="https://www.psych.auckland.ac.nz/en/about/new-zealand-attitudes-and-values-study.html" target="_blank" rel="noopener">New Zealand Attitudes and Values Study</a>.</p> <p>We found social media use and wellbeing impact each other. Poorer wellbeing – specifically higher psychological distress and lower life satisfaction – predicted higher social media use one year later, and higher social media use predicted poorer wellbeing one year later.</p> <p><strong>A vicious cycle</strong></p> <p>Interestingly, wellbeing impacted social media use <em>more</em> than the other way round.</p> <p>Going from having “no distress” to being distressed “some of the time”, or “some of the time” to “most of the time”, was associated with an extra 27 minutes of daily social media use one year later. These findings were the same for men and women across all age groups.</p> <p>This suggests people who have poor wellbeing might be turning to social media more, perhaps as a coping mechanism – but this doesn’t seem to be helping. Unfortunately, and paradoxically, turning to social media may worsen the very feelings and symptoms someone is hoping to escape.</p> <p>Our study found higher social media use results in poorer wellbeing, which in turn increases social media use, exacerbating the existing negative feelings, and so on. This creates a vicious cycle in which people seem to get trapped.</p> <p>If you think this might describe your relationship with social media, there are some strategies you can use to try to get out of this vicious cycle.</p> <p><strong>Reflect on how and why you use social media</strong></p> <p>Social media aren’t inherently bad, but <a href="https://doi.org/10.1093/jcmc/zmz013" target="_blank" rel="noopener">how and why</a> we use them is really important – <em>even more</em> than how much time we spend on social media. For example, using social media to interact with others or for entertainment has been linked to improved wellbeing, whereas engaging in comparisons on social media can be detrimental to wellbeing.</p> <p>So chat to your friends and watch funny dog videos to your heart’s content, but just watch out for those comparisons.</p> <p>What we look at online is important too. One <a href="https://doi.org/10.1016/j.bodyim.2020.02.002" target="_blank" rel="noopener">experimental study</a> found just ten minutes of exposure to “fitspiration” images (such as slim/toned people posing in exercise clothing or engaging in fitness) led to significantly poorer mood and body image in women than exposure to travel images.</p> <p>And mindless scrolling can also be harmful. Research suggests this passive use of social media is more damaging to wellbeing <a href="https://doi.org/10.1111/sipr.12033" target="_blank" rel="noopener">than active use</a> (such as talking or interacting with friends).</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/489514/original/file-20221013-6097-aup4h7.jpeg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/489514/original/file-20221013-6097-aup4h7.jpeg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/489514/original/file-20221013-6097-aup4h7.jpeg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/489514/original/file-20221013-6097-aup4h7.jpeg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/489514/original/file-20221013-6097-aup4h7.jpeg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/489514/original/file-20221013-6097-aup4h7.jpeg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/489514/original/file-20221013-6097-aup4h7.jpeg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/489514/original/file-20221013-6097-aup4h7.jpeg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" alt="A person scrolls through a social media site on their phone" /></a><figcaption><span class="caption">Mindless scrolling can be damaging to your wellbeing.</span> <span class="attribution">Shutterstock</span></figcaption></figure> <p>So be mindful about how and why you use social media, and how it makes you feel! If most of your use falls under the “harmful” category, that’s a sign to change or cut down your use, or even take a break. One 2015 experiment with more than 1,000 participants found taking a break from Facebook for just one week <a href="https://doi.org/10.1089/cyber.2016.0259" target="_blank" rel="noopener">increased life satisfaction</a>.</p> <p><strong>Don’t let social media displace other activities</strong></p> <p>Life is all about balance, so make sure you’re still doing important activities away from your phone that support your wellbeing. <a href="https://doi.org/10.3389/fpsyg.2021.609967" target="_blank" rel="noopener">Research</a> suggests time spent outdoors, on hobbies or crafts, and engaging in physical activity can help improve your wellbeing.</p> <p>So put your phone down and organise a picnic with friends, join a new class, or find an enjoyable way to move your body.</p> <p><strong>Address your poor wellbeing</strong></p> <p>According to our <a href="https://link.springer.com/article/10.1007/s00127-022-02363-2" target="_blank" rel="noopener">findings</a>, it may be useful to think of your own habitual social media use as a symptom of how you’re feeling. If your use suggests you aren’t in a good place, perhaps you need to identify and address what’s getting you down.</p> <p>The first, very crucial step is getting help. A great place to start is talking to a health professional such as your general practitioner or a therapist. You can also reach out to organisations like <a href="https://www.beyondblue.org.au/" target="_blank" rel="noopener">Beyond Blue</a> and <a href="https://headspace.org.au/" target="_blank" rel="noopener">Headspace</a> for evidence-based support.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/191590/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em>Writen by Hannah Jarman. Republished with permission from <a href="https://theconversation.com/social-media-use-and-poor-wellbeing-feed-into-each-other-in-a-vicious-cycle-here-are-3-ways-to-avoid-getting-stuck-191590" target="_blank" rel="noopener">The Conversation</a>.</em></p> <p><em>Image: Getty Images</em></p>

