tag:theconversation.com,2011:/fr/topics/social-support-16952/articlesSocial support – The Conversation2023-12-14T03:32:31Ztag:theconversation.com,2011:article/2195042023-12-14T03:32:31Z2023-12-14T03:32:31ZWe followed 14 ‘long haulers’ for 3 months. Here’s what they told us about living with long COVID<figure><img src="https://images.theconversation.com/files/565680/original/file-20231214-29-kbdizh.jpg?ixlib=rb-1.1.0&rect=8%2C0%2C5875%2C3925&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-handsome-ill-sick-man-lying-2225051059">Yurii_Yarema/Shutterstock</a></span></figcaption></figure><p>At least <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00493-2/fulltext">65 million people</a> around the world are estimated to have <a href="https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition">long COVID</a>, which describes the continuation or development of symptoms at least three months after an initial COVID infection.</p>
<p>Long COVID is a complex, multi-system disease that can be disabling and may even <a href="https://time.com/6240713/long-covid-deaths/">be fatal</a> in some cases. We still don’t understand the exact causes of long COVID, and there’s no clear treatment for it.</p>
<p>Over three months, <a href="https://www.sciencedirect.com/science/article/pii/S0277953623008420">we followed 14 people</a> suffering from long COVID – or “long haulers” – to better understand their experiences. In particular, we wanted to see how their ability to manage their health (called agency) and the help they get from others (social support) influence how they fare.</p>
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Read more:
<a href="https://theconversation.com/when-does-covid-become-long-covid-and-whats-happening-in-the-body-when-symptoms-persist-heres-what-weve-learnt-so-far-188976">When does COVID become long COVID? And what's happening in the body when symptoms persist? Here's what we've learnt so far</a>
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<h2>A few key themes</h2>
<p>Participants recorded short videos about their daily lives, focusing on their symptoms, how they were coping, and any lifestyle changes they were making. </p>
<p>They experienced a range of symptoms, including fatigue, breathing difficulties and brain fog. Research has shown these are <a href="https://www.nature.com/articles/s41579-022-00846-2">common symptoms</a> among people with long COVID.</p>
<p>Participants faced psychological and social challenges, with some feeling lonely and hopeless, often made worse by social stigma around expressing mental distress. One participant said:</p>
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<p>Most of my family haven’t contacted me that much over the last five months. So I’ve really just been on my own 24/7, which does wear anyone down.</p>
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<p>Another said she had not</p>
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<p>reached out to my friends too much about it because I just feel like such a hypochondriac. </p>
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<img alt="A senior woman sits on a couch looking out the window." src="https://images.theconversation.com/files/565678/original/file-20231214-29-a9b1jz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565678/original/file-20231214-29-a9b1jz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565678/original/file-20231214-29-a9b1jz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565678/original/file-20231214-29-a9b1jz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565678/original/file-20231214-29-a9b1jz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565678/original/file-20231214-29-a9b1jz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565678/original/file-20231214-29-a9b1jz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">People with long COVID may feel isolated.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/face-senior-caucasian-hoary-woman-looking-2264099993">Perfect Wave/Shutterstock</a></span>
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<p>Some participants felt health-care professionals didn’t take their experiences and symptoms seriously or didn’t understand. One described “an overall very, very poor understanding of the pathophysiology of the condition which is harming patients like me”.</p>
<h2>Agency and social support</h2>
<p>Although each person had a unique experience with long COVID, we were able to group these experiences into clusters based on the social support they received and the agency they had in managing their condition. </p>
<p>Agency is a result of multiple factors that accumulate over time including socioeconomic background, education and health literacy. Agency can improve when people feel in control of their situation.</p>
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<img alt="A matrix divided into four quadrants representing the agency/social support clusters." src="https://images.theconversation.com/files/564600/original/file-20231209-25-6mmwxy.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564600/original/file-20231209-25-6mmwxy.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=460&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564600/original/file-20231209-25-6mmwxy.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=460&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564600/original/file-20231209-25-6mmwxy.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=460&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564600/original/file-20231209-25-6mmwxy.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=578&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564600/original/file-20231209-25-6mmwxy.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=578&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564600/original/file-20231209-25-6mmwxy.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=578&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">We grouped participants into four clusters.</span>
<span class="attribution"><a class="source" href="https://www.sciencedirect.com/science/article/pii/S0277953623008420">Figueiredo et al., Social Science & Medicine, 2023</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p>In general, those with high agency and high social support reported a better experience managing long COVID than those in the other clusters. </p>
<p>People with agency sought out information about their condition and potential treatments, followed through with prescribed treatment plans when available, monitored symptoms, sought support, and were involved in advocacy and research.</p>
<p>Social support was similarly important, manifesting in different ways – for example a spouse who helped their partner get dressed, or a manager who supported reducing work days. In some cases friends provided regular support, while family played a crucial role, often becoming long-term informal carers.</p>
<p>Having a wide group of supporters helped long haulers feel like less of a burden to others and avoided the fear of over-relying on an individual carer. One participant’s church group provided a helpful social network, and reinforced her self-belief. Online communities also offered support.</p>
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Read more:
<a href="https://theconversation.com/from-diagnosis-to-services-and-support-how-australias-long-covid-response-is-falling-short-215056">From diagnosis to services and support: how Australia's long COVID response is falling short</a>
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<p>Those who had low agency and low social support generally reported the worst experiences. One participant who we grouped in this category said:</p>
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<p>Long COVID has destroyed so many aspects of my life […] it’s impossible to overstate the negative impact that it’s had.</p>
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<h2>Our findings align with existing evidence</h2>
<p>Our study was confined to a small group, and participants were only from Australia, which limits how much the findings can be generalised. </p>
<p>That said, our findings align with broader evidence highlighting the complexity of long COVID as a condition with <a href="https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00501-X/fulltext">both physical and psychosocial dimensions</a>.</p>
<p>Our study’s emphasis on patient agency and social support also corresponds with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850205/">emerging literature</a> emphasising the important role these factors play in chronic disease management.</p>
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<img alt="A woman comforts another woman." src="https://images.theconversation.com/files/565679/original/file-20231214-27-iwujjf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565679/original/file-20231214-27-iwujjf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565679/original/file-20231214-27-iwujjf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565679/original/file-20231214-27-iwujjf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565679/original/file-20231214-27-iwujjf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565679/original/file-20231214-27-iwujjf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565679/original/file-20231214-27-iwujjf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Support from friends and family helps.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/shot-pretty-young-woman-supporting-comforting-2061681305">Josep Suria/Shutterstock</a></span>
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<h2>Supporting people with long COVID</h2>
<p>We suggest health-care professionals consider which “cluster” a person with long COVID falls into (low or high agency and low or high social support) and tailor the support they offer accordingly.</p>
<p>For example, long haulers who are more proactive (high agency) could benefit most from educational materials suggesting, for example, different ways to cope, safe exercise routines, diet tips, and strategies to manage mental health concerns.</p>
<p>Meanwhile, people with long COVID who find it hard to manage their health (low agency) but have good support from others (high social support), might benefit from educational materials that show their family and friends how to help them.</p>
<p>Being part of online communities could also help these patients. Although online groups can provide social support and improve a person’s sense of agency, not all information shared in these communities is accurate or reliable.</p>
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Read more:
<a href="https://theconversation.com/how-physios-and-occupational-therapists-are-helping-long-covid-sufferers-195354">How physios and occupational therapists are helping long COVID sufferers</a>
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<p>And what about people with low agency and low social support?</p>
<p>Providing clear, straightforward information about long COVID can enhance their participation in helping manage their health.</p>
<p>Connecting them with support groups, communities or counselling can improve social support. Evidence shows emotional connections <a href="https://bmjopen.bmj.com/content/13/3/e067166">help reduce feelings of distress</a> and boost wellbeing among people with long COVID.</p>
<p>Finally, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648579/">case management services</a> can help long-haulers access and utilise community resources, and simplify their health-care journey.</p><img src="https://counter.theconversation.com/content/219504/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The project “EAT, MOVE, HEAL for Long-COVID” (Project ID: PRJ00000010) was funded by a 2022 Strategic Capability Deployment Fund, RMIT University, Victoria, Australia.</span></em></p><p class="fine-print"><em><span>Catherine Itsiopoulos has received funding from NHMRC for other research. She is a member of professional bodies including Dietitians Australia and The Australasian Society of Lifestyle Medicine. Catherine is a member of RMIT University 'Eat, Move Heal Network' researching to develop tools to support patients with long COVID19 at home.</span></em></p><p class="fine-print"><em><span>Jacob Sheahan receives funding from the Wellcome Trust, and the ACRC is funded by Legal and General.</span></em></p><p class="fine-print"><em><span>Zhen Zheng co-leads the Eat, Move, Heal for Long-COVID Program that aims to provide educational materials to people with long COVID and to health-care professionals. </span></em></p><p class="fine-print"><em><span>Magdalena Plebanski does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Participants recorded short videos about their daily lives, focusing on their symptoms, how they were coping, and any lifestyle changes they were making.Bernardo Figueiredo, Associate Professor of Marketing, RMIT UniversityCatherine Itsiopoulos, Professor and Dean, School of Health and Biomedical Sciences, RMIT UniversityJacob Sheahan, Research Fellow, Edinburgh College of Art, The University of EdinburghMagdalena Plebanski, Professor of Immunology, RMIT UniversityZhen Zheng, Associate Professor, STEM | Health and Biomedical Sciences, RMIT UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2115582023-08-22T12:25:41Z2023-08-22T12:25:41ZOnline gaming communities could provide a lifeline for isolated young men − new research<figure><img src="https://images.theconversation.com/files/543047/original/file-20230816-15-gx4a3y.jpg?ixlib=rb-1.1.0&rect=7%2C0%2C5104%2C2858&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Many gamers discuss deeply personal and sensitive topics with each other.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/back-of-the-head-shot-of-an-african-american-gamer-royalty-free-image/1448557185">gorodenkoff/iStock via Getty Images Plus</a></span></figcaption></figure><p>Online gaming communities could be a vital lifeline for young men struggling silently with mental health issues, <a href="https://doi.org/10.1080/00380237.2023.2199171">according to new research</a>. </p>
<p><a href="https://scholar.google.com/citations?hl=en&user=dn6NJr4AAAAJ">My</a> <a href="https://scholar.google.com/citations?hl=en&user=Rj7Jpt8AAAAJ">colleagues</a> and <a href="https://scholar.google.com/citations?hl=en&user=TOKNbGcAAAAJ">I</a> analyzed an all-male online football gaming community over the course of a year. We discovered that members who reported more depressive symptoms and less real-life support were roughly <a href="https://doi.org/10.1080/00380237.2023.2199171">40% more likely</a> to form and maintain social ties with fellow gamers compared with those reporting more real-life support.</p>
<p>This finding suggests the chat and community features of online games might provide isolated young men an anonymous “<a href="https://www.theatlantic.com/family/archive/2022/04/third-places-meet-new-people-pandemic/629468/">third place</a>” – or space where people can congregate other than work or home – to open up, find empathy and build crucial social connections they may lack in real life. </p>
<h2>Why it matters</h2>
<p>Mental health issues like depression and suicide are on the rise <a href="https://doi.org/10.1017/S0033291717002781">among young men</a> in the U.S., yet social stigmas and traditional masculinity often inhibit them <a href="https://doi.org/10.1016/j.cpr.2016.09.002">from seeking professional assistance</a>. Up to <a href="https://www.samhsa.gov/data/sites/default/files/reports/rpt29393/2019NSDUHFFRPDFWHTML/2019NSDUHFFR1PDFW090120.pdf">75% of people</a> with mental illnesses go without treatment, with <a href="https://doi.org/10.1037/a0017224">men especially unlikely to pursue counseling or therapy</a>. </p>
<p>Online social spaces, like gaming communities, may offer an alternative avenue to find connection and discuss serious personal problems without the barriers of formal mental health services. The social features of online games allow players to privately chat and build friendships, potentially creating vital informal support networks. While not a substitute for professional care, these virtual forums could encourage discussion of mental health challenges among young men facing social isolation and untreated depression. </p>
<p>More comprehensive research is still needed, but the social features of online games may literally provide young men a lifeline when they have nowhere else to turn.</p>
<h2>How we do our work</h2>
<p>We asked members of a small online gaming community to tell us specifically who in the community they talked to about important life matters. Using an open-ended survey, we then asked about these conversations. We also asked them to report how often they felt certain depressive symptoms, as well as their feelings on in-person and online social support.</p>
