Me and My Acne

             

Did you know that June is Acne Awareness Month, and September is National Skin Care Awareness Month? I didn’t.

I battled acne for years, so I did not need one specific week or month to be reminded of how debilitating it is. My acne was all I saw or heard about, so I walked looking down to avoid making eye contact with judgmental people. While I knew better than to let my acne define me, I still felt like it robbed me of my dignity and self-worth.

In the past, when I met someone, the first thing I noticed about them was their skin. It surprised (and somewhat irritated) me every time they said, “Oh I use anything on my face, my skin is not sensitive and I’ve never had issues with acne.”

The question, “What is going on with your skin?” was soon followed by all sorts of suggested remedies to treat my acne. I politely nodded, confirmed that I had used most of these “tried and true” remedies, and proceeded to die a little more inside.

I started developing acne at age 12 or 13, due to hormonal changes. Back then, things were very different and I clearly did not know any better. Prior to developing acne, the soap I used on my body was what I used on my face. I did not use a facial wash or toner, nor did I use sunscreen. The moisturizer I used on my face was not designed to manage acne.

My mother and I developed a plan to eliminate my acne, which included drinking plenty of water, eating fresh fruit and vegetables, applying organic masks, steaming my face, using minimal and mild skin-care products, and so on. There were good days and there were terrible days. On the bad days, I could hear my acne mercilessly mocking me.

As the years progressed, I started developing acne on my upper shoulders that left unsightly dark blemishes on my skin. I could not wear sleeveless tops even in the uncomfortable hot weather because it was not worth the gasps from everyone who saw my acne scars.

I started using a prescription acne ointment that I firmly believe came from the putrid bowels of hell. Within three days of using this product, my skin cleared up. Not one pimple survived. Within a week or two, the blemishes on my face and upper back had disappeared. I cannot describe the joy I felt or the smirk on my face when I wore my sleeveless tops and dresses.  I should have known that my joy would be short-lived, particularly when I started noticing the serious side effects of the ointment.

1)      More than three people complimented me on my amazing skin while indicating that I was becoming fairer.

2)      Fine hair started growing on the corners of my mouth.

3)      The ointment contained steroids, hence its ability to work so fast.

 I immediately stopped using the ointment. I had no desire to use a product with steroids that was lightening my skin, nor did I want to ingest the toxic chemicals found in skin-lightening products.

Abruptly stopping its use led to my skin attempting to revert to its original tone, which left my skin light in some places and dark in others. I also developed acne blemishes on my forehead, cheeks, and chin that were far worse than what I had before using the ointment. I looked like someone had used my face as a dart board. After several trips to the doctor’s office, I started taking prescription oral medications that gave me terrible vertigo and also used topical acne products that I later found out contained ingredients associated with various forms of cancer.

My mother and I agreed that I needed to stop using/taking every prescription acne product, save for a mild fragrance-free soap, 100% pure Aloe Vera skin gel, and sunscreen. It took weeks of using the gel, but my skin completely cleared up. I later switched to using the Clean and Clear wash and toner. At some point, I started using Proactive which worked wonderfully but switched back to Clean and Clear.

According to the American Academy of Dermatology, acne affects up to 50 million people in the U.S.  A key thing I learned is that early diagnosis and treatment are imperative to prevent long-term skin issues.

Considering that skin is our largest organ, it goes without saying that we need to take very good care of it so it can perform its various jobs well.

When it comes to acne, a one-size-fits-all treatment approach is unrealistic. I’ve not experienced acne in many years, thanks to my diet and skin-care routine. Everyone’s body, health, and skin are very different, so what worked for me will not necessarily work for someone else. Regardless, what worked for me is as follows:

Diet

I drink between 6-8 glasses of water each day.

I do not eat a lot of red meat and chicken, and prefer fish. If I eat beef and chicken, I do my best to buy meat that is free of antibiotics and hormones.

My diet consists of soups, salads, and fresh organic fruits and vegetables. I always believed that organic foods would break my budget, but discovered this is not the case.

I prefer to take my fruits and vegetables in smoothie form for the most part, so I can get the full nutrients while taking the recommended amount of fruit and vegetables per day. The book, “Simple Green Smoothies” by Jen Hansard and Jadah Sellner is a great resource for smoothies. You may also visit their website via this link.

Products

I always visit the Environmental Working Group’s (EWG) website for invaluable information on cosmetics, food scores, healthy cleaning, and pesticides in produce, among other tips. Before I buy any personal care products, I look them up on EWG to see product ratings based on their ingredients. I use:

1.      Facial Wash: Cetaphil Gentle Skin Cleanser for all skin types

2.      Toner: Clean and Clear

3.      Moisturizer: Simple Skincare Protecting Light Moisturizer SPF 15

4.      Facial Scrub: St. Ives Fresh Skin Apricot Scrub

At night, I apply a home-made product that I made using frankincense oil, pure aloe vera gel, pure shea butter oil, pure coconut oil, and vitamin E mixed together. My skin absolutely loves this product and is noticeably softer and smoother. I am also in the process of transitioning to organic hair care and make-up products.