Technology

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People who are bad with numbers often find it harder to make ends meet – even if they are not poor

<h2>The big idea</h2> <p>People who are bad with numbers are more likely to experience financial difficulties than people who are good with numbers. That’s according to <a href="https://doi.org/10.1371/journal.pone.0260378" target="_blank" rel="noopener">our analyses</a> of the <a href="https://wrp.lrfoundation.org.uk/explore-the-poll" target="_blank" rel="noopener">Lloyd’s Register Foundation World Risk Poll</a>.</p> <p>In this World Risk Poll, people from 141 countries were asked if 10% was bigger than, smaller than or the same as 1 out of 10. Participants were said to be bad with numbers if they did not provide the correct answer – which is that 10% is the same as 1 out of 10. <a href="https://doi.org/10.1371/journal.pone.0260378" target="_blank" rel="noopener">Our analyses</a> found that people who answered incorrectly are often among the poorest in their country. Prior studies in the <a href="https://doi.org/10.1111/j.1468-0297.2010.02394.x" target="_blank" rel="noopener">United States</a>, <a href="https://doi.org/10.1111/j.1475-5890.2007.00052.x" target="_blank" rel="noopener">United Kingdom</a>, <a href="https://doi.org/10.1016/j.joep.2016.02.011" target="_blank" rel="noopener">the Netherlands</a> and <a href="https://doi.org/10.1111/joca.12294" target="_blank" rel="noopener">Peru</a> had also found that people who are bad with numbers are financially worse off. But <a href="https://doi.org/10.1371/journal.pone.0260378" target="_blank" rel="noopener">our analyses of the World Risk Poll</a> further showed that people who are bad with numbers find it harder to make ends meet, even if they are not poor.</p> <p>When we say that they found it harder to make ends meet, we mean that they reported on the poll that they found it difficult or very difficult to live on their current income, as opposed to living comfortably or getting by on their current income.</p> <p><a href="https://doi.org/10.1371/journal.pone.0260378" target="_blank" rel="noopener">Our analyses</a> also indicate that staying in school longer is related to better number ability. People with a high school degree tend to be better with numbers than people without a high school degree. And college graduates do even better. But even among college graduates there are people who are bad with numbers – and they struggle more financially.</p> <p>Of course, being good with numbers is not going to help you stretch your budget if you are very poor. <a href="https://doi.org/10.1371/journal.pone.0260378" target="_blank" rel="noopener">We found</a> that the relationship between number ability and struggling to make ends meet holds across the world, except in low-income countries like Ethiopia, Somalia and Rwanda.</p> <h2>Why it matters</h2> <p>The ability to understand and use numbers is also called <a href="http://doi.org/10.1093/oso/9780190861094.001.0001" target="_blank" rel="noopener">numeracy</a>. Numeracy is <a href="https://doi.org/10.1787/1f029d8f-en" target="_blank" rel="noopener">central to modern adult life</a> because numbers are everywhere.</p> <p>A lot of well-paying jobs involve working with numbers. People who are bad with numbers often perform worse in these jobs, including <a href="https://doi.org/10.1111/ecin.12873" target="_blank" rel="noopener">banking</a>. It can therefore be hard for people who are bad with numbers to <a href="http://www.doi.org/10.1108/00400919710164125" target="_blank" rel="noopener">find employment and progress in their jobs</a>.</p> <p>People who are bad with numbers are less likely <a href="https://www.pnas.org/content/116/39/19386.short" target="_blank" rel="noopener">to make good financial decisions</a>. Individuals who can’t compute how interest compounds over time <a href="https://doi.org/10.1111/j.1540-6261.2009.01518.x" target="_blank" rel="noopener">save the least and borrow the most</a>. People with poor numerical skills are also more likely <a href="https://doi.org/10.1037/0022-3514.41.3.586" target="_blank" rel="noopener">to take on high-cost debt</a>. If you’re bad with numbers, it is hard to <a href="https://doi.org/10.1017/S1474747215000232" target="_blank" rel="noopener">recognize</a> that paying the US$30 minimum payment on a credit card with a $3,000 balance and an annual percentage rate of 12% means it will never be paid off.</p> <h2>What still isn’t known</h2> <p>It is clear that people who are bad with numbers also tend to struggle financially. But we still need to explore whether teaching people math will help them to avoid financial problems.</p> <h2>What’s next</h2> <p>In her book “<a href="http://doi.org/10.1093/oso/9780190861094.001.0001" target="_blank" rel="noopener">Innumeracy in the Wild</a>,” Ellen Peters, director of the Center for Science Communication Research at the University of Oregon, suggests that it is important for students to take math classes. American high school students who had to <a href="https://doi.org/10.3368/jhr.51.3.0113-5410R1" target="_blank" rel="noopener">take more math courses</a> than were previously required had better financial outcomes later in life, such as avoiding bankruptcy and foreclosures.</p> <p>Successfully teaching numeracy also means helping students gain confidence in using numbers. People with <a href="https://doi.org/10.1073/pnas.1903126116" target="_blank" rel="noopener">low numerical confidence</a> experience bad financial outcomes, such as a foreclosure notice, independent of their numeric ability. This is because they may not even try to take on complex financial decisions.</p> <p>Numerical confidence can be boosted in different ways. Among American <a href="https://doi.org/10.1037/0022-3514.41.3.586" target="_blank" rel="noopener">elementary school children</a> who were bad with numbers, setting achievable goals led to better numerical confidence and performance. Among American <a href="https://doi.org/10.1371/journal.pone.0180674" target="_blank" rel="noopener">undergraduate students</a>, a writing exercise that affirmed their positive values improved their numerical confidence and performance.</p> <p>Other important next steps are to find out whether training in numeracy can also be provided to adults, and whether training in numeracy improves the financial outcomes of people who do not live in high-income countries.</p> <div> <p><em><strong>This article originally appeared on <a href="https://theconversation.com/people-who-are-bad-with-numbers-often-find-it-harder-to-make-ends-meet-even-if-they-are-not-poor-172272" target="_blank" rel="noopener">The Conversation</a>.</strong></em></p> <p><em>Image: Shutterstock</em></p> </div>