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<a href="https://images.theconversation.com/files/542863/original/file-20230815-21-1h8pry.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Man with gaming headphones looks distressed while staring at his screen." src="https://images.theconversation.com/files/542863/original/file-20230815-21-1h8pry.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/542863/original/file-20230815-21-1h8pry.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/542863/original/file-20230815-21-1h8pry.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/542863/original/file-20230815-21-1h8pry.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/542863/original/file-20230815-21-1h8pry.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/542863/original/file-20230815-21-1h8pry.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/542863/original/file-20230815-21-1h8pry.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Virtual friendships can have real-life impacts.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/asian-gamer-is-upset-royalty-free-image/1395300802">PonyWang/E+ via Getty Images</a></span>
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<p>We found some members discussed deeply personal and sensitive topics with each other. Many mentioned talking about struggles like stress, anxiety and depression. Some brought up relationship problems they were facing with romantic partners or family members. Others sought advice on major life decisions related to jobs, moving or going back to school. </p>
<p>Several participants specifically said they confided about topics they felt unable to discuss with people in their real lives, suggesting these online friendships provided an outlet they were otherwise lacking. The depth of sharing indicates these online friendships had moved beyond superficial topics into deeper emotional support and bonding.</p>
<h2>What still isn’t known</h2>
<p>Our research was limited to 40 male participants interested in college football video games. Further investigations using larger, more diverse samples across various gaming genres are needed to confirm these preliminary findings.</p>
<p>A key question is whether online social support directly improves depression – or are depressed individuals simply more inclined to seek connections virtually? Despite a massive industry and audience for online gaming, its mental health impacts remain murky. </p>
<h2>What’s next</h2>
<p>My colleagues and I are launching studies that analyze the impact of multiplayer games on teamwork, leadership and social skills in high school and college students compared with traditional extracurricular activities. We are also investigating how involvement in esports can cultivate lasting social relationships and foster a sense of community. </p>
<p>Through multiyear studies, we hope to understand online gaming’s risks – alongside its promise for improving mental health, social integration and life skills.</p>
<p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take on interesting academic work.</em></p><img src="https://counter.theconversation.com/content/211558/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tyler Prochnow does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>For young men who struggle with mental health or lack connections in real life, chat and community features of online games can be a source of support.Tyler Prochnow, Assistant Professor of Health Behavior; School of Public Health, Texas A&M UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2032192023-04-06T18:12:34Z2023-04-06T18:12:34ZThe Canadian government should make the grocery rebate permanent to combat the affordability crisis<figure><img src="https://images.theconversation.com/files/519424/original/file-20230404-28-gmrcj4.jpg?ixlib=rb-1.1.0&rect=117%2C338%2C8414%2C5436&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The federal government's grocery rebate will provide one-time monetary relief to 11 million low- and modest-income Canadians and families.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>One of the most anticipated measures of the <a href="https://www.budget.canada.ca/2023/home-accueil-en.html">2023 Canadian federal budget</a> is the <a href="https://www.budget.canada.ca/2023/report-rapport/chap1-en.html#m1">grocery rebate</a>. The rebate is designed to provide relief to millions of Canadians who are struggling with <a href="https://www150.statcan.gc.ca/n1/pub/62f0014m/62f0014m2022014-eng.htm">rising grocery prices</a> and <a href="https://doi.org/10.24095/hpcdp.42.10.04">food insecurity</a>.</p>
<p>It is a temporary cash transfer of up to $467 for eligible couples with two children, $234 for single Canadians without children and $225 for seniors.</p>
<p>The rebate will cover 11 million low- and modest-income Canadians and families who currently receive the quarterly <a href="https://www.canada.ca/en/revenue-agency/services/forms-publications/publications/rc4210/gst-hst-credit.html">Goods and Services/Harmonized Sales Tax (GST/HST) Credit</a>, which is based on recipients’ net income from their previous tax filing.</p>
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Read more:
<a href="https://theconversation.com/federal-budget-2023-grocery-rebate-is-the-right-direction-on-food-insecurity-but-theres-a-long-road-ahead-201926">Federal budget 2023: Grocery rebate is the right direction on food insecurity, but there's a long road ahead</a>
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<p>As I argued in an <a href="https://theconversation.com/better-income-assistance-programs-are-needed-to-help-people-with-rising-cost-of-living-190216">earlier <em>The Conversation Canada</em> article</a>, the GST/HST credit is the only program that provides targeted assistance to Canada’s low-income population. It provides a maximum annual benefit of $306 per adult and eligible dependant, plus $161 per child under 19 or for single individuals, and is paid quarterly. </p>
<figure class="align-center ">
<img alt="A white middle-aged woman in a green suit gestured while speaking from behind a podium. A crowd of people are seated behind her." src="https://images.theconversation.com/files/519406/original/file-20230404-16-r8g1qw.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/519406/original/file-20230404-16-r8g1qw.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/519406/original/file-20230404-16-r8g1qw.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/519406/original/file-20230404-16-r8g1qw.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/519406/original/file-20230404-16-r8g1qw.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/519406/original/file-20230404-16-r8g1qw.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/519406/original/file-20230404-16-r8g1qw.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Deputy Prime Minister and Minister of Finance Chrystia Freeland delivers the federal budget in the House of Commons on Parliament Hill in Ottawa on March 28, 2023.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Sean Kilpatrick</span></span>
</figcaption>
</figure>
<h2>Gradual policy changes</h2>
<p>The GST/HST credit is an example of policy incrementalism — gradual changes that take place over time. The <a href="https://www.budget.canada.ca/pdfarch/1986-sd-eng.pdf">original refundable sales tax credit</a> was introduced in 1986 to help about four million families and individuals. It paid $50 per adult and $25 per child for incomes below $15,000 annually.</p>
<p>Canada has a history of similar incremental policies. 1967 saw the introduction of refundable credits for seniors in the form of the <a href="https://www.historymuseum.ca/cmc/exhibitions/hist/pensions/cpp-timeline_e.html">Guaranteed Income Supplement</a>. 1978 saw the introduction of the <a href="https://www.tamarackcommunity.ca/latest/the-introduction-and-evolution-of-child-benefits-in-canada">Child Tax Benefit</a> — which eventually became the <a href="https://www.canada.ca/en/revenue-agency/services/child-family-benefits/canada-child-benefit-overview.html">Canada Child Benefit</a> in 2016.</p>
<p>What distinguished the sales tax credit (later renamed the GST credit) is its universality. All residents of Canada over the age of 19 are eligible for the credit, provided their family or individual income is sufficiently low.</p>
<p>Policy advocates often dismiss incremental policies as too modest to make a difference, and <a href="https://www.cbc.ca/news/canada/manitoba/grocery-rebate-manitoba-1.6792638">the grocery rebate is no exception to this criticism</a>. </p>
<p>The often suggested alternative is the great <a href="https://ppforum.ca/articles/canadas-next-leap-of-faith/">leap of faith</a> to a fully funded and unconstrained new policy initiative, but even momentous advances, <a href="https://www.cjhp-online.ca/index.php/cjhp/article/view/498/492">such as medicare, proceeded in stages</a>. Canadian medicare began with universal medical coverage in Saskatchewan in 1962, before spreading to the other provinces over the rest of the decade under federal legislation.</p>
<p>History teaches us that policies requiring significant government funding usually start out as a smaller, pared-down version first. A limited and less expensive policy allows the government to assess the popularity and public willingness to pay for expansion of the policy.</p>
<p>The new <a href="https://www.budget.canada.ca/2023/report-rapport/chap2-en.html#m15">Canadian Dental Benefit</a> is limited to $1,300 over two years for children under 12 in families with incomes under $90,000. The expected national pharmacare program is likely to follow a similar path of modest beginnings.</p>
<h2>Basic income</h2>
<p>The GST/HST credit fits within a grander scheme for a basic income in Canada. The <a href="https://basicincomecanada.org/what_is_basic_income/">basic income movement in Canada</a> argues for an unconditional cash transfer to enable everyone to meet their basic needs, participate in society and live with dignity, regardless of work status. That goal can be met with a universal taxable benefit.</p>
<p>Alternatively, as is most often proposed in the North American context, the goal could also be met with a benefit that is reduced as income grows, so that only lower-income families and individuals are recipients. The GST/HST credit meets these requirements. </p>
<p>This approach has a significant policy history as a <a href="https://mitsloan.mit.edu/ideas-made-to-matter/negative-income-tax-explained">negative income tax</a> or guaranteed annual income. The essence of this approach is to provide a maximum benefit for those with lowest incomes, a benefit that is reduced as income increases, and a break-even level of income beyond which no benefits are paid.</p>
<p>Canada has run basic annual income pilot programs before — in <a href="https://www.umanitoba.ca/media/Simpson_Mason_Godwin_2017.pdf">Manitoba in the 1970s</a> and <a href="https://theconversation.com/the-cancellation-of-ontarios-basic-income-project-is-a-tragedy-101555">recently in Ontario from 2017-18</a> — but neither resulted in a basic income initiative.</p>
<p>Instead, we have witnessed significant incremental policy developments, primarily for seniors and families with children, that leave gaps for couples and individuals without children.</p>
<figure class="align-center ">
<img alt="A young Black woman looks at produce while leaning on a shopping cart. She is holding a pen and a piece of paper." src="https://images.theconversation.com/files/519425/original/file-20230404-26-gmrcj4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/519425/original/file-20230404-26-gmrcj4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/519425/original/file-20230404-26-gmrcj4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/519425/original/file-20230404-26-gmrcj4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/519425/original/file-20230404-26-gmrcj4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/519425/original/file-20230404-26-gmrcj4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/519425/original/file-20230404-26-gmrcj4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The rebate is designed to provide relief to millions of Canadians who are struggling with rising food prices.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2>Making the rebate permanent</h2>
<p>The GST/HST credit rectifies policy gaps for couples and individuals without children, but is still very modest. The grocery rebate could be made permanent by doubling the size of the GST/HST credit. </p>
<p>Doubling the GST/HST credit would result in a refundable annual benefit of $1,868 for a family of four or $936 for an individual. This would still only amount to a modest four to five per cent of <a href="https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1110006601">Canada’s official poverty measure</a>.</p>
<p>Permanently doubling the GST/HST would cost the government about $5 billion. That’s in the range of other program initiatives like the dental and pharmacare plans. It would signal the government’s intent to address poverty and achieve <a href="https://www.canada.ca/en/employment-social-development/programs/results/poverty-reduction.html#h2">Canada’s official poverty goals</a>. </p>
<p>Affordability encompasses the rising cost of basic needs and its impact on lower-income Canadians. The <a href="https://www.budget.canada.ca/2023/report-rapport/chap1-en.html">2023 budget</a> addresses these concerns in terms of child care, junk fees, predatory lending, the right to repair and housing. </p>
<p>It is difficult to see how these measures, or <a href="https://theconversation.com/better-income-assistance-programs-are-needed-to-help-people-with-rising-cost-of-living-190216">others taken by the provinces and territories</a>, will have significant and immediate effects on Canadians like the grocery rebate will. In addition, only some of these measures target basic needs and those least able to meet them.</p>
<p>The main weapon against the rising cost of living <a href="https://www.bankofcanada.ca/core-functions/monetary-policy/">continues to be monetary policy</a>. This leaves income assistance as the primary way to protect those less fortunate and the GST/HST credit as the best universal lever available.</p><img src="https://counter.theconversation.com/content/203219/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Wayne Simpson does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The federal government should make the grocery rebate permanent by adding it to the GST/HST credit.Wayne Simpson, Professor, Department of Economics, University of ManitobaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1984742023-03-28T19:29:00Z2023-03-28T19:29:00ZSuicide prevention: Protective factors can build hope and mitigate risks<figure><img src="https://images.theconversation.com/files/517342/original/file-20230324-24-cfiq1p.jpg?ixlib=rb-1.1.0&rect=233%2C17%2C1523%2C1053&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Protective factors like supportive relationships can counteract suicide risk factors.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/suicide-prevention--protective-factors-can-build-hope-and-mitigate-risks" width="100%" height="400"></iframe>
<p>Globally, an estimated <a href="https://www.who.int/news-room/fact-sheets/detail/suicide">700,000 people take their own life every year</a> — a statistic that underscores the importance of suicide prevention. </p>
<p>Suicidal thoughts (ideation), plans and attempts are suprisingly common: <a href="https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/healthy-living/suicide-canada-key-statistics-infographic/ENG.pdf">12 per cent of Canadians have thought about suicide during their lifetime, 4.3 per cent made a plan and 3.1 per cent attempted it</a>.</p>
<p>Past suicide prevention efforts have emphasized the <a href="https://doi.org/10.1111/acps.13059">identification and mitigation of risk factors</a>. Most guidelines comprise <a href="https://pubmed.ncbi.nlm.nih.gov/27841450/">lists of non-specific factors such as mental illness, physical illness, life stress, special population status or access to lethal means</a>. This leaves room for improvement.</p>
<p>The focus is increasingly shifting toward protective factors that make it less likely that individuals will consider, attempt or die by suicide. Protective factors can help counterbalance the effects of risk factors on mental health. For example, <a href="https://doi.org/10.1016/j.genhosppsych.2013.10.006">optimism and gratitude may reduce suicidal ideation even if someone is experiencing depression</a>.</p>