Stress

I do my very best to manage stress because this definitely contributed to my acne breakouts in high school and college. Having a regular exercise routine, on top of engaging in fun activities with loved ones creates an important work-life balance for me.

Acne has the capacity to cause depression (particularly for those who are bullied or teased), low self-esteem, anxiety, and permanent damage to the skin. But it does not have to define you. Remember these three important things:

·         Respect your process. It took time for me to find the remedy/routine that worked for my skin, and I certainly was not as patient as I could have been with my process. Frustration and a lack of patience contributed to more stress which made my acne worse. In addition, I was so anxious to eliminate my acne that I thoughtlessly started using an ointment that could have seriously harmed my health in the long-term.

·         Be patient with others. Most people meant well when they gave me unsolicited advice on acne treatments. It was annoying because I already felt bad and was drowning in information and advice. I learned to speak up and let people know that while I appreciated their advice, I needed a break from hearing about the one thing that occupied 99% of my thoughts.

·         Be kind to yourself. I thought my acne made me unattractive. Such thoughts were harmful since they manifested physically and emotionally. Constant self-affirmation and support from loved ones gave me the confidence I needed to not allow my acne to consume me.

 References

1.      Zaega- Beauty You Can Trust (2016). Retrieved August 22, 2016: http://www.zaega.com/your-skins-most-important-jobs-6-ways-your-skin-is-working-for-you.html

2.      Hansard, J. and Sellner, J. (2015). Simple Green Smoothies: 100+ Tasty Recipes to Lose Weight, Gain Energy, and Feel Great in Your Body.

3.      Hansard, J. and Sellner, J. (2016). Retrieved August 26, 2016: http://simplegreensmoothies.com/

4.      Environmental Working Group (2016). http://www.ewg.org/consumer-guides

5.      Cetaphil (2016). Retrieved August 26, 2016: http://www.cetaphil.com/gentle-skin-cleanser

6.      Clean and Clear (2016). Retrieved August 26, 2016: https://www.cleanandclear.com/astringents-toners/essentials-deep-cleaning-astringent

7.      Simple Skincare (2016). Retrieved August 26, 2016: http://www.simpleskincare.com/our-products/product/protecting-light-moisturizer-spf-15.html

8.      St. Ives (2016). Retrieved August 26, 2016: http://www.stives.com/product/detail/361679/fresh-skin-apricot-scrub

9.      American Academy of Dermatology. (2016). Acne. Retrieved August 27, 2016: https://www.aad.org/media/stats/conditions

Images

1.      Acne.com. (2016). How to Recognize All the Different Signs of Acne [Image], Retrieved August 27, 2016: http://www.acne.com/types-of-acne/acne-signs/

2.      Skinpossible. (2016). Say “Goodbye” to Acne and Acne Scars! [Image], Retrieved August 27, 2016: http://www.skinpossible.ca/calgary-acne-and-acne-scars.html

3.      Cetaphil (2016). [Image], Retrieved August 26, 2016: http://www.cetaphil.com/gentle-skin-cleanser

4.      Clean and Clear (2016). [Image], Retrieved August 26, 2016: https://www.cleanandclear.com/astringents-toners/essentials-deep-cleaning-astringent

5.      Simple Skincare (2016). [Image], Retrieved August 26, 2016: http://www.simpleskincare.com/our-products/product/protecting-light-moisturizer-spf-15.html

6.      St. Ives (2016). [Image], Retrieved August 26, 2016: http://www.stives.com/product/detail/361679/fresh-skin-apricot-scrub

It's World Humanitarian Day

     

Image 1

“When all the trees have been cut down, when all the animals have been hunted, when all the waters are polluted, when all the air is unsafe to breathe, only then will you discover you cannot eat money.”¹

I had a conversation with a close friend of mine named Sandra*. She said that for the first time in a long time, she genuinely felt content and at peace. I asked her to tell me about her journey to inner peace, and what she shared brought to mind the image below:

Image 2

In her late 20s, Sandra was fortunate to acquire a great job that guaranteed a very comfortable life for her. In addition, she married and had children and lived what many would consider the perfect life. After a while, she became discontent because she always wanted more, yet it was still never enough. There was always a better car, a higher-paying job, more fashionable clothing, the latest technology, better and more expensive schools for her children, and so on. Her life’s purpose focused on maintaining an image and keeping up with everyone else.