Money & Banking

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Stroke, cancer and other chronic diseases more likely for those with poor mental health

<p><a href="https://www.aihw.gov.au/reports-statistics/health-welfare-services/mental-health-services/overview">Four million Australians</a>, including our friends, family members, co-workers and neighbours, are living with mental health conditions, including anxiety and depression.</p> <p>A <a href="https://www.vu.edu.au/australian-health-policy-collaboration/publications#chronic-diseases">new report out today</a> from the <a href="https://www.vu.edu.au/australian-health-policy-collaboration">Australian Health Policy Collaboration</a> has found these four million Australians are at much greater risk of chronic physical disease and much greater risk of early death.</p> <p>Having a mental health condition increases the risk of every major chronic disease. Heart disease, high blood pressure, arthritis, back pain, diabetes, asthma, bronchitis, emphysema and cancer are all much more likely to occur among people with anxiety and depression. </p> <p>More than 2.4 million people have both a mental and at least one physical health condition.</p> <p>For the first time in Australia, this report quantifies the extent of this problem. For example, people with mental health conditions are more likely to have a circulatory system disease (that is, heart disease, high blood pressure and stroke). The likelihood increases by 52% for men, and 41% for women.</p> <p>More than a million people are affected by both a circulatory system disease and a mental health condition. These diseases are Australia’s biggest killers.</p> <p>For painful, debilitating conditions such as arthritis and back pain, the numbers are even higher. Arthritis is 66% more likely for men with mental health conditions, and 46% more likely for women, with 959,000 people affected.</p> <p>Back pain is 74% more likely for men with mental health conditions, and 68% more likely for women, with more than a million affected.</p> <p>The gender differences are significant. Women with mental health conditions are much more likely to have asthma than women across Australia as a whole (70% more likely), while men are 49% more likely to have asthma with a mental health condition.</p> <p>The biggest gender difference is cancer. Men with mental health conditions are 84% more likely to have cancer than the general population, and for women the figure is 20%.</p> <p>As more women live with mental health conditions than men, overall, women are 23% more likely to be living with both a mental and physical health condition than men.</p> <p>The report shows having a co-existing mental health condition and chronic physical disease generally results in worse quality of life, greater functional decline, needing to use more health care and higher healthcare costs. </p> <p>These people require more treatment, use more medications, and have to spend more time, energy and money managing their health. People with a mental health condition are also <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60240-2/abstract">more likely to be poorer</a>, less likely to work, less likely to receive health screening and, sadly, <a href="https://www.rethink.org/media/810988/Rethink%20Mental%20Illness%20-%20Lethal%20Discrimination.pdf">more likely to receive substandard care</a> for their physical diseases.</p> <p>On average, people with mental health conditions die younger than the general population, and mostly from preventable conditions. We know from <a href="https://www.bmj.com/content/346/bmj.f2539">earlier research</a>that people with severe mental illnesses die much earlier than the rest of the population. Our report shows even common mental health conditions such as anxiety and depression contribute to more chronic disease, leading to higher rates of early death.</p> <h2>Why?</h2> <p>We don’t know exactly why people with mental health conditions have poorer physical health. The <a href="https://acmedsci.ac.uk/policy/policy-projects/multimorbidity">Academy of Medical Sciences</a> has identified that poor mental health and psychosocial risk factors such as feeling dissatisfied with life, not feeling calm, having sleep problems that affect work, and financial concerns can predict physical disease.</p> <p>Other factors, such as <a href="https://theconversation.com/low-income-earners-are-more-likely-to-die-early-from-preventable-diseases-87676">low socioeconomic status</a>, poor social networks, living in rural areas and smoking are associated with both poor mental health and poor physical health.</p> <p>We do know people with mental health conditions often don’t receive advice about healthy lifestyles, don’t get common tests for disease, and are less likely to receive treatment for disease. Some of this is due to <a href="https://www.ncbi.nlm.nih.gov/pubmed/21379357">stigma and discrimination</a>, and sometimes it’s neglect. People with mental health conditions can <a href="https://www.ranzcp.org/Files/Publications/RANZCP-Serious-Mental-Illness.aspx">fall through the gaps between disjointed physical and mental health systems</a>. </p> <h2>What can we do about it?</h2> <p>There is <a href="https://www.ranzcp.org/Files/Publications/RANZCP-Keeping-body-and-mind-together.aspx">momentum for change</a> among the mental health sector, with dozens of organisations signing up to the <a href="https://equallywell.org.au/">Equally Well</a> consensus statement. This aims to improve the quality of life of people living with mental illness by providing equal access to quality health care. </p> <p>There’s some great work being done around the country, including in the <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/inm.12459">Hunter region</a>, where people with mental health conditions can access tailored help with physical health risk factors such as smoking and diet.</p> <p>People using mental health services should have their physical health regularly assessed, and any problems addressed as early as possible. Better coordination of care would preserve healthcare resources and improve quality of life.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/stroke-cancer-and-other-chronic-diseases-more-likely-for-those-with-poor-mental-health-100955" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Mind