<p>This emerging field offers evidence-based strategies to protect against suicidal thoughts and behaviours and reduce their frequency.</p>
<h2>Social support and connectedness</h2>
<p>The interpersonal theory of suicide describes the social nature of suicide and emphasizes <a href="https://doi.org/10.1016/j.jrp.2013.04.007">two key elements explaining why people consider suicide</a>: feelings of not belonging, and the sense of being a burden to others.</p>
<figure class="align-center ">
<img alt="Illustration of a stick figure preventing a line of dominoes from falling over" src="https://images.theconversation.com/files/517346/original/file-20230324-22-65cut6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/517346/original/file-20230324-22-65cut6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=300&fit=crop&dpr=1 600w, https://images.theconversation.com/files/517346/original/file-20230324-22-65cut6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=300&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/517346/original/file-20230324-22-65cut6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=300&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/517346/original/file-20230324-22-65cut6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=377&fit=crop&dpr=1 754w, https://images.theconversation.com/files/517346/original/file-20230324-22-65cut6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=377&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/517346/original/file-20230324-22-65cut6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=377&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Anyone — especially those with whom a trusting relationship has been established — can be a source of support by both offering and asking for help.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p><a href="https://doi.org/10.1016/j.jad.2013.01.033">Research on social support</a> suggests that the perception that one is cared for, loved, esteemed, and a member of a network of mutual obligations, contributes to a sense of belonging, making it a protective factor against suicide. Different <a href="https://doi.org/10.1192/bjp.bp.115.169094">social networks can provide emotional support, practical help or information</a>. </p>
<p>Individuals who perceived they had strong <a href="https://doi.org/10.1001/jamanetworkopen.2020.27491">social support had an approximately 40 per cent reduced risk of suicidal ideation and attempts</a>. Connection with others may also be protective for people experiencing interpersonal adversity in one sphere of their life. For instance, <a href="https://doi.org/10.1001/jamapediatrics.2014.1223">strong family connections may protect against suicidal ideation for a youth experiencing bullying in school</a>. </p>
<p>Social support is a key protective factor for suicide, and anyone — especially those with whom a trusting relationship has been established — can be a source of support by both offering and asking for help. </p>
<h2>Beliefs and sense of meaning</h2>
<p>Several therapeutic approaches promote searching for meaning in life. Meaning has been described by Michael Steger, director of the Center for Meaning and Purpose at Colorado State University, as having two key components: <a href="https://doi.org/10.1080/17439760.2015.1137623">a sense of comprehensibility, and the pursuit and attainment of goals</a>. </p>
<p>Both the <a href="https://doi.org/10.1186/s12888-020-02485-4">presence and search for meaning can protect against suicidal behaviours by decreasing hopelessness</a>, a negative attitude about future life events. Furthermore, <a href="https://doi.org/10.1016/j.jrp.2013.04.007">gratitude indirectly buffers against suicidal ideation by contributing meaning in life</a>. Gratitude exercises, such as daily journaling, are easily implementable interventions. </p>
<figure class="align-center ">
<img alt="Illustration of three silhouettes of a human head with different emotional expressions" src="https://images.theconversation.com/files/517347/original/file-20230324-20-mdnoy8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/517347/original/file-20230324-20-mdnoy8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/517347/original/file-20230324-20-mdnoy8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/517347/original/file-20230324-20-mdnoy8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/517347/original/file-20230324-20-mdnoy8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/517347/original/file-20230324-20-mdnoy8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/517347/original/file-20230324-20-mdnoy8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Several therapeutic approaches promote searching for meaning in life.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Cultural, religious and personal beliefs are also recognized sources of guidance to perceive life as meaningful. For instance, <a href="https://doi.org/10.1080/07481187.2014.970299">a study of Asian-American students found that for some, a desire to not let loved ones down was protective against suicide attempts</a>. </p>
<p>Other studies suggest <a href="https://doi.org/10.1080/19349637.2012.744620">spiritual faith provides the ability to find personal meaning amidst stressful life circumstances</a>. The relationship between religion and suicide is complex. Several studies have found religion to play a protective role <a href="https://doi.org/10.1093/med/9780198834441.003.0002">against suicidal ideation and attempt</a>. This arises from social factors (mutual care of members of supportive community), ethical considerations (condemnation of suicide) and fear (God’s wrath), as well as by <a href="https://doi.org/10.1080/13811118.2015.1004494">interpreting suffering in a tolerable way</a>. </p>
<p>A <a href="https://doi.org/10.1001/jamapsychiatry.2016.1243">study of U.S. women showed that those who frequently attended religious service</a> had approximately five-fold lower rate of suicide mortality compared to those who never attended. </p>
<h2>Mindfulness and self-compassion</h2>
<p><a href="https://doi.org/10.1007/s12671-021-01815-1">Self-compassion and mindfulness</a> have received increasing attention for their potential to buffer against suicidal thoughts and behaviours. </p>
<p>Educational psychologist <a href="https://self-compassion.org/the-three-elements-of-self-compassion-2/">Kristin Neff</a> defines <a href="https://doi.org/10.3389/fpsyg.2021.633482">self-compassion as kindness towards oneself in a time of pain</a>. </p>
<p>Self-compassion decreases negative self-judgments, which helps counteract negative emotional states such as self-loathing and self-isolation. Adopting a compassionate stance may help individuals accept difficult thoughts and emotions as a way out of suffering, and is critical for <a href="https://doi.org/10.1007/s10879-022-09550-x">moving individuals toward a life that is not structured around avoidance or escape from painful thoughts, emotions and physiological sensations</a>.</p>
<p>A related concept is mindfulness, defined as the practice of purposely bringing one’s attention to the present moment without judgement. Mindfulness-based interventions may be a promising practice to help navigate suicidal thoughts and behaviours. </p>
<p>Most interventions are a form of mental training to develop skills such as mindful awareness, focused attention and well-being. These skills allow one to <a href="https://doi.org/10.1080/13811118.2020.1833796">respond rather than react to stimuli, enhancing cognitive and emotional regulation</a>. </p>
<p><a href="https://doi.org/10.1001/jamapsychiatry.2018.1109">Dialectical behaviour therapy, the gold-standard treatment for chronic suicidality, also promotes acceptance while advocating for change by focusing on emotion regulation</a>. Dialectic thinking allows an individual to hold two seemingly opposite ideas as part of the same truth. Accepting that opposites can co-exist by engaging in more flexible thinking is a valuable strategy to regulate intense emotions.</p>
<p>Recent research in the field of mindfulness has begun to describe the role played by the mind-body connection in mechanisms related to suicide. In the presence of suicidal ideation, individuals with reported <a href="https://doi.org/10.1016/j.psychres.2019.112661">low levels of dissociation, defined as detachment from reality, were less likely to attempt suicide</a>. </p>
<p>Subsequent studies have shown the benefit of interventions aimed at improving interoception — the ability to sense and accept internal sensations and emotions — in reducing suicidal ideation. Engaging in <a href="https://doi.org/10.1016/j.beth.2021.02.001">self-guided progressive body relaxation exercise led to improved body trust and reduced identification with suicide</a>.</p>
<h2>Healthy lifestyle and habits</h2>
<p>Sleep hygiene and physical activity promote overall well-being in both physiological and psychological ways, given the strong mind-body connection.</p>
<figure class="align-center ">
<img alt="Red umbrella against gray stormy sky, with blue sky under the umbrella" src="https://images.theconversation.com/files/517357/original/file-20230324-25-7x7gzd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/517357/original/file-20230324-25-7x7gzd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=375&fit=crop&dpr=1 600w, https://images.theconversation.com/files/517357/original/file-20230324-25-7x7gzd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=375&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/517357/original/file-20230324-25-7x7gzd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=375&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/517357/original/file-20230324-25-7x7gzd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=471&fit=crop&dpr=1 754w, https://images.theconversation.com/files/517357/original/file-20230324-25-7x7gzd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=471&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/517357/original/file-20230324-25-7x7gzd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=471&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Protective factors such as optimism and gratitude may reduce suicidal ideation even if someone is experiencing depression.</span>
<span class="attribution"><span class="source">(Canva)</span></span>
</figcaption>
</figure>
<p>Sleep serves critical roles in <a href="https://doi.org/10.5665/sleep.4886">cognitive functions</a>, <a href="https://doi.org/10.3389/fpsyt.2022.920789">mood regulation and impulse control, among other things</a>. Research has shown an association between sleep duration and suicide risk. One study observed the lowest risk for suicidal ideation and attempts for <a href="https://doi.org/10.1016/j.smrv.2018.07.003">people sleeping eight to nine hours per day</a>. The same study suggested an 11 per cent reduction in risk of suicide plans for every one-hour increase in sleep.</p>
<p>Evidence also shows the benefits of physical activity. A recent systematic review has shown that physically <a href="https://doi.org/10.1016/j.jad.2017.08.070">active individuals reported almost 50 per cent lower suicidal ideation</a>. </p>
<p>Physical activity <a href="https://doi.org/10.1080/00223980.2021.1992334">can also be perceived as a form of self-compassion and an exercise in gratitude by recognizing the importance of treating the body with care</a>. Emerging evidence also suggests that the documented benefits of physical activity, such as walking, are larger when it takes place in nature. A study found that <a href="https://doi.org/10.1016/j.jad.2022.08.121">people with treatment-resistant major depressive disorder who walked in nature experienced fewer negative internal feelings than those who walked in urban streets</a>. </p>
<h2>Protective factors and resilience</h2>
<p>Suicide is complex. <a href="https://doi.org/10.3389/fpsyt.2016.00108">People considering or who have attempted suicide are suffering from tremendous emotional pain</a>. There is no one-size-fits-all recipe for prevention, but sharing knowledge about things that can help guard against suicide is critical. It raises hope and is part of the solution. </p>
<p>These protective factors for suicide can be regarded as <a href="https://doi.org/10.1111/acps.13059">pillars of resilience</a>. As a society, it is imperative to continue bringing more awareness to the discussion of suicide and to help people build resilience individually and collectively. </p>
<p><em>If you or someone you know is thinking about suicide, call 911 for emergency services. For support, call Canada Suicide Prevention Service at 1-866-277-3553 (from Québec) or 1-833-456-4566 (other provinces), or send a text to 45645. Visit <a href="https://talksuicide.ca/crisis-services-canada">Crisis Services Canada</a> for more resources.</em></p><img src="https://counter.theconversation.com/content/198474/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Marie-Claude Geoffroy holds a Canada Research Chair (II) on Youth Suicide Prevention and receives fundings from numerous public and private funding organisations including a FRQ-SC research team.</span></em></p><p class="fine-print"><em><span>Massimiliano Orri receives funding from the Canadian Institutes of Health Research, the Fonds de Recherche du Québec, the American Foundation for Suicide Prevention, the Helsefonden, the Brain and Behavior Research Foundation, and the MQ Foundation. </span></em></p><p class="fine-print"><em><span>Bassam Khoury and Naomie Gendron do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The focus of suicide prevention is shifting toward protective factors: characteristics that make it less likely that individuals will consider, attempt or die by suicide.Naomie Gendron, Medical Student, McGill UniversityBassam Khoury, Associate Professor, Department of Educational and Counselling Psychology, McGill UniversityMarie-Claude Geoffroy, Assistant Professor, Department of Educational and Counselling Psychology and Canada Research Chair in Youth Suicide Prevention, McGill UniversityMassimiliano Orri, Assistant Professor, McGill Group for Suicide Studies, Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1962642022-12-15T15:50:34Z2022-12-15T15:50:34ZCanada delays expanding medical assistance in dying to include mental illness, but it’s still a policy built on quicksand<figure><img src="https://images.theconversation.com/files/500879/original/file-20221213-14-4j61be.jpeg?ixlib=rb-1.1.0&rect=506%2C191%2C5867%2C4242&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The planned expansion of Canada's medical assistance in dying (MAID) law to include people with mental illnesses whose death is not imminent has been delayed, but not cancelled.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>The federal government admitted Thursday it needs more time before expanding Canada’s controversial medical assistance in dying (MAID) policy to enable MAID solely for mental illness.</p>
<p>Although the government had recently announced its intention to proceed with expanding MAID for those with mental health disorders by next March, <a href="https://www.ctvnews.ca/politics/feds-seeking-to-delay-expansion-of-medical-assistance-in-dying-laws-1.6196668">Justice Minister David Lametti said he had heard from medical experts that the health-care system wasn’t prepared to deal with patients who want to end their lives for mental health reasons</a>. He did not commit to a new deadline. </p>
<p>But the justice minister said Ottawa was only seeking to delay implementation of the MAID changes — it’s still clear the government remains intent on <a href="https://www.theglobeandmail.com/canada/article-maid-canada-mental-health-law/">further expanding its legislation to include mentally ill people who are suicidal and could get better</a>.</p>
<p>It’s one of many controversial elements of the proposed changes to the MAID legislation, and remains cause for concern.</p>
<p>Canada’s federal minister of disability inclusion recently expressed feeling devastated about Canadians being driven to <a href="https://www.cbc.ca/news/politics/assisted-dying-carla-qualtrough-1.6625412">seek assisted death through MAID — medical assistance in dying — due to lack of social supports</a>.</p>
<p>Some are pushing for <a href="https://nationalpost.com/news/quebec-college-of-physicians-slammed-for-suggesting-maid-for-severely-ill-newborns">MAID for infants</a>, while others think <a href="https://www.theglobeandmail.com/canada/article-maid-canada-mental-health-law/">non-dying disabled people on wait lists</a> should receive MAID. When <a href="https://www.thestar.com/politics/provincial/2022/11/29/justice-minister-david-lametti-under-fire-for-unbelievable-comparisons-between-euthanasia-and-suicide.html?rf">the minister of justice suggests we should make it easier for those ambivalent about suicide to die</a>, that is bone chilling.</p>