Soon enough, her career was no longer exciting, and her friendships turned into draining interactions that often lacked substance and value. No amount of retail therapy could fill the gaping hole she felt inside her. She became completely consumed by her unhappiness. She did not discuss her feelings with others because she knew she would be judged and called ungracious and ungrateful. How could she possibly complain about being unhappy when her life was so much better than many others? As expected, Sandra’s health started to suffer. She lacked the desire to exercise or engage in fun activities and battled insomnia for months.

Image 3

Sandra had one group of friends who were like her – driven by money, amassing material wealth, and maintaining a certain image. She noticed that when she interacted with them, she came away from those interactions feeling bad about herself. She and her friends were not oblivious to suffering in the world. They often donated money to charity, but their reasons for doing so were not completely genuine, particularly for those who gave more just to upstage each other. They became comfortable with saying they had done their part and given good money, but not once did they volunteer their time to engage in hands-on volunteer work.

The more Sandra became discontent, the more she sought out her different group of friends whose lives revolved around humanitarian work, social justice, and positive change. When she interacted with these friends, she came away from those conversations feeling energized, encouraged, and curious, with a need to do something more with her life. This group of friends had a passion and purpose for living that was not driven by material wealth, but by an insatiable need to commit all their time and talents to finding solutions to the world’s most pressing needs. In the past, she found it difficult to hang out with this group of friends on a regular basis because, while she admired them, their stories depressed her.

Sandra’s friends shared their experience with visiting, living, and/or working in parts of the world where human suffering was at its worst. Others had spent their entire careers engaged in civil, animal, and environmental rights/protection.

She finally figured out what was making her so sad and discontent. She realized that she had been quite selfish with her wealth, time, and talents. More importantly, she realized that she was not living her life’s purpose. She had access to resources that could improve countless people’s lives. She had the knowledge and the skill-set to contribute to finding solutions to the world’s most crucial issues, but she had spent her life “being shallow”.

She decided to do more and quickly became overwhelmed. Like many others, every time she accessed social media or the news, all she saw were countless stories about poverty, war, greed, violence, disease, and corruption. She had no idea where to start or where she’d be of most use.

Sandra’s journey begun with her figuring out what she cared the most about. Was it Animal Rights? Civil Rights? Social Justice? Women and Gender Rights? Healthcare Reform? Human Rights? Environmental Rights? Children’s Rights? She had a variety of causes to learn about and become involved in and started speaking to those who were already engaged in these causes. Once she identified what she most cared about, her next steps were to plan how she could help. She started by donating funds to organizations whose work she supported. Next, she started volunteering with local organizations whose mission and vision aligned with her interests, and eventually, she transitioned to work for an organization whose mission, vision, and work she fully supported.

Today, Sandra is in the process of starting her own Nonprofit that focuses on the areas she sees the most need in.

There is absolutely nothing wrong with being wealthy and building upon your wealth. Many people work very hard to get to where they are, so it’s only natural to enjoy the fruits of their labor as they see fit.

                           

However, the quote below by Meagher has an important message—many people are materially wealthy but deeply unhappy because their money can’t buy them inner peace, true love, happiness, or real friends.

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How can you help on World Humanitarian Day (WHD)?

1)      We do not have to wait until August 19 to find ways to help others. This is something we should strive to do every day, given all the pain and suffering in the world. World issues can be resolved through resources and making a conscious decision to put others before ourselves.

2)      We should not help others just because it makes us feel better. We should help others because it improves the quality of their lives² and will often times encourage them to help others the same way.

Image 5

The 2016 theme for WHD is “One Humanity”. According to the UN, WHD will “highlight how the world came together in Istanbul for the World Humanitarian Summit earlier this year, and made commitments to support people affected by crisis and ensure that aid workers can safely and more effectively deliver to those in need.”³ More information may be found via this link⁴ on events that will be held around the world to honor this day, as well as information on what you can do to help.

Volunteering has many benefits,⁵ not just for those you help but for you as well. Aside from talking to your loved ones and friends, visit sites such as Volunteer Match to locate organizations in your city that you can volunteer with on a regular basis. There is always something for everyone, whether it’s feeding the homeless, animal shelters, visiting the sick and shut-in, and building communities, etc.

Finally, remember that WHD is a great day to (i) plan an event of your own to help those in need; (ii) encourage others to become more involved in making the world a better place; and (iii) honor those who risk their lives every day in humanitarian service.

*Not her real name.