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Meghan Markle’s book’s poor debut

<p><span style="font-weight: 400;">Meghan Markle’s new children’s book has had an inauspicious start as sales dive and critics seem unimpressed.</span></p> <p><em><span style="font-weight: 400;">The Bench</span></em><span style="font-weight: 400;"> debuted at number 60 on Amazon’s children’s books chart but failed to make the top 200 bestsellers list.</span></p> <p><span style="font-weight: 400;">Sales have been poor despite a $5.50 reduction on its initial $24 cover price on the website.</span></p> <p><span style="font-weight: 400;">Within hours of its release, WH Smith had marked its copies with “buy one get one half price” stickers according to </span><em><span style="font-weight: 400;">The Sun</span></em><span style="font-weight: 400;">.</span></p> <p><span style="font-weight: 400;">A $5.50 discount was also seen at Waterstones in Piccadilly, central London.</span></p> <p><span style="font-weight: 400;">The poor performance comes after Kate Middleton’s photography book, </span><span style="font-weight: 400;">Hold Still</span><span style="font-weight: 400;">, hit the number two spot on Amazon on its release date in May.</span></p> <p><span style="font-weight: 400;">The Duchess of Sussex said the book was based on a poem she had penned for Prince Harry on Father’s Day.</span></p> <p><span style="font-weight: 400;">Dedicating the 34-page book to him and son Archie, she called them “the man and boy who make my heart go pump-pump.”</span></p> <p><span style="font-weight: 400;">When it came to reviews, the book was dismissed by online critics as a vanity project that should have stayed in the family.</span></p> <p><span style="font-weight: 400;">Alex O’Connell, arts editor at </span><em><span style="font-weight: 400;">The Times</span></em><span style="font-weight: 400;">, said: “The story is so lacking in action and jeopardy you half wonder if the writing job was delegated to a piece of furniture.”</span></p> <p><span style="font-weight: 400;">The book, illustrated by US illustrator Christian Robinson, shows Meghan cradling newborn daughter Lillibet while Harry and Archie feed chickens.</span></p> <p><span style="font-weight: 400;">A diverse group of fathers and their growing sons are also shown connecting over life’s simple pleasures throughout the book, which tells the story of an eternal bond between a father and son as witnessed through the eyes of a mother.</span></p>

Books

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Veterans have poorer mental health than Australians overall