<p>When Canada embarked on this journey years ago, I cautioned about the importance of ensuring we <a href="https://www.theglobeandmail.com/opinion/how-mental-illness-complicates-assisted-dying/article30193498/">“do the least harm” with our expanding laws</a>. As physician chair of my hospital MAID team, I have seen the myths and realities that have fuelled our MAID expansion. </p>
<h2>False autonomy and false compassion</h2>
<p>As a society, we take comfort that MAID is provided for compassionate relief from suffering. Individually, MAID has been sold to Canadians as an autonomous choice, and framed as a right. When MAID was introduced in 2016, for those whose deaths were reasonably foreseeable, these principles may have been true. In contrast, our MAID expansion to non-dying disabled people has been misled by the fallacies of false autonomy and false compassion.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-is-access-to-medically-assisted-death-a-legislated-right-but-access-to-palliative-care-isnt-161994">Why is access to medically assisted death a legislated right, but access to palliative care isn’t?</a>
</strong>
</em>
</p>
<hr>
<p>True autonomy requires true choice. For those of us fortunate enough to live lives with privilege, choosing “death with dignity” can be sold as an autonomous choice. Yet we have now had marginalized Canadians living in poverty be given state-supported suicide who have openly said they chose MAID not to avoid suffering from illness, but because <a href="https://www.cbc.ca/news/canada/manitoba/sathya-dharma-kovac-als-medical-assistance-in-death-1.6605754">society had failed to provide them a chance to live with dignity</a>. </p>
<figure class="align-right ">
<img alt="A woman in a navy jacket" src="https://images.theconversation.com/files/500681/original/file-20221213-14387-fa7efg.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/500681/original/file-20221213-14387-fa7efg.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=458&fit=crop&dpr=1 600w, https://images.theconversation.com/files/500681/original/file-20221213-14387-fa7efg.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=458&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/500681/original/file-20221213-14387-fa7efg.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=458&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/500681/original/file-20221213-14387-fa7efg.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=575&fit=crop&dpr=1 754w, https://images.theconversation.com/files/500681/original/file-20221213-14387-fa7efg.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=575&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/500681/original/file-20221213-14387-fa7efg.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=575&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Minister of Employment, Workforce Development and Disability Inclusion Carla Qualtrough, pictured in the House of Commons on Dec. 8, recently described MAID requests driven by lack of social supports as devastating.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Justin Tang</span></span>
</figcaption>
</figure>
<p>Most would be hard-pressed to argue it reflects true autonomy with a range of choices when the marginalized poor are enticed toward “painless” death to escape a painful life of poverty.</p>
<p>Canadians have rationalized that non-dying disabled people are being provided MAID in the name of compassion. However, it is not compassionate to provide death for one reason while pretending it is for another. We have reassured ourselves that MAID is for medical conditions that will not improve, or are irremediable. In the court cases that originally established MAID — which involved conditions like <a href="https://bccla.org/2012/10/in-memory-of-gloria/">ALS</a> and <a href="https://www.cbc.ca/news/canada/montreal/medically-assisted-dying-law-overturned-quebec-1.5280702">spinal stenosis</a> — or for medical conditions like cancers, that can be true.</p>
<p>However, evidence shows it is <a href="https://www.eagmaid.org/report">impossible to predict that a mental illness will not improve in any individual</a>. Yet expansion activists mistakenly believe they can make such predictions. Science tells us their chance of being right amounts to chance or less, with <a href="https://doi.org/10.1017/s0033291722002951">precision modelling showing only 47 per cent of “irremediability” predictions end up being correct</a> — which is worse than flipping a coin.</p>
<h2>False safety</h2>
<p>Perhaps most tragically, the twin pillars of false autonomy and false compassion fuelling the expansion agenda have been propped up by the third myth of false safety.</p>
<p>Until now, expansion activists have reassured that “<a href="https://www.suicideinfo.ca/local_resource/suicide-physician-assisted-death/">MAID is not suicide</a>.” When provided to help avoid a painful death for those who are dying, we can distinguish MAID from suicide. Yet when expanded to those seeking death for mental illness, evidence shows MAID becomes indistinguishable from suicide. <a href="https://cca-reports.ca/reports/medical-assistance-in-dying/">We cannot differentiate those seeking psychiatric euthanasia from suicidal individuals</a> who resume fulfilling lives after being provided suicide prevention, rather than facilitated death. </p>
<figure class="align-center ">
<img alt="A woman sitting a table looking pensive" src="https://images.theconversation.com/files/500851/original/file-20221213-26864-o5h4ft.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/500851/original/file-20221213-26864-o5h4ft.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/500851/original/file-20221213-26864-o5h4ft.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/500851/original/file-20221213-26864-o5h4ft.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/500851/original/file-20221213-26864-o5h4ft.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/500851/original/file-20221213-26864-o5h4ft.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/500851/original/file-20221213-26864-o5h4ft.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Until now, expansion activists have reassured that ‘MAID is not suicide.’</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>All this sobering evidence is sadly borne out by our <a href="https://globalnews.ca/news/9176485/poverty-canadians-disabilities-medically-assisted-death/">now common headlines</a> of assisted suicide <a href="https://www.ctvnews.ca/health/woman-with-chemical-sensitivities-chose-medically-assisted-death-after-failed-bid-to-get-better-housing-1.5860579">being provided</a> to <a href="https://www.ctvnews.ca/health/woman-with-disabilities-nears-medically-assisted-death-after-futile-bid-for-affordable-housing-1.5882202">marginalized Canadians</a> seeking <a href="https://www.chatelaine.com/health/maid-assisted-death-poverty/">escape from life suffering</a> and <a href="https://toronto.citynews.ca/2022/10/13/medical-assistance-death-maid-canada/">poverty</a>. </p>
<p>The government-appointed federal panel, <a href="https://policyoptions.irpp.org/magazines/missing-the-mark-on-a-profound-social-change-with-maid-for-mental-illness/">chaired by an expansionist in favour of MAID for mental illness</a>, was responsible for providing safeguards, standards and guidelines for how to implement MAID for mental illness. Instead, the panel recommended that <a href="https://www.canada.ca/en/health-canada/news/2022/05/final-report-of-the-expert-panel-on-maid-and-mental-illness.html">no further legislative safeguards be required before providing death for mental illness, and did not provide any specific standards</a> for the length, type or number of treatments that should be tried before providing MAID. Its report even suggested society had made an “ethical choice” that MAID should be provided even if suicide and MAID were the same.</p>
<p>Two members of the initial 12-member panel resigned, including the <a href="https://www.hilltimes.com/story/2022/06/16/maid-expert-panel-recommendations-are-inadequate-contends-panel-member-who-resigned/270807/">health-care ethicist</a> and <a href="https://www.theglobeandmail.com/opinion/article-expert-panel-maid-mental-illness/">a mental health advocate panelist with lived experience</a>. </p>
<h2>Suicide prevention</h2>
<p>The whole issue of suicide prevention has been shockingly absent from many of these discussions, including those with key medical associations. In all of its consultations on <a href="https://www.justice.gc.ca/eng/csj-sjc/pl/charter-charte/c7.html">Bill C-7</a> leading up to the <a href="https://www.ctvnews.ca/politics/senators-amend-maid-bill-to-put-18-month-time-limit-on-mental-illness-exclusion-1.5302151">sunset clause</a>, the Canadian Psychiatric Association (of which I am a former past president) inexplicably <a href="https://www.cpa-apc.org/wp-content/uploads/Brief-JUST-12-Nov-2020-FIN.pdf">never once presented known evidence about suicide risks associated with mental illness</a>. </p>
<p>While some organizations such as the <a href="https://suicideprevention.ca/media/statement-on-the-expansion-of-medical-assistance-in-dying-to-those-without-a-reasonably-foreseeable-death/#:%7E:text=The%20Canadian%20Association%20for%20Suicide,process%20that%20is%20already%20happening">Canadian Association for Suicide Prevention</a> discussed the importance of preventing suicide, <a href="https://www.cpa-apc.org/wp-content/uploads/Brief-LCJC-23-Nov-2020-FIN.pdf">CPA never raised this crucial topic</a> — indeed they <a href="https://sencanada.ca/en/Content/Sen/Committee/432/LCJC/02ev-55071-e">avoided using any variant of the word “suicide.”</a></p>
<figure class="align-right ">
<img alt="A man in a dark suit and tie gestures with his hand." src="https://images.theconversation.com/files/500677/original/file-20221213-14838-oz0t5e.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/500677/original/file-20221213-14838-oz0t5e.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/500677/original/file-20221213-14838-oz0t5e.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/500677/original/file-20221213-14838-oz0t5e.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/500677/original/file-20221213-14838-oz0t5e.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=498&fit=crop&dpr=1 754w, https://images.theconversation.com/files/500677/original/file-20221213-14838-oz0t5e.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=498&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/500677/original/file-20221213-14838-oz0t5e.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=498&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Minister of Justice David Lametti in the House of Commons on Nov. 22, 2022. Lametti recently made controversial statements about MAID.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Adrian Wyld</span></span>
</figcaption>
</figure>
<p>With this vacuum of national leadership and evidence-based guidance, perhaps it is not surprising that our <a href="https://www.thestar.com/politics/provincial/2022/11/29/justice-minister-david-lametti-under-fire-for-unbelievable-comparisons-between-euthanasia-and-suicide.html?rf">minister of justice recently suggested that MAID “provides a more humane way for [people with mental illness] to make a decision” when “for physical reasons and possibly mental reasons, [they] can’t make that choice themselves to do it themselves.”</a></p>
<p>This remarkable statement, coming from the person entrusted with responsibly implementing Canada’s assisted dying laws, will keep me and many of my colleagues up at night.</p>
<h2>The need to pause</h2>
<p>I am not a conscientious objector. However it is clear to me that Canada’s planned expansion of MAID to mental illness is based on ignorance — if not outright disregard — of fundamental <a href="https://www.cdc.gov/suicide/prevention/index.html">suicide prevention principles</a>. It appears to ignore what drives the most marginalized people to consider death as an alternative to life suffering. Perhaps, though, it does not ignore the <a href="https://globalnews.ca/news/7407627/health-care-costs-canada-assisted-dying/">cost savings of providing MAID</a> rather than treatment and community support for dignified living.</p>
<p>The <em><a href="https://scc-csc.lexum.com/scc-csc/scc-csc/en/item/14637/index.do">Carter v. Canada</a></em> and <a href="https://www.canlii.org/en/qc/qccs/doc/2019/2019qccs3792/2019qccs3792.html?searchUrlHash=AAAAAQANdHJ1Y2hvbiBnbGFkdQAAAAAB&resultIndex=1"><em>Truchon v. Canada</em></a> court cases shaping MAID laws did not review or rule on MAID for mental illness. Expanding MAID within three months would have meant providing facilitated suicide for the mentally ill without any standards, or any consideration of the role of suicide prevention.</p>
<p>Postponing the March 2023 expansion of euthanasia for mental illness is the only responsible course. Canadians and mental health organizations recognized this and called for it, with the Canadian Association for Suicide Prevention and over 200 individual psychiatrists so far signing <a href="https://www.socpsych.org/calltoaction">a petition to this effect</a>, and the academic chairs of the departments of psychiatry across Canada <a href="https://www.theglobeandmail.com/canada/article-maid-delay-mental-illness-medical-experts/">joining this call for delay</a>. </p>
<p>To proceed with the planned changes would have been morally, medically and politically irresponsible. Moving forward, it will be important to ensure our future policies are evidence-based. Fortunately, the situation is not yet irremediable.</p>
<p><em>If you are experiencing suicidal thoughts, you need to know you’re not alone. If your life or someone else’s is in danger, call 911 for emergency services. For support, call Canada Suicide Prevention Service (CSPS) at 1-833-456-4566. Visit <a href="https://talksuicide.ca">Crisis Services Canada</a> for more resources.</em></p><img src="https://counter.theconversation.com/content/196264/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Karandeep Sonu Gaind is Chief of Psychiatry and physician chair of the Humber River Hospital MAiD team, a former president of the Canadian Psychiatric Association and a founding director of the nascent Society of Canadian Psychiatry, and was retained as an expert by the former Attorney General of Canada in the Truchon and Lamb cases.</span></em></p>Canada’s planned expansion of MAID to mental illness is based on ignorance — if not outright disregard — of fundamental suicide prevention principles.Karandeep Sonu Gaind, Professor of Psychiatry, University of TorontoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1927402022-10-20T21:38:28Z2022-10-20T21:38:28ZBurnout and isolation: Why employees and managers can’t ignore the social and mental health impact of working from home<figure><img src="https://images.theconversation.com/files/490917/original/file-20221020-20-55pft3.jpg?ixlib=rb-1.1.0&rect=213%2C44%2C4699%2C3226&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The pandemic made many people more aware of the impossibility of severing work from life.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/burnout-and-isolation--why-employees-and-managers-can-t-ignore-the-social-and-mental-health-impact-of-working-from-home" width="100%" height="400"></iframe>
<p>The COVID-19 pandemic has spurred on a variety of workplace maladies, including “<a href="https://www.gallup.com/workplace/351545/great-resignation-really-great-discontent.aspx">the great resignation</a>,” “<a href="https://www.gallup.com/workplace/398306/quiet-quitting-real.aspx">quiet quitting</a>,” “<a href="https://www.cbc.ca/news/business/two-jobs-pandemic-1.6577522">overemployment</a>,” <a href="https://www.statcan.gc.ca/en/subjects-start/labour_/labour-shortage-trends-canada">labour shortages</a> and conflicts between managers and employees over <a href="https://www.pewresearch.org/social-trends/2022/02/16/covid-19-pandemic-continues-to-reshape-work-in-america/">returning to in-person work</a>. </p>
<p>Employee burnout and well-being may be at the heart of several of these issues. </p>
<p>Two new studies highlight the importance of social connection in the workplace and illustrate why working from home may not be the optimal workplace arrangement. Hybrid work-from-home schedules may help prevent burnout and improve mental health.</p>
<h2>So, what is burnout?</h2>
<p>The <a href="https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/129180281">International Classification of Diseases</a> describes burnout as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” </p>