  

 References

1.      Native American Quotes and Thoughts. N.d. Retrieved August 8, 2016: http://www.stevenredhead.com/Native/quotes.html  

2.      Segal, J. and Robinson, L. (2016). Volunteering and its Surprising Benefits. How Volunteering Makes us Healthier and Happier. Retrieved August 5, 2016: http://www.helpguide.org/articles/work-career/volunteering-and-its-surprising-benefits.htm

3.      UN World Humanitarian Day 19 August. (2016). 2016 Theme: One Humanity. Retrieved August 10, 2016: http://www.un.org/en/events/humanitarianday/

4.      UN Office for the Coordination of Humanitarian Affairs. World Humanitarian Day 2016. Retrieved August 9, 2016: http://www.unocha.org/whd2016

5.      World Humanitarian Day Do Something Good. (2016). Feel Good About Helping Others. Helping Patients and Prevent Medical Negligence & Neglect. Retrieved August 5, 2016: http://www.whd-iwashere.org/

Images

1.      Affairs Blog. (2015). UN Observance: World Humanitarian Day, 19 August 2015. Retrieved August 5, 2016: https://globalroundtableissues.wordpress.com/2015/08/21/un-observance-world-humanitarian-day-19-august-2015/

2.      Onesizzle Sad Comics. (n.d.). Be Grateful for What You Have. Retrieved August 5, 2016: https://onsizzle.com/i/look-at-that-new-car-i-wish-i-had-a-568799  

3.      Manson, M. (2013). Stop Trying to Be Happy. Retrieved August 5, 2016: https://markmanson.net/stop-trying-to-be-happy

4.      Quote Addicts. (n.d.). Retrieved August 5, 2016:

http://quoteaddicts.com/topic/some-people-are-so-poor-all-they-have-is-money/

5.      Vandervelden, D. (2014). Retrieved August 5, 2016: http://blog.greatmate.com/why-should-we-help-others/

Opinion Piece: Why communications is necessary for health systems research.

Communications is one of the most integral components in any system. As systems are composed of various units, communicating among each unit allows for the system to achieve its function. If said medium is efficient, It allows for equitable resource allocation while providing a medium by which data may be collected and studied.

What is Health Systems Research?

Why Talk About Communications?

In my opinion, communications is integral to the sustainable and fluid functioning of any health system. Whether by reporting or effective social messaging, the need of long term study can be demonstrated and thereby funding secured for continued study. For health systems research, it allows for effective data retrieval and sensible comprehension of the results. As a health system is accountable to the society it serves, it is necessary to adopt specific messaging vehicles that reach the national audience and maximizes on exposure.

Understanding the message itself is a whole different ball game; the comprehension of the message you communicate varies based on culture and other socio-economic factors. You could positively or negatively frame your health promotion and education messages with varying behavioral change effects on message recipients. Listen to this short clip on “the power of words” by the 2015 World Champion of Public Speaking. I believe he outlines the power of messaging quite simply.

Communications is necessary for health systems research because it involves people, institutions and activities to function equitably and effectively. One must communicate well in order to achieve efficient functioning of various component pieces or partners, prevent the unnecessary allocation of resources and adhere to leading standards of practice. Above all, your message should answer the most important question...

Why should I care about your MESSAGE?

When receiving any health message, an organization or individual should obviously tailor communications to the audience and answer the aforementioned question well. Whether by the use of templates or creative messaging, vivid and clear communications are what will help you achieve your objective. I personally believe in the power of story telling. Stories are learnt but they can also be relayed to another very easily. 

So why is communications necessary for health systems research? 

Communications lead, inform, motivate and inspire the positive change we wish to see in the world. Isn't this why we go into research? 

When they Breed, You will Bleed

“If they breed, you will bleed” is a message you would see on a billboard, warning of the dangers posed by dengue in Sri Lanka. According to the WHO, two-fifths of the world’s population; are at risk of dengue fever, with an estimated 50 million infections annually around the globe. As Sri Lanka and a few other South Asian countries share the classification of “Category A country” by the WHO; the vector borne disease remains one of the leading causes of hospitalization and death among children. According to the Epidemiological Unit, Ministry of Health, Sri Lanka; 25164 suspected dengue cases have been reported island wide for the year 2013 (Reported Oct 14^th 2013). Of which 48.11% of patients were from the western province of the country, where the population density is the highest on the island.

The prevention campaign which aimed to curb the spread of this disease was initiated in early 2010.  From the implementation of the legal act (National Dengue Prevention Act), adjusting national management guidelines and the vast research employed into finding a biological control for the dengue mosquito; Sri Lanka has been rushing to purge the deadly virus off its grounds. The recent advances in entomology research founded a new species of mosquito in Sri Lanka, “Topomyia". It’s relevance to dengue is that in its larval stage; the Topomyia larvae would feed on the larvae of the genus Aedes. It is a hope that this discovery will help in the multi-pronged advance against the dengue menace.