<p>A career in the Australian Defence Force (ADF), or the armed forces in any country, can be rewarding, but also demanding. Challenges include the rigorous training, frequent moves, and maintaining social connections.</p> <p>Beyond this, military personnel may be exposed to trauma during combat, peace-keeping missions, border protection, disaster and humanitarian relief, and training accidents.</p> <p>They may be confronted not only with threats to their own lives or safety, but also with the suffering or death of others, which can have a significant emotional and <a href="http://www.defence.gov.au/Health/DMH/Docs/MHPWSReport-FullReport.pdf">psychological impact</a>.</p> <p>So it’s not surprising we see <a href="https://www.dva.gov.au/health-and-wellbeing/research-and-development/health-studies/mental-health-prevalence-report">higher rates of mental illness</a> among veterans compared to the overall Australian population.</p> <p>The rates of suicide are also concerning, particularly among younger veterans. Between 2001 and 2016, <a href="https://www.aihw.gov.au/reports/veterans/national-veteran-suicide-monitoring/contents/summary">373 Australian veterans</a> took their lives. Male veterans under 30 had a suicide rate more than twice the national average for men the same age. These figures have led to considerable community concern, including <a href="https://www.abc.net.au/radionational/programs/drive/plea-to-pm-for-royal-commission-into-veterans-suicide/11678984">calls for a royal commission</a> into veteran suicide.</p> <p>Whether or not this eventuates, we should be targeting veterans with a high level of care that better reflects their unique set of needs.</p> <p><strong>Transitioning back into civilian life</strong></p> <p>Recent research has highlighted <a href="https://www.dva.gov.au/health-and-wellbeing/research-and-development/social-research/transition-and-wellbeing-research">one of the most challenging periods for military personnel</a> can be transitioning back to civilian life.</p> <p>Major lifestyle changes can be stressful for anyone, but leaving the ADF can feel like more than leaving a job. It will likely represent a change in a person’s way of life across the board.</p> <p>While many transitioning personnel may initially experience some uncertainty and a sense of losing some part of themselves, most make the adjustment successfully. For others, the problems may not go away and for some, may become worse, unless they receive help.</p> <p>A comprehensive study commissioned by the Departments of Veterans’ Affairs (DVA) and Defence in 2015 found ADF members who had discharged or transitioned to the Reserves were <a href="https://www.dva.gov.au/health-and-wellbeing/research-and-development/social-research/transition-and-wellbeing-research">at greater risk</a> of experiencing mental health issues compared to both those who were still serving and the broader Australian community.</p> <p>For example, in the previous 12 months, 17.7% of transitioned ADF personnel had experienced post-traumatic stress disorder (PTSD) compared to 8.7% still serving in the ADF full-time, and 5.2% in the Australian community.</p> <p>Other common mental health conditions in transitioned ADF personnel include depression (11.2%), and anxiety disorders such as panic disorder (5.4%), agoraphobia (11.9%) and social phobia (11%), all estimated to be higher than <a href="https://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4326.0Main+Features32007?OpenDocument">rates in the general population</a>.</p> <p>Rates of suicidality (thinking about, planning or attempting suicide) were more than double for those who had transitioned out of full-time ADF service compared to those still serving in the ADF full-time (21.7% versus 8.8%), and <a href="https://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4326.0Main+Features32007?OpenDocument">ten times greater</a> than the Australian community.</p> <p><strong>Seeking and receiving help</strong></p> <p>About 75% of veterans who reported they had mental health concerns in the DVA study had sought and received assistance at some point from a GP or mental health professional. These rates are much higher than in the general community and auger well for the <a href="https://www.dva.gov.au/health-and-wellbeing/research-and-development/health-studies/pathways-care-report">preparedness of veterans to seek care</a>.</p> <p>However, as is the case in the Australian community and internationally, there is an under-engagement with evidence-based treatment and practice. Only <a href="https://www.dva.gov.au/health-and-wellbeing/research-and-development/social-research/transition-and-wellbeing-research">about 25%</a> of help-seeking veterans were estimated to be receiving evidence-based care, such as cognitive behavioural therapy. This may be because veterans don’t stay engaged in health services for long enough to receive evidence-based treatments.</p> <p>So while the help-seeking and care delivery for veterans is on par with, and in some ways exceeds, that of the general community, there’s room for improvement to ensure veterans remain engaged with services and receive the treatment they need.                                                                                                                                                                                                            </p> <p><strong>What could we be doing better?</strong></p> <p>Coming from a health system in the armed forces where health care is organised for them, veterans may have heightened expectations about the level of coordinated and integrated practice.</p> <p>So first, we need improved integration and coordination of services, including development of outreach capabilities which more proactively engage with veterans and their families and connect them to appropriate services. Outreach can be led by health professionals or intersect with existing peer support networks.</p> <p>Second, we need to enhance the knowledge and skills among health professionals in the various services to which veterans are reaching out. Importantly, services and treatments should be delivered with appropriate “military cultural awareness”.</p> <p>This means practitioners demonstrating they understand the types of experiences veterans may have been exposed to, and the potential lasting impacts of these experiences. Veterans are likely to be more engaged in services if they feel well understood.</p> <p>Parallel to this, we need to be aware of the needs of, and actively support, the families who often bear the brunt of the mental health problems experienced by the veterans. <a href="https://www.openarms.gov.au/">Open Arms – Veterans &amp; Families Counselling</a>, a free national counselling service, plays a large role in provision of this support.</p> <p>Ultimately we need to continue to focus on innovations in the prevention of and early interventions for mental health problems among veterans, including suicidality. In doing so we must maintain a focus on well-being outcomes more broadly and not just on symptoms and conditions, ensuring our goal remains assisting veterans in living a meaningful and satisfying life in all its domains.</p> <p><em>If this article has raised issues for you or you’re concerned about someone you know, call Open Arms on 1800 011 046 or Lifeline on 13 11 14.</em></p> <p><em>Written by Nicole Sadler. Republished with permission of <a href="https://theconversation.com/veterans-have-poorer-mental-health-than-australians-overall-we-could-be-serving-them-better-119525">The Conversation.</a> </em></p>