<p>As a <a href="https://www.forbes.com/sites/karlynborysenko/2019/05/29/burnout-is-now-an-officially-diagnosable-condition-heres-what-you-need-to-know-about-it/?sh=54b94c62b99b">diagnosable condition</a>, burnout consists of three symptoms: </p>
<ol>
<li>physical exhaustion, </li>
<li>disengagement with work and colleagues, and </li>
<li>cynicism for one’s job and career. </li>
</ol>
<p>For many who have experienced burnout, it can feel just like the metaphor that describes it: something akin to a burnt-up shriveled match stick, cold to the touch. </p>
<h2>What causes burnout and how can it be stopped?</h2>
<p>According to <a href="https://www.forbes.com/sites/edwardsegal/2022/10/15/surveys-show-burnout-is-an-international-crisis/?sh=7d4422ed7cf7">global research</a>, approximately 50 per cent of employees and 53 per cent of managers are burnt out in the wake of the COVID-19 pandemic. Workplaces are clearly not thriving. </p>
<p>As a social epidemiologist studying contemporary emotional distress within the context of public health crises, I’ve been keen to understand what factors contribute to burnout and how it can be successfully managed — particularly given the ongoing challenges created by COVID-19. </p>
<figure class="align-center ">
<img alt="A row of matches with red tips, with one burnt up match" src="https://images.theconversation.com/files/490930/original/file-20221020-24-zk0f61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/490930/original/file-20221020-24-zk0f61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/490930/original/file-20221020-24-zk0f61.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/490930/original/file-20221020-24-zk0f61.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/490930/original/file-20221020-24-zk0f61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/490930/original/file-20221020-24-zk0f61.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/490930/original/file-20221020-24-zk0f61.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Burnout can feel just like the euphemism that describes it: something akin to a burnt-up shriveled match stick.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>You might think researchers would know everything there is to know about burnout at this point. After all, <a href="https://doi.org/10.1176/ps.29.4.233">burnout has been studied</a> since at least the late 1970s. <a href="https://pubmed.ncbi.nlm.nih.gov/28903843/">Many of the studies conducted since</a> then have focused on workplace conditions, such as pay, hours, management styles and the nebulous “workplace culture.” </p>
<p>As such, management of burnout has often focused on reshaping work environments and reforming bad managers. While these are of course necessary, <a href="https://doi.org/10.1002/1348-9585.12360">it’s not immediately clear that they’re enough</a>. </p>
<p>With the emergence of the pandemic, many people have new levels of awareness of the impossibility of severing work from life. For some, that awareness comes from how tired they are when they get home from a shift. For others working from home, it may come from the disappearing divide between home and office. </p>
<p>In any case, our emotional and psychological well-being is with us whether we’re at work or at home. As such, it makes sense that we take a holistic view of burnout. Social connection is a key driver of burnout.</p>
<h2>The social costs and benefits of working from home</h2>
<p>In a <a href="https://doi.org/10.1002/1348-9585.12360">recent study</a> by my lab at Simon Fraser University, we sought to identify the most important risk factors for burnout. We looked at a range of variables, including the classic factors of workload, satisfaction with pay, dignity in the workplace, control over one’s work, and pay adequacy, as well as more novel variables such as home ownership, an array of demographic factors, social support and loneliness.</p>
<p>In conducting this study, we found that loneliness and lack of social support come out as leading contributors to burnout, perhaps just as important — if not moreso — than physical health and financial security. In summary, the study contributes to a <a href="https://www.nytimes.com/2022/10/09/opinion/burnout-friends-isolation.html">growing understanding</a> of burnout as a social problem driven by isolation. </p>
<p>One potential and evolving source of isolation is the emerging trend of working from home. As many people have had the privilege to learn, there are many benefits of working from home. <a href="https://www.theguardian.com/world/2021/apr/15/pet-time-and-power-naps-working-from-home-during-the-covid-crisis">It enables people to save time on their commutes and have more freedom to get chores done around the house or take a quick nap on their breaks</a>. This means they have more time and energy for friends and family at the end of the day. </p>
<p>On the other hand, <a href="https://hbr.org/2021/03/remote-workers-need-small-talk-too">working from home means losing out on those water cooler conversations and casual collisions with coworkers</a> — which have a <a href="https://www.pnas.org/doi/10.1073/pnas.2120668119#sec-2">surprisingly profound</a> impact on well-being. Furthermore, considering <a href="https://www.weforum.org/agenda/2019/11/friends-relationships-work-productivity-career/">how important workplaces and schools are for finding and building friendships</a>, a loss of these spaces could have serious long-term consequences for people’s social health — especially if the time spent with others at work is now spent at home alone.</p>
<h2>The importance of social connection to health and happiness</h2>
<figure class="align-center ">
<img alt="Three people having a discussion while gathered around a laptop" src="https://images.theconversation.com/files/490934/original/file-20221020-13-hip9f8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/490934/original/file-20221020-13-hip9f8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/490934/original/file-20221020-13-hip9f8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/490934/original/file-20221020-13-hip9f8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/490934/original/file-20221020-13-hip9f8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/490934/original/file-20221020-13-hip9f8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/490934/original/file-20221020-13-hip9f8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Research highlighted the importance of social connection to workplace well-being.</span>
<span class="attribution"><span class="source">(Pexels/Kampus Production)</span></span>
</figcaption>
</figure>
<p>To understand the impacts of working from home on mental health, my team conducted a <a href="https://doi.org/10.3390/ijerph191811588">second study</a> to look at differences in self-rated mental health across individuals who work only from home, only in person, or who worked partially in-person and partially at home. We controlled for potentially important factors such as income, hours of work, occupation, age, gender, and ethnicity.</p>
<p>Our results showed that 54 per cent of those who worked only in person and 63 per cent of those who worked only at home reported good or excellent mental health. From these results, you might conclude that working from home is best for mental health — a finding contrary to a <a href="https://www.uprightpose.com/the-health-dilemma-of-the-work-from-home-era/">growing number of studies that highlight the disadvantages and challenges of working from home</a>. </p>
<p>However, there’s a catch: a whopping 87 per cent of those who reported a hybrid work arrangement — meaning they worked partially in-person and partially at home — had good or excellent mental health. </p>
<p>While the type of work done at home and in-person certainly shapes these trends, our findings nevertheless point to the possibility that hybrid work might give employees the best of both worlds — especially within the context of our first study, which highlighted the importance of social connection to workplace well-being. Indeed, hybrid work arrangements may allow employees to maintain those positive connections with colleagues while also providing a better balance between work and life. It really may be the best of both worlds — at least for those who can work this way.</p>
<p>As employees and employers continue to adapt to the new normal in the midst of the COVID-19 pandemic, our research provides a strong reminder for us to all remember the importance of social connection. It’s all too easy to forget that <a href="http://ccare.stanford.edu/press_posts/good-social-relationships-are-the-most-consistent-predictor-of-a-happy-life/">strong social relationships and communities are the foundation of health and happiness</a> within and outside the workplace.</p><img src="https://counter.theconversation.com/content/192740/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kiffer George Card receives funding from the Canadian Institutes for Health Research, the Canadian Research Coordinating Committee, Michael Smith Health Research BC, and Social Sciences and Humanities Research Council. He is affiliated with Simon Fraser University’s Faculty of Health Sciences, The Pacific Institute on Pathogens, Pandemics and Society, The Institute for Social Connection, The Community-based Research Centre, the GenWell Project, The Island Sexual Health Society, and the Mental Health and Climate Change Alliance.
</span></em></p>Two new studies highlight the importance of social connection in the workplace and illustrate why working from home may not be the optimal workplace arrangement.Kiffer George Card, Assistant Professor in Health Sciences, Simon Fraser UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1902202022-09-20T19:26:34Z2022-09-20T19:26:34ZFor Canadians with disabilities, multiple types of support were important during COVID-19<figure><img src="https://images.theconversation.com/files/484400/original/file-20220913-4889-p041wh.jpg?ixlib=rb-1.1.0&rect=13%2C39%2C8661%2C5735&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Family and household resources were critical to individuals who struggled with both employment income and savings during COVID-19. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/for-canadians-with-disabilities--multiple-types-of-support-were-important-during-covid-19" width="100%" height="400"></iframe>
<p>Canadians who <a href="https://www.canada.ca/en/financial-consumer-agency/corporate/covid-19/summary-covid-19-surveys.html">lost their incomes and accumulated debt during COVID-19</a> are still struggling to recover financially. Between 2019 and 2022, one-third fewer Canadians said they had an emergency fund that would cover three months of expenses.</p>
<p>The pandemic revealed gaps in <a href="https://theconversation.com/cerb-helped-canadians-during-covid-19-but-not-the-most-vulnerable-173217">how we collectively address those most vulnerable</a> in times of crisis. Many struggled with government-mandated countermeasures, from masks to social distancing to accessing PPE and vaccines. </p>
<p>The pandemic left many without work, and for those who were able to keep their jobs, the very <a href="https://www.cbc.ca/news/business/canada-return-office-wfh-fall-pandemic-1.6570575">nature of work changed drastically</a>. Some experienced reduced hours while others, including those working remotely, saw more work. Many <a href="https://www.mcgill.ca/newsroom/channels/news/covid-19-lockdowns-deepened-struggle-work-family-balance-334723">struggled to maintain a healthy work-life balance</a>, and others tried to stay financially afloat through government supports.</p>
<p>What is clear is that individuals who were in financially precarious situations before the pandemic were hit the hardest, and are now dealing with <a href="https://www.cbc.ca/newsinteractives/features/inflation-multiple-jobs-manitoba">inflation and higher costs of living</a>. <a href="https://www.cbc.ca/news/business/inflation-disability-benefits-odsp-canada-benefits-cpp-1.6427751">Canadians on fixed disability benefits</a> are among those struggling the most with high inflation.</p>
<h2>Work doesn’t guarantee liveable income</h2>
<p>Just under half of disabled Canadians were <a href="https://www150.statcan.gc.ca/n1/pub/89-654-x/89-654-x2018002-eng.htm">out of work</a> before the COVID-19 pandemic, but even for those who do have jobs, employment doesn’t guarantee <a href="https://doi.org/10.1111/cars.12288">a life without poverty</a>. </p>
<p>When Canadians with disabilities do work, they tend to hold <a href="https://doi.org/10.1016/j.rssm.2014.08.002">low-paying</a>, precarious, non-union jobs in the food and service sectors. It makes sense that many people with disabilities end up mobilizing other sources of income to make ends meet, including savings, family supports and government benefits.</p>
<figure class="align-center ">
<img alt="A pair of hands counting Canadian bills on a table" src="https://images.theconversation.com/files/484406/original/file-20220913-4760-wldx3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/484406/original/file-20220913-4760-wldx3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/484406/original/file-20220913-4760-wldx3k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/484406/original/file-20220913-4760-wldx3k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/484406/original/file-20220913-4760-wldx3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/484406/original/file-20220913-4760-wldx3k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/484406/original/file-20220913-4760-wldx3k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">People with disabilities tend to have fewer savings than those without disabilities, leaving them in a financially precarious situation.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Based on an analysis of over 1,000 Canadians with disabilities, <a href="https://doi.org/10.1111/soin.12504">our new study</a> found that individuals used family, savings and government supports to supplement inadequate employment income during the pandemic. But, access to these different supports varied considerably. </p>
<p>While these supports are incredibly important for people with disabilities, many people face obstacles in accessing them in the first place. Restrictive benefits often exclude many who need them, and income support programs can keep people trapped in bad jobs.</p>
<h2>Nothing to fall back on</h2>
<p>Our study found that individuals who remained employed — especially those in good jobs — felt the most secure. But even among this more secure group, the pandemic was a wake-up call. As one person told us: </p>
<blockquote>
<p>“[I]f I was to lose my job, or if anything was to happen, my savings aren’t enough to pay the bills.”</p>
</blockquote>
<p>People with disabilities <a href="https://doi.org/10.1111/cars.12268">have 25 per cent less in assets</a> than Canadians without disabilities, which means they can’t rely as much on rainy-day funds. </p>
<p>Many individuals tapped into their savings to make ends meet. This eased concerns for some people, but others — like those nearing retirement — worried their savings would never recover. As one respondent noted: </p>
<blockquote>
<p>“All our lives we’ve put money aside for retirement and figured we had enough. But now with the economy and the stock markets and everything we’re really worried.”</p>
</blockquote>
<p>Most of the people we interviewed were unemployed and had to make use of a combination of resources. When they were successful at doing so, respondents expressed fewer concerns about their current and future economic insecurity. </p>
<h2>Government support was crucial</h2>
<p>Family and household resources were critical to individuals who struggled with both employment income and savings. </p>
<p>Although individuals felt more secure living with another income earner, having children in the household or having to provide resources to other family members generated concerns about economic insecurity. </p>
<p>One respondent said:</p>
<blockquote>
<p>“The problem is more so helping other family members that have been laid off and so forth. So that’s taken a big chunk of my savings.” </p>
</blockquote>
<p>This is why government supports were so important during the pandemic. They <a href="https://www.ctvnews.ca/health/coronavirus/stories-of-cerb-canadians-share-how-they-re-using-the-emergency-benefit-1.4931779">provided stability when jobs, savings and family weren’t enough</a>.</p>
<p>This support was crucial considering households with disabilities tend to face higher living expenses and income penalties, particularly when other household members take time off work to provide care. The Canada Emergency Response Benefit (CERB) was an important stop-gap for many respondents who lost income during the pandemic.</p>