Vector borne diseases have been plaguing the world since our inception on this planet. Dengue, Malaria, Filariasis and Yellow Fever, are emerging mosquito borne diseases. Their threat to human health remains detrimental in some parts of the globe more than others.  For example; In Sri Lanka, Dengue prevention campaigns sprouted overnight creating awareness and policies aimed at controlling the endemic. The National Dengue Prevention Act in particular caught my attention. It has been constantly implemented and the fact that fines and legal prosecution are now used as protocols for fending off the hemorrhagic fever is nauseating.

Considering that the vector mosquito breeds in pockets of clean stagnant water, the breeding grounds are bound to be more numerous in the low socioeconomic areas of the country. With terrible housing conditions, overcrowding and roofs that are barely kept together; a perfect environment for water collection is produced. Marginalizing individuals in this way is a mockery of any democratic governing body. It would make more sense to provide incentives e.g.; tax deductions, if the public health inspectors are satisfied.

I also wanted to touch on the fact that a new mosquito species has been found. With more research being funded into that topic; the intention I believe is to incorporate this new species of mosquito in the hopes that the Aedes mosquito will be kept at bay. My concern is that a new viral disease may emerge by simply introducing large numbers of this new organism in to the environment. Tipping the scales of a biological food chain is no simple safe task! Using Mother Nature’s own, to alter our surroundings for our own gain may amplify other dangers in the long run. Before such integration, thorough research must be carried out because if they breed. You never know of the dangers do you... 

“…The Lungs of our Land”

                 

I love living in Columbus, Ohio. This city is culturally diverse and offers various opportunities to indulge in festivals¹, the arts, sports, nightlife, and (my favorite), nature.

Ohio has done a magnificent job of preserving its natural resources, such as scenic parks and sanctuaries² where people can enjoy quiet, clean air, beautiful nature, and safe places to meditate, spend time with loved ones, or exercise. Local citizens recognize the beauty and value of our natural resources³ (especially trees), and through partnerships with relevant organizations, strive to maintain and educate people on how they can contribute to preserving our environment.⁴

Roosevelt once said, “a nation that destroys its soils destroys itself. Forests are the lungs of our land, purifying the air and giving fresh strength to our people”. And he was right.

Current news and social media are filled with worrisome accounts about worldwide environmental degradation, climate change, eradication of endangered species, and the violent abuse of our vanishing natural resources. It is common to hear about the destruction of forests and parks, despite scientific proof of the negative effects that deforestation has on the plants and animals that need these spaces to survive.

According to National Geographic, forests account for 30% of the world’s land area, but each year, large tracts of forests are decimated for a variety of reasons (agriculture, forest fires, greedy politicians, and powerful industries).⁵

Trees are vital because they provide oxygen, stabilize soil, sustain the life of wild species, provide materials for shelter, and store carbon.⁶ The negative effects of deforestation include biodiversity loss, soil erosion, air pollution, soil and water pollution, and climate change.⁷ Given what it means especially for the air and soil quality, we each have a duty to protect our natural/green surroundings, which begins with replacing every tree that we cut down.

Each year, Columbus, Ohio celebrates the Columbus Arts Festival⁸, one of the best and most anticipated events in the state. “Music, spoken word, dance, theater, acoustic, and jazz and blues stages, hands-on arts activities, exhibitions of local student artwork and local artist collectives, and a wide selection of quality food and beverages round out Columbus’s favorite outdoor summer event.”⁹

The combination of a beautiful location and the celebration of diversity make this a highly anticipated event. I attend this festival each year and particularly enjoyed it last weekend. The Arts festival is held in the scenic downtown Scioto Mile¹⁰ riverfront of Columbus. Even outside of the festival, this is one of my favorite places to spend time in, particularly in the warm summer evenings, given the peaceful ambiance and preservation of nature in this area.

Just as I was celebrating this beautiful festival, news came in about a lethal mass shooting in Orlando, Florida.¹¹ With each day, we learn more about the motivation behind this senseless act of violence. This tragic incident has once again led to heated discussions about gun control, extremism, and prejudice.

Almost on a daily basis, we read stories about prejudice, intolerance, violence, and suffering. Our society has become one where we view our differences as a threat. As such, many fall into a trap where we allow our differences to divide us, thus leading to environments of hate and mistrust.

So why is it that some people embrace different cultures/differences/diversity, while others fear and reject them? Maya Angelou said “It is time for parents to teach young people early on that in diversity there is beauty and there is strength”.

Those who embrace, respect, and appreciate diversity learn early on in life to look at differences as a source of information, strength, and inspiration. Instead of being fearful of what they do not understand, they have learned to step outside of their comfort zones, read, learn, think for themselves, and interact with those different from them. As such, whatever stereotypes and biases they have of others eventually disappear. They, therefore, light a proverbial candle that is passed on to others and create communities that no longer look at “being different” as a problem.