Retirement Life

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“Very poor taste”: Airline slammed after morbid Twitter gaffe

<p><span style="font-weight: 400;">An airline has had to apologise to the public after tweeting a grim statistic as a part of a “Tuesday Trivia” promotion.</span></p> <p><span style="font-weight: 400;">The airline tweeted statistics about the likelihood of a passenger dying during a crash based on their seating assignment.</span></p> <p><span style="font-weight: 400;">“According to data studies by Time, the fatality rate for the seats in the middle of the plane is the highest.</span></p> <p><span style="font-weight: 400;">“However, the fatality rate for the seats in the front is marginally lesser and is least for seats at the rear third of a plane,” the tweet said.</span></p> <p><span style="font-weight: 400;">There was an image of an aircraft seat accompanying the tweet as well as the message:  “Seats at the back of a plane are the safest!”.</span></p> <p><span style="font-weight: 400;">Many twitter users responded in droves, saying that the tweet was inappropriate.</span></p> <p><span style="font-weight: 400;">KLM India removed the tweet and replaced it with an apology.</span></p> <blockquote class="twitter-tweet" data-lang="en"> <p dir="ltr">We would like to sincerely apologise for a recent update. The post was based on a publically available aviation fact, and isn't a <a href="https://twitter.com/KLM?ref_src=twsrc%5Etfw">@KLM</a> opinion. It was never our intention to hurt anyone's sentiments. The post has since been deleted.</p> — KLM India (@KLMIndia) <a href="https://twitter.com/KLMIndia/status/1151574115049803777?ref_src=twsrc%5Etfw">July 17, 2019</a></blockquote> <p><span style="font-weight: 400;">However, for some Twitter users, the damage was done.  </span></p> <p><span style="font-weight: 400;">“If I’m gonna die it’s going to be in first class,” one person commented.</span></p> <p><span style="font-weight: 400;">“Frankly, I’m glad to know the seats in the back of the plane are the safest,” another added.</span></p> <p><span style="font-weight: 400;">“Besides the tweet which was in very poor taste, your statement also wasn’t a fact because there’s just not enough data (thankfully) to make that assertion,” one person wrote.</span></p> <p><span style="font-weight: 400;">One user pointed out the morbid timing of the tweet.</span></p> <p><span style="font-weight: 400;">“Not the best tweet on the fifth anniversary of crash of #MH17,” a user wrote.</span></p>

Travel Trouble

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Why single women are more likely to retire poor

<p><em><strong>Diana Warren, Research Fellow, Australian Institute of Family Studies, explains why single women are more likely to retire in a state of poverty.</strong></em></p> <p>The participation of women in the labour force has increased substantially over the last few decades, but women still retire with around half as much superannuation as men.</p> <p>Women are still more likely than men to have interrupted career patterns and work casually or part-time. Women have longer life expectancies than men and generally retire younger, so they spend longer in retirement, on average, than men do.</p> <p>The three main causes of the gap in superannuation are:</p> <p><strong>1. The gender wage gap</strong> — the Workplace Gender Equality Agency estimates the difference between women’s and men’s average weekly full-time equivalent earnings, as a percentage of men’s earnings is currently 18 per cent.</p> <p><strong>2. Time out of paid employment</strong> — to care for children or other family members.</p> <p><strong>3. Working hours</strong> — women are more likely than men to work part-time.</p> <p>The combined result of these factors is a gender difference in superannuation savings that compounds over time.</p> <p>Take, for example, a man and a woman, both aged 30 and working full-time. The man earns $73,000 per year before tax and has a superannuation balance of $20,000. The woman earns $60,000 per year before tax and, because of the wage difference, has a superannuation balance of $15,000. If they both continue working full-time, with no time out of the labour force, their superannuation balance at age 65 will be $751,000 and $611,000 respectively.</p> <p><strong>Small break, big impact</strong></p> <p>If the woman has a baby at age 31 and takes one year out of the labour force without pay (and without employer superannuation contributions), before returning to full-time work, her superannuation balance at age 65 will drop to $584,000. If she returns to work 3 days per week at 60 per cent of her full-time salary from then on, her superannuation balance at age 65 would drop to $384,000 after a one-year career break, or $325,000 after a five-year career break.</p> <p>While compulsory employer superannuation contributions are based on income, the gender gap in superannuation savings will continue. There is no single clear solution that will overcome this issue. However, this doesn’t necessarily mean women will be worse off in retirement. Data from the HILDA Survey show that most Australians approaching retirement are living with a spouse or partner. For women in couple households, the overall savings of the couple, combined with a full or part age pension are generally enough to maintain a reasonable standard of living. Where difficulties often arise for women is when a relationship ends, or their partner dies.</p> <p>Analysis by the Australian Institute of Family Studies shows that, based on household disposable incomes in 2012–13, most partnered retirees had a reasonable standard of living. The age pension is not far short of the budget required for a modest standard of living in retirement, as defined by the Association of Superannuation Funds of Australia (ASFA). Still, compared to partnered retirees, it is much more common for single retirees to rely almost entirely on the age pension.</p> <p>The ASFA retirement standards assume that retirees own their home outright, and have very little in the way of housing expenses. While this is the case for most retirees, single retirees were less likely to own their home. Among single female retirees aged 65 to 69, 30 per cent were paying rent and 8 per cent were paying off a mortgage.</p> <p>When housing expenses were taken into consideration, the percentage of retirees who were able to afford a modest lifestyle was reduced considerably, particularly among single women. Around 65 per cent of single retired women aged 65 to 79 were not able to afford at least a modest lifestyle. Single men fared slightly better, with nearly 50 per cent of single male retirees aged 65 to 69, and around 60 per cent of those aged 70 or older not able to afford a modest standard of living (see below).</p> <p><strong>Couples do better</strong></p> <p>At present, single women are the least likely to be able to afford even a modest lifestyle in retirement.</p> <p>Changes to superannuation policy to address the gender gap in superannuation savings, along with policies that encourage the increased labour force participation of women, may assist retirees in decades to come. But for the current group of retirees, policies targeting assistance to those in genuine financial hardship, particularly those who do not own their own home, will be more effective for improving living standards.</p> <p>What are your thoughts?</p> <p><em>Written by Diana Warren. First appeared on <a href="http://www.theconversation.com" target="_blank"><strong><span style="text-decoration: underline;">The Conversation</span></strong></a>.</em><img width="1" height="1" src="https://counter.theconversation.com/content/51126/count.gif?distributor=republish-lightbox-advanced" alt="The Conversation"/></p>