<figure class="align-center ">
<img alt="The landing page for the Canada Emergency Response Benefit is seen on a computer screen" src="https://images.theconversation.com/files/484139/original/file-20220912-14-iq2myw.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/484139/original/file-20220912-14-iq2myw.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/484139/original/file-20220912-14-iq2myw.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/484139/original/file-20220912-14-iq2myw.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/484139/original/file-20220912-14-iq2myw.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/484139/original/file-20220912-14-iq2myw.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/484139/original/file-20220912-14-iq2myw.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The Canada Emergency Response Benefit provided financial support to employed and self-employed Canadians who were affected by COVID-19.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Giordano Ciampini</span></span>
</figcaption>
</figure>
<p>Disabled people who were registered with a federal <a href="https://www.canada.ca/en/revenue-agency/services/tax/individuals/segments/tax-credits-deductions-persons-disabilities/disability-tax-credit.html">disability tax credit</a> were 12 per cent less likely to think their financial futures would worsen. However, only 11 per cent of respondents were registered for it. </p>
<p>Similarly, while a disability tax credit is required for opening a Registered Disability Savings Plan, only 32 per cent of disabled Canadians make use of the savings plan according to a <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/211201/dq211201c-eng.htm">recent Statistics Canada report</a>. </p>
<h2>Where does this leave us?</h2>
<p>There’s much to appreciate about Canada’s policy response to COVID-19. The country acted quickly to provide income for those losing employment and expanded a range of benefits to create additional supports. </p>
<p>These actions helped low-income workers throughout Canada, but left out those without access to the labour market. <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/220713/dq220713d-eng.htm">Fewer than 40 per cent of disabled workers received CERB</a>, a figure that excludes all the non-workers who were ineligible. </p>
<p>The federal government’s over-reliance on the provinces to distribute benefits and support also meant that <a href="https://www12.statcan.gc.ca/census-recensement/2021/as-sa/98-200-X/2021005/98-200-X2021005-eng.cfm">responses to the COVID-19 pandemic varied across the country</a>. </p>
<p>This was part of a larger movement that has been <a href="https://doi.org/10.1111/cars.12268">shifting economic risks and burdens</a> to individuals, emphasizing personal responsibility rather than structural inequalities. This kind of approach to policy-making is detrimental to people with disabilities who access government benefits to support their income.</p>
<p>The recent re-introduction and tabling of <a href="https://www.justice.gc.ca/eng/csj-sjc/pl/charter-charte/c22_1.html">Bill C-22</a>, which aims to create new disability benefits for working-age Canadians, is a step in the right direction. </p>
<p>The bill was <a href="https://www.cbc.ca/news/politics/liberals-reintroduce-disability-benefits-bill-1.6474363">introduced by the Liberal government in June 2021</a>, but died when Prime Minister Justin Trudeau called the federal election. Now, most likely in response to the public outcry about how little the federal government did for Canadians with disabilities during the pandemic, it’s back on the table. However, it has disabled Canadians wondering if it’s too little, too late.</p><img src="https://counter.theconversation.com/content/190220/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David Pettinicchio receives funding from Social Sciences and Humanities Research Council of Canada</span></em></p><p class="fine-print"><em><span>Michelle Maroto receives funding from the Social Sciences and Humanities Research Council of Canada (SSHRC).</span></em></p>Supports that were crucial in helping Canadians with disabilities stay afloat during COVID-19 are no longer available, causing concern from many about their economic future.David Pettinicchio, Associate Professor, Sociology, University of TorontoMichelle Maroto, Associate Professor of Sociology, University of AlbertaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1808782022-04-13T13:51:51Z2022-04-13T13:51:51ZRussia-Ukraine conflict is driving up wheat prices: this could fuel instability in Sudan<figure><img src="https://images.theconversation.com/files/457128/original/file-20220408-42486-j3hdvh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Widespread protests have followed changes in the subsidised price of Baladi bread, a traditional Sudanese flatbread.</span> <span class="attribution"><span class="source">Photo by MUJAHED SHARAF AL-DEEN SATI/AFP via Getty Images</span></span></figcaption></figure><p>Russia’s invasion of Ukraine <a href="https://theconversation.com/how-russia-ukraine-conflict-could-influence-africas-food-supplies-177843">has disrupted</a> agricultural production and trade from one of the world’s major food exporting regions. The war threatens to drive rising food prices still higher and create scarcity, especially for regions most dependent on wheat and other exports from Russia and Ukraine. </p>
<p>Particularly affected is the Middle East and North Africa region. These Arab countries <a href="https://www.arab-reform.net/publication/the-impact-of-the-ukraine-war-on-the-arab-region-food-insecurity-in-an-already-vulnerable-context/">consume</a> the highest wheat per capita, about 128 kg of wheat per capita, which is twice the world average. <a href="https://s3.eu-central-1.amazonaws.com/storage.arab-reform.net/ari/2022/03/11145720/Wheat_En_FInal.pdf">More than half</a> of this comes from Russia and Ukraine.</p>
<p>Sudan, which is part of the Middle East and North Africa region, faces a uniquely difficult set of circumstances as these disruptions loom. As with other countries in the region, wheat is a key food item. It’s second only to sorghum as a source of calories, accounting for <a href="https://www.ifpri.org/cdmref/p15738coll2/id/134867/filename/135075.pdf">a fifth</a> of the total calories consumed daily. Demand for wheat has grown rapidly in the last 15 to 20 years driven mainly by population growth and changing consumer preferences for bread and other wheat products. </p>
<p>However, only <a href="https://elibrary.worldbank.org/doi/abs/10.1596/34103">about 15%</a> of the wheat consumed is grown in Sudan, and this share could shrink <a href="https://www.reuters.com/world/africa/rising-hunger-looms-sudan-with-little-aid-sight-2022-04-01/">due to</a> rising fertiliser and energy <a href="https://www.one.org/africa/blog/rising-food-prices-africa-unrest/">prices</a>. The majority of imported wheat in Sudan is <a href="https://www.ifpri.org/blog/russia-ukraine-conflict-likely-compound-sudans-existing-food-security-problems">sourced from</a> Russia and Ukraine, which together accounted for 59% of imports in 2020. </p>
<p>Moreover, because it is the staple food of the urban population, especially the urban poor, wheat is politically important. In recent years large-scale protests <a href="https://theconversation.com/no-easy-end-to-stand-off-between-al-bashir-and-sudans-protesters-112635">have followed</a> changes in the subsidised price of Baladi bread (traditional flatbread). </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/sudans-food-riots-show-that-the-transitional-government-still-has-much-to-achieve-155911">Sudan's food riots show that the transitional government still has much to achieve</a>
</strong>
</em>
</p>
<hr>
<p>The situation in Sudan is already tense, for months there have been <a href="https://allafrica.com/stories/202204060733.html">widespread protests</a> against the current military government. The wheat crisis could escalate things further. </p>
<h2>Rising wheat prices</h2>
<p>Prices for wheat and fuel were <a href="https://ebrary.ifpri.org/utils/getfile/collection/p15738coll2/id/134867/filename/135075.pdf">already spiking</a> before the war started. They began rising in 2019 as a result of a series of domestic problems in Sudan, including high inflation and political instability, with severe adverse consequences for the Sudanese economy. </p>
<iframe title="Sudan import of wheat" aria-label="Interactive area chart" id="datawrapper-chart-Ba0cb" src="https://datawrapper.dwcdn.net/Ba0cb/1/" scrolling="no" frameborder="0" style="width: 0; min-width: 100% !important; border: none;" height="400" width="100%"></iframe>
<p>Wheat prices continued to <a href="https://www.ifpri.org/cdmref/p15738coll2/id/134867/filename/135075.pdf">surge in 2021</a> due largely to overall domestic inflation, foreign exchange shortages that limited wheat imports, a rapid depreciation of the exchange rate and continued low productivity of domestic production. In addition, the removal of fuel subsidies in <a href="https://reliefweb.int/report/sudan/giews-country-brief-sudan-29-june-2021">June 2021</a> contributed to increased production costs for farmers and bakeries for non-subsidised inputs such as water, yeast, cooking gas, labour, and oil.</p>
<p>Many bakeries went out of business as production costs increased more than the official sales price of subsidised flat bread. </p>
<p>Inflationary pressures were compounded further by a cut in funding from international donors following the <a href="https://www.reuters.com/markets/us/exclusive-sudan-cut-off-650-million-international-funding-after-coup-2021-12-08/">military coup</a> in October 2021. </p>
<p>These problems intensified in 2022. </p>
<p>On 1 January, the Sudan government abandoned all forms of subsidies on wheat (grain, flour and bread), <a href="https://www.fao.org/giews/food-prices/food-policies/detail/en/c/1096022/">forcing milling companies</a> to <a href="https://sudan.ifpri.info/2021/09/15/a-deeper-look-into-sudans-wheat-value-chains-and-wheat-policy-options/">obtain</a> grain in the higher-priced open market. Overall, between July 2021 and February 2022, the wholesale price of wheat in Khartoum rose by 112% (about 60% in real terms).</p>
<p>Then came Russia’s invasion of Ukraine. </p>
<p>The resulting disruption of wheat exports has pushed imported wheat prices <a href="https://www.ifpri.org/blog/russia-ukraine-war-exacerbating-international-food-price-volatility">still higher</a>. Bread prices are expected to rise further as well, both because of higher wheat prices and increased production costs due to higher oil and gas prices. </p>
<p>For example, the price of gas used as cooking fuel for most bakeries has <a href="https://al-ain.com/article/bread-prices-double-sudan">recently jumped</a> 56%; the price of a jerry can of oil <a href="https://al-ain.com/article/bread-prices-double-sudan">has jumped</a> 67%. </p>
<p>Higher wheat and petroleum prices also add to pressure on foreign exchange reserves, contributing to a recent government decision to sell gold to fund additional food imports in advance of the upcoming Ramadan months when household food consumption typically increases sharply. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/457091/original/file-20220408-42951-d8eqbt.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/457091/original/file-20220408-42951-d8eqbt.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/457091/original/file-20220408-42951-d8eqbt.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/457091/original/file-20220408-42951-d8eqbt.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/457091/original/file-20220408-42951-d8eqbt.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/457091/original/file-20220408-42951-d8eqbt.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/457091/original/file-20220408-42951-d8eqbt.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Sudan Wheat Model Simulations. Source: IFPRI.</span>
</figcaption>
</figure>
<p>To assess the impact of the surge in domestic prices in 2021 and what could happen to the market prices of imports and domestic wheat consumption due to the conflict in Ukraine in early 2022, we ran simulations using a partial equilibrium model of Sudan’s <a href="https://www.ifpri.org/blog/russia-ukraine-conflict-likely-compound-sudans-existing-food-security-problems">wheat economy</a>. </p>
<p>The model used for our simulations is a simplified version of a <a href="http://www.ifpri.org/program/impact-model">partial equilibrium multi-market model</a> commonly used for agricultural trade policy analysis that takes into account agricultural production, household consumption, prices and trade. </p>
<p>Model simulations indicate that the 61% surge in the wholesale price of wheat in Sudan between August 2021 and February 2022 reduced the country’s wheat imports by 24% and total wheat consumption (including consumption of wheat products) <a href="https://ebrary.ifpri.org/utils/getfile/collection/p15738coll2/id/134867/filename/135075.pdf">by 15%</a>. Simulations of a possible further 20% increase in real wheat prices, due to the Ukraine invasion, suggest this could lead to an additional decline in wheat imports and consumer demand for wheat products of 9 and 5 percentage points, respectively.</p>
<p>These wheat price shocks have serious consequences for Sudan’s food economy and especially for urban poor households. In the model simulations, wheat consumption dropped by 16%-19% between July 2021 and February 2022 because of domestic policy changes. And then by another 5% in March 2022. </p>
<p>The welfare of rural poor households, who constitute the majority of the Sudan’s population, is least affected by these wheat market shocks given their relatively low per capita consumption of wheat products in 2022 (about 12 kgs/person).</p>
<h2>What can be done</h2>
<p>Sudan needs to address the immediate impacts of the current crisis. It should then look to building its resilience to reduce the impacts of the next one. Here are several policy measures to consider:</p>
<ul>
<li><p>Increased investments in roads, and other market infrastructure, such as physical markets and stalls. This would help reduce, transaction costs, raise producer prices and improve the functioning and efficiency of markets. </p></li>
<li><p>Additional research and extension efforts to increase production of alternatives to wheat production. This could include drought-tolerant sorghum and millet on non-irrigated land and high value export crops on irrigated land. </p></li>
<li><p>Introduce a cash transfer system targeting the poorest households as bread subsidies are removed. This could build on the experiences from the <a href="https://sudan.un.org/en/47747-sudan-government-and-wfp-sign-agreement-sudan-family-support-programme">Sudan Family Support Program (Samarat)</a> introduced in 2021 but then halted, as well as lessons from successful <a href="https://www.worldbank.org/en/news/feature/2018/11/15/the-story-of-takaful-and-karama-cash-transfer-program#:%7E:text=The%20Takaful%20and%20Karama%20conditional%20and%20unconditional%20cash,support%20of%20a%20US%24400%20million%20World%20Bank%20program.">cash transfer programs</a> in other countries, including Egypt’s Takaful and Karama programmes.</p></li>
<li><p>Address food security data gaps and improve monitoring. Accurate targeting of either cash or in-kind transfer programmes would require up-to-date household data. </p></li>
<li><p>Strengthen public sector capacity to address key problems. These include the effectiveness of standards agencies to enforce regulations for monitoring of wheat flour quality, ensuring competition in wheat milling, and effectively building and managing a cash transfer program. </p></li>
</ul>
<p>Putting some – or all – of these in place can help build a more resilient wheat system in Sudan. This would give households the wherewithal to better withstand future economic shocks.</p>
<p><em>A version of this article was published <a href="https://www.ifpri.org/blog/russia-ukraine-conflict-likely-compound-sudans-existing-food-security-problems">here</a></em></p><img src="https://counter.theconversation.com/content/180878/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clemens Breisinger receives funding from ONE CGIAR and the United States Agency for International Development. </span></em></p><p class="fine-print"><em><span>David Laborde Debucquet receives funding from United States Agency for International Development (USAID) to study the role of international trade in global and national food security.</span></em></p><p class="fine-print"><em><span>Joseph Glauber receives funding from USAID. Glauber is also a visiting research scholar at the American Enterprise Institute.