As I consider how we perceive differences, culture, diversity, and respect for the earth…I question the type of legacy we are leaving for future generations, and what kind of earth they will inherit. All over the world, various countries/states/cities are experiencing weather extremes that were certainly not the norm years ago. In addition, we continue to experience violence fueled by hate, prejudice, and intolerance.

When asked whether I believe that there is still hope for humanity, my answer is always the same: there are many times I have lost faith in the human race, particularly when we commit inhumane acts towards others, animals, and the environment. But my hope has been repeatedly restored by those who move beyond words and volunteer their time and talents to making our world a much better place. As Gandhi said, “As human beings, our greatness lies not so much in being able to remake the world – that is the myth of the atomic age – as in being able to remake ourselves.”

References

1.      Festivals and Events. (2016). Retrieved from: http://www.ohio.org/interests/festivals-events

2.      Ohio State Parks. (2016). Find an Ohio Park. Retrieved from: http://parks.ohiodnr.gov/findapark

3.      Ohio State Parks. (2016). ODNR Division of Ohio State Parks.  Volunteer for Ohio State Parks – Ohio State Parks Volunteer Opportunities. Retrieved from: http://parks.ohiodnr.gov/volunteer

4.      Keep Ohio Beautiful. (2016). Retrieved from: http://keepohiobeautiful.org/about-us/

5.      National Geographic. Deforestation. Retrieved from: http://environment.nationalgeographic.com/environment/global-warming/deforestation-overview/

6.      Royal Parks Foundation. (2016). Why are Trees So Important? Retrieved from: http://www.supporttheroyalparks.org/visit_the_parks/the_regents_park/tree_map/why_trees_are_important

7.      Clay, J. (2004). World Agriculture and the Environment. World Wide Fund Global – Palm Oil & Forest Conversion. Retrieved from:  http://wwf.panda.org/what_we_do/footprint/agriculture/palm_oil/environmental_impacts/forest_conversion/

8.      Goldstein, J. (2016). 55^th Annual Columbus Arts Festival Brings Art, Music, & More to the Riverfront June 10-12. Greater Columbus Arts Council. Retrieved from: https://www.columbusartsfestival.org/contact/press-room/55th-annual-columbus-arts-festival-brings-art-music-more-to-the-riverfront-june-10-12/  

9.      Goldstein, J. (2016). 55^th Annual Columbus Arts Festival Brings Art, Music, & More to the Riverfront June 10-12. Greater Columbus Arts Council. Retrieved from: https://www.columbusartsfestival.org/contact/press-room/55th-annual-columbus-arts-festival-brings-art-music-more-to-the-riverfront-june-10-12/

10.  Columbus Recreation and Parks Department. (2016). Columbus Downtown Destination. Inside the Scioto Mile. Retreved from: http://www.sciotomile.com/

11.  Alvarez, L., & Perez-Pena, R. (2016). Orlando Gunman Attacks Gay Nightclub, Leaving 50 Dead. The New York Times, Retrieved from: http://www.nytimes.com/2016/06/13/us/orlando-nightclub-shooting.html?_r=0

Images

1.      Vervroegen, E. (2008). WWF: Lungs [Image], Retrieved June 10, 2016: http://adsoftheworld.com/media/print/wwf_lungs

2.      40 Days of Prayer Against Racism May 26 [Image], Retrieved June 10, 2016: https://www.pinterest.com/kimmyrachelle/against-racism/ 

Coercive tobacco control health promotion: the curious case of Mayor Duterte

News of Davao City, Philippines Mayor Rodrigo Duterte, who is running for the Presidential election, has warranted international media attention and sparked global outrage for his contentious comments regarding an Australian rape victim. This instance sheds light on the character portrayal the media capitalizes on. His strategy of being portrayed in a threatening light has been thought to have resulted in his success in managing Davao City.[1]

Before garnering worldwide attention for his racy remarks, Mayor Duterte was positively regarded for his work in making Davao City smoke-free by various organizations, including the World Health Organization. It is widely known that tobacco is a leading cause of death, illness and impoverishment; tobacco is a wicked policy problem. But, Mayor Duterte has employed a unique solution to tobacco control by utilizing his reputation as a ‘feared’ leader to coerce citizens into quitting and refraining from using tobacco products. A prime example is the city’s billboards depicting the mayor crushing a cigarette in his fist.