Retirement Income

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10 money lessons we can learn from the less fortunate

<p><em><strong>Rob Stock is a finance expert from New Zealand. In this piece, he talks about the lessons that have been learned from a course designed from low income earners in west Auckland, and examines how we can apply these sometimes-harsh lessons to our own lives.</strong></em></p> <p>The idea that you have a "money personality" is widely pedalled.</p> <p>I am a saver. I am a spender. I am an impulse buyer.</p> <p>They are statements that sound like our money natures are immutable.</p> <p>But they are far from it, a study of the low income people who have completed the ANZ-funded MoneyMinded course in south and west Auckland suggests.</p> <p>Those who do the course, which is provided by the Solomon Group, have often been sent by Work and Income.</p> <p>These are people who are getting by on the lowest rung of our economic ladder.</p> <p>But the before and after behaviours, attitudes and the way people who have done the course, see themselves has been revealed in a study by University of Auckland Business School professor Peter Boxall.</p> <p>Boxall's report contains lessons for everyone on facing up to their financial failings and the changes to your wealth, health and sense of hope that come with doing so.</p> <p><strong>Lesson 1: Anyone can change</strong></p> <p>Boxall's study showed that there were "statistically significant" changes for the better in 92 per cent of the behaviours and attitudes of the people who had done the course in the last couple of years. There were behavioural changes. Just under half of those surveyed said they had paid bills on time before doing MoneyMinded. Afterwards, that jumped to over 80 per cent. There was evidence that core money beliefs had changed as well as behaviours. Before doing the course four in ten people agreed to the statement: "I believe money is there to be spent." After, that dropped to three in ten. If you doubt your ability to change on your own, get yourself trained.</p> <p><strong>Lesson 2: Changes of behaviour can bring new hope</strong></p> <p>Boxall found that before doing the MoneyMinded course, just under 30 per cent of people felt the way they managed their finances would have no impact on their future. That's a fairly hopeless view of the world. It speaks of people who feel their income is just too low for financial literacy to make any difference to their long-term hopes. After the course, just 8 per cent still thought that. People have learnt is that money smarts can make a difference, even on tight budgets, though Boxall said those with households incomes of $25,000-$45,000 showed more positive changes in attitude and behaviour compared to those on lower incomes.</p> <p><strong>Lesson 3: Get a money buddy</strong></p> <p>One-on-one, you can only learn so much from a financial literacy teacher, but when you do that learning with others, the impact is magnified. When asked if they had learned "a lot" from the other people on the course, 94 per cent said they had. In fact, many participants are still in contact and are there for each to talk money matters over when there's a need.</p> <p><strong>Lesson 4: Even the poorly-educated can learn money skills</strong></p> <p>Basic literacy and numeracy are massive challenges to many. Literacy is measured on a scale of 1-5, where levels one and two are people who can't deal with anything but relatively simple printed material. Things like loan contracts and bank terms and conditions are anything but simple.</p> <p><strong>Lesson 5: Get a rainy day fund</strong></p> <p>Before doing MoneyMinded, 63 per cent said they were unable to cope with unexpected expenses. That dropped to just 3 per cent afterwards. Just under a third had savings for emergencies before doing the course. Afterwards that rose to eight in 10 people. A lack of savings can result in pressure to take on high-interest debt and is a big source of stress as families are never more than one unexpected bill from disaster.</p> <p><strong>Lesson 6: Plug the spending leaks</strong></p> <p>The blight of many financial lives is the "lost opportunity". This is generally the money that could have been saved, or paid off debt that was blown on something essentially pointless, like a habit of buying more clothes than you could reasonably wear in a week, daily energy drinks or coffees bought from cafes. Everybody has "spending leaks", which are things they spend on which don't improve their lives in any substantial way, but reduce their ability to amass savings and clear their debts. To go from being a spender to a saver, a person needs to spend less than they earn. A quarter of those surveyed said they knew before the course how to identify their spending "leaks". That rose to over 90 per cent after.</p> <p><strong>Lesson 7: Anyone can save</strong></p> <p>Plugging the leaks led to a big jump in those who identified themselves as "more of a saver than a spender", from 20 per cent to 70 per cent. Most saved around $10 a week. It's not a lot, but the vast majority of people on the course had household incomes of $25,000 or less, so saving anything is a triumph of determination, restraint and skill.</p> <p><strong>Lesson 8: Learn to say no</strong></p> <p>Saying no, even when you do not have the money is hard, even if it means taking on debt to stump up the readies. But learning to say no is a skill like any other. Confidence to say no when there was no money to make a contribution jumped from just over 40 per cent of people to just over 70 per cent. Additionally, said course founder Frank Solomon, people who had actual savings felt more empowered to give, while limiting it to an affordable amount.</p> <p><strong>Lesson 9: Debt and the mobile shopping trucks are big issue</strong></p> <p>Social Development minister Anne Tolley has come up with a plan to try and limit the damage she believes the mobile shopping trucks are causing. It follows a re-writing of the laws designed to limit the damage caused by loan sharks and other fringe lenders. Mobile shopping trucks are in fact lenders. If you have no cash, you can call them up, and take the goods on tick. There's no money to be paid immediately, but the buyer incurs a debt to be paid back  through a series of instalments. The interest rates charged are often high. One in five taking the MoneyMinded course said they had truck debt.</p> <p><strong>Lesson 10: It's not about the money.</strong></p> <p>Being good with money is about doing your best for your family. When asked to agree or disagree with the statement "Since doing MoneyMinded, I feel able to better provide for my family" 97 per cent agreed. And 86 per cent reported feeling less stressed about their futures.</p> <p>Are you good with money? Let us know in the comments.</p> <p><em>Written by Rob Stock. First appeared on <a href="http://www.stuff.co.nz/" target="_blank"><strong><span style="text-decoration: underline;">Stuff.co.nz</span></strong></a>. </em></p>