</span></em></p><p class="fine-print"><em><span>Oliver Kiptoo Kirui receives funding from United States Agency for International Development(USAID). </span></em></p><p class="fine-print"><em><span>Paul Dorosh receives funding from a USAID/Khartoum Sudan Strategy Support Program. </span></em></p>Wheat and bread play a central role for food security and political stability in Sudan.Clemens Breisinger, Senior Research Fellow, International Food Policy Research Institute (IFPRI) David Laborde Debucquet, Senior Research Fellow, International Food Policy Research Institute (IFPRI) Joseph Glauber, Senior Research Fellow, International Food Policy Research Institute (IFPRI) Oliver Kiptoo Kirui, Research Fellow, International Food Policy Research Institute (IFPRI) Paul Dorosh, Director of Development Strategy and Governance Division, International Food Policy Research Institute (IFPRI) Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1772462022-04-07T16:41:57Z2022-04-07T16:41:57ZFaster diagnosis of frailty in seniors aging at home is key to helping them stay independent<figure><img src="https://images.theconversation.com/files/456640/original/file-20220406-22-skjmyw.jpg?ixlib=rb-1.1.0&rect=201%2C100%2C6045%2C4365&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Frailty is a state of reduced physical function for seniors living independently in the community. It can affect endurance, balance, cognition or social engagement.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>In the next 10 years, the number of Canadians living with frailty will grow to <a href="https://www.cfn-nce.ca/frailty-matters/">more than two million</a>. Frailty matters because it not only affects seniors’ ability to function, but also puts their health at risk.</p>
<p><a href="https://www.cfn-nce.ca/frailty-matters/what-is-frailty/">Frailty</a> is a state of reduced physical function for seniors living independently in the community. It looks different for different individuals and can affect endurance, balance, cognition or social engagement. Often frailty assessment is limited to in-office assessments by physicians. If it could be assessed in other settings, it may provide opportunities to respond to seniors’ needs for services faster and with less burden on the health-care system.</p>
<p>As nurse practitioners, we led a quality improvement project to expand identification and response to frailty for seniors living in the community. The project also engaged social work staff and others working in seniors’ services in Edmonton to assess older adults for frailty, performing these assessments at a seniors’ centre in the community. </p>
<p>Our goal was to confirm that frailty screening could be effective without medical professionals’ involvement, and to test a new method to identify and prevent functional decline. </p>
<h2>Enabling frailty assessment</h2>
<p>Unfortunately — or, looking back now, maybe serendipitously — the project began at the same time as the onset of the COVID-19 pandemic and the team had to pivot quickly to ensure continuation and success. The pandemic forced the team to think about frailty assessment in totally different ways and to develop an innovative approach to assess and respond to frailty virtually. </p>
<figure class="align-center ">
<img alt="A woman with gray hair smiling while holding a telephone to her ear." src="https://images.theconversation.com/files/456642/original/file-20220406-12-ovb2w1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/456642/original/file-20220406-12-ovb2w1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/456642/original/file-20220406-12-ovb2w1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/456642/original/file-20220406-12-ovb2w1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/456642/original/file-20220406-12-ovb2w1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/456642/original/file-20220406-12-ovb2w1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/456642/original/file-20220406-12-ovb2w1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Virtual assessment used questions over the phone to assess frailty.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>We needed to find a way to continue this important work despite limited face-to-face interactions. </p>
<p>Originally, the plan was to have primary care providers use a pre-existing tool, the <a href="https://www.dal.ca/sites/gmr/our-tools/clinical-frailty-scale.html">Clinical Frailty Scale</a> (CFS) developed at Dalhousie University, to assess frailty during in-person appointments at a community-based seniors’ organization in downtown Edmonton. Since in-person visits were limited, our team identified an alternative approach that involved interviewing seniors by telephone and having them provide a self-assessment of their frailty level. </p>
<p>Permission was obtained from Dalhousie to adapt the Clinical Frailty Scale to a Virtual Frailty Screening tool. Seniors responded well to the process and, after a few tweaks, we pivoted to a new and improved virtual version of <a href="https://doi.org/10.1177/21501327211034807">Building Resilience and Responding to Seniors Frailty, known as DRAGONFLY</a>.</p>
<h2>Providing support in the community</h2>
<p>Virtual Frailty Screening scores ranged from zero to nine and were divided into three categories: mild frailty (scores of one to three), moderate frailty (four to six) and severe frailty (seven to nine). Interestingly, it was the moderately frail seniors who required the most support. Those who were experiencing mild frailty didn’t require active intervention and those experiencing severe frailty were well supported. It was those seniors in the moderate category who required intensive intervention. </p>
<p>The DRAGONFLY team’s response focused on providing both social and clinical supports for care in community. The most common social supports included financial assistance, housing support, transportation, home services, legal referrals and completion of medical paperwork. More specifically, assisting seniors with paperwork to access funds or adequate housing. </p>
<p>Other seniors required more practical resources, such as a connection to a driving service for medical appointments or assistance with grocery delivery during the pandemic. </p>
<figure class="align-center ">
<img alt="A man with gray hair holding a pen while a younger woman smiles beside him" src="https://images.theconversation.com/files/456643/original/file-20220406-7184-39dzm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/456643/original/file-20220406-7184-39dzm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/456643/original/file-20220406-7184-39dzm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/456643/original/file-20220406-7184-39dzm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/456643/original/file-20220406-7184-39dzm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/456643/original/file-20220406-7184-39dzm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/456643/original/file-20220406-7184-39dzm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The most common social supports included financial assistance, housing support, transportation, home services, legal referrals and completion of medical paperwork.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Social connections were very important. Seniors were referred to recreation programming to enhance engagement with peers, connections with other seniors from specific newcomer communities, caregiver support, psychosocial support groups and virtual communities. Well-being supports included use of multicultural navigators to help newcomers acclimatize to their new homes, LGBTQ2S connections, medical translation and counselling for those who struggle with hoarding behaviours. </p>
<p>The most common clinical supports included connecting to a new primary care provider, help finding allied health providers such as physiotherapists or pharmacists, primary care network program registration, facilitating pharmacy reviews, connecting with drop-in mental health counselling and health navigation. </p>
<p>Putting these in place and following up with seniors via phone on a regular basis demonstrated improvement in their resilience. We saw a significant decrease in their support needs and gaps over a 12-month period. </p>
<h2>Frailty in the community</h2>
<p>Assessing and responding to frailty in the community has never been so important. The pandemic highlighted the inherent <a href="https://theconversation.com/after-covid-19s-tragic-toll-canada-must-improve-quality-of-life-in-long-term-care-homes-139763">risks of congregate living</a> and the importance of maintaining older adults living in their communities as long as possible. Independent living contributes to <a href="https://theconversation.com/enabling-better-aging-the-4-things-seniors-need-and-the-4-things-that-need-to-change-151191">greater health for seniors</a> and also helps to keep <a href="https://www.cma.ca/news-releases-and-statements/new-study-cost-and-demand-elder-care-double-next-10-years">health-care costs lower</a>. </p>
<p>We already know that seniors who are socially engaged are <a href="https://doi.org/10.1186/s12889-019-7841-7">not only happier, but healthier</a>. Thinking about and implementing new ways of identifying frailty and including social services as a major sector in this work represents a new way to integrate our health and social spheres, rooting wellness in our communities, not in our clinics.</p>
<p>Our program made an important difference to over 100 seniors during a very challenging time for them. In the face of social distancing and limited face-to-face services, DRAGONFLY continued to assess frailty in seniors in the community and allowed us to respond to functional needs in a meaningful way. </p>
<p>This project is coming to an end, but we are currently working with <a href="https://drivehappiness.ca">other organizations</a> that serve seniors and hope to apply the lessons of DRAGONFLY to build capacity to assess and respond to frailty, preventing its progression.</p><img src="https://counter.theconversation.com/content/177246/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tammy O'Rourke receives funding from Healthcare Excellence Canada.</span></em></p><p class="fine-print"><em><span>Anne Summach is affiliated with the Nurse Practitioner Association of Alberta.</span></em></p>Frailty — the physical limitations of seniors living in the community — needs to be assessed before it can be addressed with social and health support. Virtual assessments can speed up this process.Tammy O'Rourke, Assistant Professor, Faculty of Health Disciplines, Athabasca UniversityAnne Summach, Assistant Teaching Professor, Nurse Practitioner Program, Faculty of Nursing, University of AlbertaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1713372021-12-03T13:43:45Z2021-12-03T13:43:45ZPregnancy apps and online spaces fail to support individuals grieving a pregnancy loss – here’s what to do about it<figure><img src="https://images.theconversation.com/files/433780/original/file-20211124-23-z246zg.jpg?ixlib=rb-1.1.0&rect=44%2C713%2C7395%2C4238&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Social technologies perpetuate a single idea of what constitutes a pregnancy.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/social-distancing-during-covid-19-pandemic-royalty-free-image/1214516643">martin-dm/E+ via Getty Images</a></span></figcaption></figure><p>Approximately <a href="https://doi.org/10.1093/epirev/mxf006">1 in 4 pregnancies in the United States ends in loss</a>. Pregnancy loss, also referred to as miscarriage, is a common reproductive health complication. </p>
<p>Many experience this loss as a significant life event, with a “before” and an “after.” It can cause <a href="https://doi.org/10.1016/0002-9378(92)91839-3">depression and post-traumatic stress disorder</a>. Yet <a href="https://doi.org/10.2307/3178398">society largely stigmatizes and dismisses it</a> by not treating it as a loss that deserves to be grieved.</p>
<p>I <a href="https://scholar.google.com/citations?hl=en&user=ju-VqbUAAAAJ">research the social implications of technology</a>. For the past several years, I’ve been investigating the intersection of pregnancy loss and social technologies. Search engines, social media, online support groups and pregnancy and fertility tracking apps are some of the technologies people use to <a href="https://doi.org/10.1016/j.wombi.2016.01.008">manage pregnancies, share experiences or exchange social support</a>. </p>
<p>My recent research shows these technologies often do not account for pregnancy loss and, as a result, can cause re-traumatization and distress.</p>
<h2>Harmful designs and algorithms</h2>
<p>In a recent study, I conducted <a href="https://doi.org/10.1145/3449201">in-depth interviews with women in the U.S.</a> who had recently experienced pregnancy loss. I found that pregnancy tracking applications failed miserably in considering pregnancy losses. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/433782/original/file-20211124-17-1lpvlbo.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Woman faces her laptop, head in hands." src="https://images.theconversation.com/files/433782/original/file-20211124-17-1lpvlbo.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/433782/original/file-20211124-17-1lpvlbo.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/433782/original/file-20211124-17-1lpvlbo.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/433782/original/file-20211124-17-1lpvlbo.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/433782/original/file-20211124-17-1lpvlbo.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=565&fit=crop&dpr=1 754w, https://images.theconversation.com/files/433782/original/file-20211124-17-1lpvlbo.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=565&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/433782/original/file-20211124-17-1lpvlbo.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=565&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">‘Oh, please stop.’</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/businesswoman-frustrated-by-bad-new-at-office-desk-royalty-free-image/1124417258">Luis Alvarez/DigitalVision via Getty Images</a></span>
</figcaption>
</figure>
<p>A participant told me, “There’s no way to tell your app, ‘I had a miscarriage. Please stop sending me these updates,’ like, ‘This week, your baby’s the size of a banana or whatever.’ There’s no way to stop those.”</p>
<p>Similarly, advertising algorithms assumed all pregnancies lead to the birth of an alive and healthy baby. Another participant told me, “I was getting ads for maternity clothes. I was just like, ‘Oh, please stop.’”</p>
<p>The design of mobile apps tells a similar story. I conducted <a href="https://doi.org/10.1177/1461444820984473">an analysis of 166 pregnancy-related apps</a> and found 72% do not account for pregnancy loss at all, 18% offer an option to report a loss without providing any support, and the remaining 10% passively link to outside sources.</p>
<p>Another tool people use during pregnancy and loss journeys are online support groups. While groups dedicated to loss can be sources of social support where people may find emotional validation, connect with others and feel seen and less alone, I found they can also foster invalidating and harmful experiences. </p>
<p>One participant reported seeing questions “like ‘Can you eat this certain thing while pregnant?’ You get some people who say, ‘Yes, I ate that all through pregnancy.’ Then you get some people who say, ‘I can’t believe you’re doing that to your body, that’s harmful for you.’” </p>
<p>Overall, the design features and algorithms that underpin content and interactions do real harm by perpetuating a single idea of what constitutes a pregnancy – one that is smooth and leads to a happy ending. By not accounting for pregnancy loss, I contend <a href="https://doi.org/10.1177/1461444820984473">they contribute to its further stigmatization</a>. </p>
<p>My work shows how technology design reinforces stereotypes about experiences like pregnancy loss – and sustains social inequities like marginalization and stigmatization. This, in turn, makes it hard for those experiencing loss to find the resources and support they need.</p>
<h2>A more humane approach</h2>
<p>If you are someone who has experienced pregnancy loss, I am sorry for your loss. Please know that you are not alone. I hope this article helps validate and make visible some of your frustrating experiences.</p>
<p>If you know someone who has experienced a pregnancy loss, know that the harms and challenges I described above are only some of the frustrations they may face. Acknowledge their loss. Ask how you may be able to support them. Get them meals, offer to pet sit or babysit for them, listen to them, sit in their sorrow with them. Know that holidays and anniversaries tend to be tough. Do not say “you will get pregnant again.” Finally, remember that lesbian, gay, bisexual, transgender and queer people also experience pregnancy and loss. </p>
<p>If you are a designer, developer or someone who makes decisions about products and advertising algorithms, I hope this research illustrates some of the real harms users may experience as a result of using products to manage intimate personal experiences like pregnancies. Please consider designing products that consider the full range of pregnancy and other human experiences. Remember that considering pregnancy loss as an outcome does not mean finding other ways to profit from your users’ loss and grief.</p>
<p>[<em>Over 140,000 readers rely on The Conversation’s newsletters to understand the world.</em> <a href="https://memberservices.theconversation.com/newsletters/?source=inline-140ksignup">Sign up today</a>.]</p><img src="https://counter.theconversation.com/content/171337/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nazanin Andalibi does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>New research shows technologies like pregnancy apps do not account for pregnancy loss 72% of the time, causing real harm to users.Nazanin Andalibi, Assistant Professor of Information, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1711312021-11-25T14:32:16Z2021-11-25T14:32:16ZEfforts to protect the poor during COVID: how five African countries fared<figure><img src="https://images.theconversation.com/files/432332/original/file-20211117-21-c24685.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Rosa Eugenia uses a capulana masks produced at a small sewing workshop in Maputo, Mozambique.