It is understood that fear tactics should be used carefully when seeking to achieve long-term behavioural change; since fear tactics evoke immediate emotion in individuals and if executed improperly the associated lessons generally do not carry out into behavioural change in the long-term. Despite this knowledge, fear tactics have succeeded in making Davao City the first 100 percent smoke-free city in Southeast Asia.[2]

Protection Motivation Theory provides a theoretical understanding of successful fear tactics. According to the theory, individuals gauge both their threat and coping appraisals. When both the threat (i.e. health dangers of smoking) and coping (i.e. self-efficacy to overcome a smoking addiction) appraisals are high, the individual has a high protection motivation, resulting in the fear tactic messaging having an effect on the individual.[3]

Mayor Duterte’s strategy aligns with the Protection Motivation Theory, as the threat appraisal is high since people are afraid of the mayor and he may have enforcement elements (such as: social, political, or police) that act to emphasize his influence. In fact, it has been well demonstrated that the most effective tobacco control measures are coercive and not voluntary (for example, regulatory by-laws banning smoking in public places).

Granted, fear tactics likely worked alongside other tobacco policy tools creating a comprehensive approach to tobacco control in Davao City, resulting in the decline in tobacco consumption prevalence.

Despite the negative attention Mayor Duterte has received, his work highlights the tremendous impact a coercive political leader can play in influencing health outcomes by championing health. It also further warrants research to explore cultural considerations in employing health promotion models of change. Perhaps certain types of strategies work better than others in Asian contexts, which may lead to consideration of alterations to some existing health promotion models of change.

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[1] http://www.filipinewsph.com/2016/04/veteran-lawyer-backs-duterte-over-rape-joke.html?m=1

[2] “Davao City first smoke-free Metropolitan City in Southeast Asia”. (2013, July 29). Tempo: News in a Flash. Retrieved on March 28, 2015 from: http://www.tempo.com.ph/2013/07/29/davao-city-first-smoke-freemetropolitan-city-in-southeast-asia/

[3] Rogers, R. W. & Prentice-Dunn, S. (1997). Handbook of health behavior research 1: Personal and social determinants. (pp. 113-132). New York, NY, US: Plenum Press, xxviii, 505 pp.

Let’s Talk About Mental Health...

John is 28 years old. His friends and family have given him nicknames such as “All-Over-the-Place, John”, “Psycho John”, “Hurricane John”, “Attention-Seeking-John”, and “Sad-Sam-John”, among others.  Some of John’s loved ones describe him as being the life of the party, constantly laughing, and always ready to help. Others say he lacks boundaries, is short-tempered, rude, immature, impulsive, self-centered, and unbearable.

John is one of the “lucky” ones. Two of his childhood friends realized there was more to his behavior than attention-seeking and being difficult. John has a mental illness and got the help and support that he needed in time.

Fact 1: According to the National Institute of Mental Health (NIMH), 57.7 million people (ages 18 and older) in America experience mental illness each year.¹

Many of us believe that mental illness doesn’t affect us and as such, we remain ill-informed. Statistics show that at some point in our lives, many of us will interact with people who suffer from a mental illness. According to the U.S. Department of Health and Human Services (DHHS):

a)      1 in 5 adults in America experienced a diagnosable mental disorder (2014);²

b)      At least 1 in 10 young people suffered from major depression (2014);³

c)      Half of all chronic mental illnesses show first signs in individuals as young as 14, with three quarters of mental health disorders beginning before the age of 24;⁴ and

d)      1 in 25 Americans live with a serious mental illness (major depression, schizophrenia, or bipolar disorder).⁵

Fact 2: Many individuals who suffer from mental illness do not receive the medical and emotional help they need. 

Due to the stigma and pre-conceived notions surrounding mental illness, many who suffer from it are rejected, abused, and discriminated against. As a result, they do not get the help that they need.  Those who do get help often end up in institutions that resemble human warehouses, as opposed to comforting environments that offer healing.⁶ The National Alliance on Mental Illness (NAMI) states that in America:

a)      60% of adults and 50% of youth between the ages of 8 and 15, with a mental illness, did not receive mental health services in the previous year.⁷

b)      90% of those who commit suicide have a history of mental illness.⁸

Fact 3: People with mental illness did not get this illness because they are weak, immature, self-centered, or stubborn.

Mental illness affects each person differently. Until a person is diagnosed with a mental illness, it is very easy to misunderstand or dismiss their behavior. According to the US DHHS:

a)      Genes, illness, trauma, and family history are some of the factors that contribute to mental illness;⁹

b)      People with mental illness can’t just overcome their illness with willpower—they genuinely require treatment, mental health services, and community support to get better;¹⁰

c)      People with mental health problems can get better and some recover completely.¹¹

Fact 4: Just because someone is mentally ill does not mean they are unpredictable and prone to violence.

With all the devastating cases of mass killings, many people assume that those who suffer from a mental illness are capable of committing an act of violence towards others or themselves.