Money & Banking

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How to manage poor vision while on holidays

<p>Poor vision can have a huge impact on our day to day lives, but it doesn’t mean your next holiday should remain a pipedream. With planning, preparation and patience, it’s still possible to enjoy travel. Here are four tips for managing poor vision on holidays.</p> <p><strong>1. Don’t be afraid to ask for assistance </strong></p> <p>Whether you’re talking about hotel staff or airline crew, travel employees at various points of your trip will be able to provide assistance and help make life easier for you. Don’t be afraid to ask for help – it really is part of their job and they’ll be more than accommodating. Many activity companies also have measures in place to accommodate the visually impaired.</p> <p><strong>2. Make sure you’re packed and prepared</strong></p> <p>Write a list before you go of everything you need to manage your vision problems (such as contact lenses, cleaning solutions and medication) and make sure you pack two of every item. It’s generally a good idea to keep these in separate bags in case one goes missing.</p> <p><strong>3. Leave plenty of time to make your connections</strong></p> <p>Rushing through a crowded train station can be testing at the best of time, let alone when you’re managing vision problems. If possible, try to make your movements outside peak transit hours and make sure you’ve left plenty of time to make all your connections.</p> <p><strong>4. Don’t be afraid to be ambitious</strong></p> <p>While many people would think that vision problems could seriously impact the amount of activities you could take, don’t be afraid to be ambitious in your trip planning. Many travel companies offer ways the visually impaired can enjoy their popular attractions. </p> <p><strong>Related links:</strong></p> <p><a href="/travel/travel-tips/2016/08/the-thing-you-must-check-when-using-a-hotel-safe/" target="_blank"><span style="text-decoration: underline;"><em><strong>The one thing you must check when using a hotel safe</strong></em></span></a></p> <p><a href="/travel/travel-tips/2016/08/surprising-thing-to-kick-you-off-a-flight/"><span style="text-decoration: underline;"><em><strong>The surprising thing that could get you kicked off a flight</strong></em></span></a></p> <p><a href="/travel/travel-tips/2016/08/healthy-snacks-you-can-actually-take-on-a-plane/"><span style="text-decoration: underline;"><em><strong>6 healthy snacks you can actually take on a plane</strong></em></span></a></p>

Travel Tips