The World Health Organization (WHO) states that “mental disorders are important risk factors for other diseases, as well as unintentional and intentional injury” (2014).¹² The US DHHS states that:

a)      Only 3%-5% of those living with a serious mental health issue have committed violent acts.¹³

b)      Those living with a serious mental health illness are 10% more likely to be victims, rather than perpetrators, of violent acts.¹⁴

c)      We likely each know a friend, family member, or colleague with a mental illness and do not realize they have it, because they are productive, active members of society living full lives.¹⁵

Fact 5: A person living with a mental illness is capable of obtaining and keeping employment.

Some mental illnesses are severe enough to disrupt daily life, making it hard and sometimes impossible for an individual to get and hold down a job. As such, many people assume that all those with mental health needs are unable to perform as well as their colleagues, or even keep their jobs. The US DHHS states that:

a)      Many people with mental health needs, who are receiving help for their illness, have good attendance, are motivated, and perform equally (or better) than their colleagues.¹⁶

b)      Identifying and treating mental illness in good time has great benefits, such as fewer reports of absenteeism, lower medical costs, more productivity, and lower disability costs.¹⁷

What can you do?

1)      Learn about the different types of mental illness. This knowledge could help you identify the common warning signs¹⁸ and better support someone you know with a mental illness.

2)      If you think someone you know might have a mental illness, seek professional advice. Putting labels on mentally ill individuals or making jokes about mental illness is harmful, disrespectful, and unkind.

3)      Start having conversations about mental health and illness. By acknowledging its existence and impact on society, we are taking steps to better understand and manage mental illness, while being supportive of those who suffer from it.

4)      One size does not fit all when it comes to treating mental illness. Do not discourage loved ones from pursuing various forms of treatment and support. Medication alone will not work in all cases. Many patients also need therapy, other forms of self-help, and community support to get better.

5)      Be as supportive as you can. It’s certainly not easy dealing with a loved one with a mental illness. But those with mental illness do not deserve to be ostracized or mistreated. Support from family and friends can go a long way in managing and recovering from mental illness.

  References

1.      National Institute of Mental Health (2013). The Numbers Count: Mental Disorders in America. Retrieved May 5, 2016: http://www.lb7.uscourts.gov/documents/12-cv-1072url2.pdf

2.      U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

3.      U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

4.      U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

5.      U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

6.      World Health Organization (2014). Mental Health: a state of well-being -10 Facts on Mental Health. Retrieved May 5, 2016: http://www.who.int/features/factfiles/mental_health/mental_health_facts/en/

7.      The National Alliance on Mental Illness (n.d.). Mental Health Facts in America. Retrieved May 4, 2016: https://www.nami.org/NAMI/media/NAMI-Media/Infographics/GeneralMHFacts.pdf

8.      The National Alliance on Mental Illness (n.d.). Mental Health Facts in America. Retrieved May 4, 2016: https://www.nami.org/NAMI/media/NAMI-Media/Infographics/GeneralMHFacts.pdf

9.      U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

10.  U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

11.  U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

12.  World Health Organization (2014). Mental Health: a state of well-being -10 Facts on Mental Health. Retrieved May 5, 2016: http://www.who.int/features/factfiles/mental_health/mental_health_facts/en/index4.html

13.  U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

14.  U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

15.  U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

16.  U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

17.  U.S. Department of Health and Human Services (2014). Mental Health Myths and Facts (2014). Retrieved May 4, 2016: https://www.mentalhealth.gov/basics/myths-facts/index.html  

18.  Parekh, R. (2015). Warning Signs of Mental Illness. American Psychiatric Association. Retrieved from: https://www.psychiatry.org/patients-families/warning-signs-of-mental-illness 

Images

1.      Mental Health America. (2016). Mental Health Month [Image], Retrieved May 5, 2016: http://www.mentalhealthamerica.net/may

2.      Mental Health America (2015). Infographic B4Stage4: Changing the Way We Think About Mental Health [Image], Retrieved May 5, 2016: http://www.mentalhealthamerica.net/infographic-b4stage4-changing-way-we-think-about-mental-health

3.       Growth Guided (2015). Here Are Five Issues Millions of Americans Face When Getting Help With Mental Illness [Image], Retrieved May 5, 2016: http://www.growthguided.com/here-are-five-issues-millions-of-americans-face-when-getting-help-with-mental-illness/

4.      Fanpop (n.d.). Mental Health Awareness – “Snap Out Of It.” [Image], Retrieved May 5, 2016: http://www.fanpop.com/clubs/mental-health-awareness/images/36499936/title/snap-out-photo

5.      Fricke, P. (2013). Functional Mental Disorders. [Image]. Retrieved May 5, 2016: http://www.siue.edu/~pfricke/

6.      The London Therapy Center (2015). Some Mental Health Facts & Myths [Image], Retrieved May 5, 2016: http://www.thelondontherapycentre.com/#!some-mental-health-myths---facts/a1jq7