</span> <span class="attribution"><span class="source">EFE-EPA/Ricardo Franco</span></span></figcaption></figure><p>The number of people living in poverty around the world is estimated to <a href="https://www.wider.unu.edu/publication/precarity-and-pandemic#:%7E:text=COVID%2D19%20and%20poverty%20incidence,and%20severity%20in%20developing%20countries&text=We%20conclude%20there%20could%20be,lines%20of%20%243.20%20and%20%245.50">have increased by half a billion people</a> due to the COVID-19 crisis. The African continent has suffered at least US$100 billion in economic costs in 2020, measured by the reduction in trade revenues and financial flows <a href="https://set.odi.org/wp-content/uploads/2020/03/Economic-impacts-of-and-policy-responses-to-the-coronavirus-pandemic-early-evidence-from-Africa.pdf">due to the pandemic</a>. </p>
<p><a href="https://www.wider.unu.edu/publication/estimates-impact-covid-19-global-poverty">Many studies</a> have been undertaken to evaluate the effects of the pandemic in Africa. But there’s little evidence of what difference tax-and-benefit systems made to poverty before or during the crisis. Two areas of government policy form the tax and benefit system. First, governments support people through various social benefits such as cash transfers. At the same time they tax households.</p>
<p>Our new <a href="https://www.wider.unu.edu/sites/default/files/Publications/Working-paper/PDF/wp2021-148-mitigating-role-tax-benefit-rescue-packages-poverty-inequality-Africa-COVID-19.pdf">study</a> closes the gap in assessing the impact of COVID-19. </p>
<p>We <a href="https://www.wider.unu.edu/publication/studying-covid-19-through-lens-microsimulation">estimated</a> the impact of the crisis on earnings and showed how earnings losses, together with tax-benefit policies, affected households’ disposable income, and thereby poverty and inequality in each country.</p>
<p>We also looked at the effect of measures taken by governments in response to the crisis, such as emergency income support and tax waivers. The impact of pausing existing social protection schemes as a consequence of lockdowns and social distancing policies also came into our analysis.</p>
<p>Our assessment covered five sub-Saharan African countries: Ghana, Mozambique, Tanzania, Uganda, and Zambia. </p>
<p>Our findings suggest that existing tax-and-benefit systems had a negligible effect in cushioning against income losses in 2020. But these varied. In Mozambique, policies did protect poor households from large income losses. But they only marginally cushioned the population-wide rise in poverty and inequality using the internationally comparable absolute poverty line of US $1.9 per day.</p>
<p>On the other hand, the case of <a href="https://www.wider.unu.edu/publication/distributional-effects-covid-19-pandemic-ghana">Ghana</a> illustrates how lockdown measures can hurt the delivery of ongoing social protection measures. The country’s pause of the large national school feeding program dwarfed the positive impact of other policy measures.</p>
<p>The systems largely failed on two fronts. They didn’t automatically pay (more) social benefits to households that saw large income shocks. And they didn’t reduce tax payments levied on those households that saw a more limited income shock.</p>
<h2>Similarities and differences</h2>
<p>Developed countries have what are so-called <a href="https://www.brookings.edu/blog/up-front/2019/07/02/what-are-automatic-stabilizers/">“automatic stabilisers”</a>. These are operated through large scale unemployment insurance systems and social benefit systems tied to income levels. As people’s incomes fall or go to zero during economic crises these systems automatically trigger a benefit payment thus mitigating more or less immediately a substantial portion of the income loss suffered by households.</p>
<p>In the African countries the analysed automatic stabilisers operated mainly through marginally reduced tax and social insurance contributions. This provided relief only for a limited number of households because it affected higher-income households working in the formal sector. They paid less taxes and social insurance contributions due to reduced earnings.</p>
<p>In the models that we built we separated out the direct effects of the pandemic from the effects of new policies and the general tax-and-benefit system. But we qualified the direct effects of the pandemic (including lockdown measures but also other factors) by looking at changes in economic activity across industries.</p>
<p>The five countries make for an interesting comparison.</p>
<p>They all have a large informal sector and low social protection coverage. They also registered the first cases of COVID-19 around March 2020. But, the intensity and effects of lockdown measures they used varied considerably, as did the effects of trade shocks, investment changes and consumer behaviour. </p>
<p>One contribution of our study is to assess how these “direct” effects on the economy, taken together, varied across countries.</p>
<p>The countries also differ in the scope and nature of tax-benefit measures taken in response to the crisis. The discretionary actions adopted in 2020 and their impacts varied substantially across the five countries. </p>
<ul>
<li><p>Mozambique: the policies did protect poor households from large income losses. But when looking at the whole population, the policies only marginally cushioned the rise in poverty and inequality.</p></li>
<li><p><a href="https://www.wider.unu.edu/publication/distributional-effects-covid-19-pandemic-ghana">Ghana</a> shows how lockdown measures can hurt the delivery of ongoing social protection measures. Pausing the large national <a href="https://www.unicef.org/ghana/press-releases/nutrition-crisis-looms-globally-more-39-billion-school-meals-missed-start-covid-19">school feeding programme</a> dwarfed the positive impact of other policy measures.</p></li>
<li><p>Uganda and Tanzania: no significant policies were adopted last year.</p></li>
</ul>
<h2>Making the most out of the available</h2>
<p>Our study was constrained by the lack of detailed data on households. This included information on how employment and earnings changed during the crisis. The crisis also disrupted standard data collection activities. For example, full-scale household surveys covering the time of the pandemic have not yet been collected for most countries. And the few that have been collected are just becoming available.</p>
<p>Our research addresses this challenge by estimating how economic activity in different sectors developed in 2020 compared to pre-pandemic trends, and <a href="https://www.wider.unu.edu/publication/deriving-shocks-household-consumption-expenditures-associated-income-shocks-resulting">translating these shocks to household-level incomes</a>. </p>
<p>We found that agriculture, one of the most important sectors in all countries analysed, did not experience a reduction in 2020 compared to its historical trend. Service sectors were hit hard in each of the five countries.</p>
<p>To check the <a href="https://www.wider.unu.edu/publication/imputation-methods-adjusting-southmod-input-data-income-losses-due-covid-19-crisis">robustness of our approach</a>, we used individual-level data <a href="https://www.worldbank.org/en/data/interactive/2020/11/11/covid-19-high-frequency-monitoring-dashboard">World Bank’s phone surveys</a> in Uganda. This is one of the few countries where more detailed data is available to compare against.</p>
<p>Another major challenge we encountered was the lack of organised official sources of detailed information about the discretionary policies implemented in response to the crisis. </p>
<h2>Policy implications</h2>
<p>Our findings show that governments in sub-Saharan Africa, in particular, face a daunting challenge in protecting the livelihoods of their citizens from a protracted crisis. </p>
<p>They face similar challenges regarding future shocks given the limited scale and coverage of existing tax and social protection policies.</p>
<p>To properly understand and manage the effects of COVID-19 and of future crises, improved data collection practices and capacities should be a priority for African governments.</p>
<p>But for now, with the worsening COVID-19 <a href="https://ourworldindata.org/coronavirus">crisis in 2021</a>, slow <a href="https://www.afro.who.int/news/less-10-african-countries-hit-key-covid-19-vaccination-goal">vaccination campaigns</a>, and generally <a href="https://social-assistance.africa.undp.org/">low levels of social protection</a>, the introduction of additional benefits in 2021 will be fundamental to protecting poor households in sub-Saharan Africa.</p>
<p>In the long run, supporting the growth of the formal sector will be essential to increasing tax revenues to better protect society’s most vulnerable. It will also help to harness the potential of tax-benefit systems to stabilise household incomes, and ultimately improve governments’ ability to respond to future crises.</p><img src="https://counter.theconversation.com/content/171131/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Study shows that agriculture, one of the most important sectors, did not decline in 2020 compared to its historical trend. Service sectors were hit hard in each of the five countries.Jesse Lastunen, Research Associate, World Institute for Development Economics Research (UNU-WIDER), United Nations UniversityPia Rattenhuber, Research Fellow, World Institute for Development Economics Research (UNU-WIDER), United Nations UniversityRodrigo Carvalho Oliveira, Research Associate, World Institute for Development Economics Research (UNU-WIDER), United Nations UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1681432021-11-03T14:46:07Z2021-11-03T14:46:07ZStudy shows the power of networking in alleviating hardship during COVID-19<figure><img src="https://images.theconversation.com/files/428559/original/file-20211026-23-1lc7xef.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Typical day in low-income communities in the Strand, Western Cape, South Africa</span> <span class="attribution"><span class="source">Hazel Swanepoel/Building Bridges</span></span></figcaption></figure><p>The national lockdown imposed by the South African government to contain the spread of COVID-19 in <a href="http://www.dirco.gov.za/docs/speeches/2020/cram0323.pdf">March 2020</a> disrupted economic activity, <a href="https://www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_753060/lang--en/index.htm">education</a> and other social activities. This led to job losses and many <a href="https://www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_753060/lang--en/index.htm">psycho-social problems</a>, putting an additional <a href="https://doi.org/10.1080/23311886.2020.1869368">strain</a> on poorer communities.</p>
<p>Their inability to pay for services <a href="https://www.municipalservicesproject.org/sites/municipalservicesproject.org/files/publications/Cost%20Recovery%20and%20the%20Crisis%20of%20Service%20Delivery%20in%20South%20Africa%20-%20complete%20manuscript.pdf">means limited or no access</a> to water, electricity, housing and healthcare. They often rely on non-profit organisations to help them. </p>
<p>The non-profit sector’s <a href="https://www.iol.co.za/capeargus/news/cape-ngos-in-dire-straits-as-funding-gets-withdrawn-17807045">overstretched</a> resources have come under even more pressure during the pandemic.</p>
<p>These entities realised that working in silos was not effective. They needed to <a href="http://siba-ese.unisalento.it/index.php/cpgp/article/viewFile/22478/19762">coordinate their efforts</a>. </p>
<p>Even before the pandemic, they had <a href="https://onlinelibrary.wiley.com/doi/10.1002/jcop.22096">identified networking</a> as a way to improve their effectiveness. Networks – or coalitions – are alliances for combined action. They share resources, ideas and information to achieve shared objectives.</p>
<h2>The study</h2>
<p>The main aim of our <a href="http://siba-ese.unisalento.it/index.php/cpgp/article/viewFile/22478/19762">study</a> was to find out what made networking difficult and what made it possible. </p>
<p>We explored the value of networking as a way to strengthen relationships among service providers in the Strand, Western Cape area. The place has high rates of unemployment and not much infrastructure. Intentional and unintentional injuries are common. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/safety-measures-for-kids-in-poor-communities-are-often-ignored-some-reasons-why-166032">Safety measures for kids in poor communities are often ignored: some reasons why</a>
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<p>Various community entities and external institutions provide support and services to the area. They make up the Local Network of Care and they are involved in social services, early childhood development, healthcare, job opportunities, youth programmes, community safety initiatives, pastoral counselling, and education. </p>
<p>The Local Network of Care consists of 69 active local organisations and social actors from multiple sectors. Among them are NGOs, the non-profits <a href="https://www.buildingbridges.org/">Building Bridges</a> and <a href="https://smartnpo.com/">SMART NPO</a>, the <a href="https://www.unisa.ac.za/sites/corporate/default/Colleges/Human-Sciences/Schools,-departments,-centres,-institutes-&-units/Institutes/Institute-for-Social-and-Health-Studies-(ISHS)">University of South Africa</a>, the <a href="https://www.samrc.ac.za/extramural-research-units/MaHRU">South African Medical Research Council</a> and the <a href="https://www.capetown.gov.za/">City of Cape Town</a>.</p>
<p>Data for this study draws on the notes we made as researchers over a three year period. We also drew on newspaper clippings, institutional reports, meeting agendas and network meeting minutes.</p>
<h2>Barriers and enablers</h2>
<p>The networks involved in the study were able to ensure that the most vulnerable people received health and safety information and food parcels during the pandemic. They also sourced and distributed personal protective equipment among front-line network partners and local creches. </p>
<p>The study identified these key barriers to the effectiveness of networking:</p>
<ul>
<li>competing priorities and limited staffing, which hampered regular attendance of meetings </li>
<li>ineffective communication </li>
<li>scarce resources </li>
<li>competing for limited funding.</li>
</ul>
<p>We found important enablers of networking to include:</p>
<ul>
<li>mobilising and sharing assets and resources </li>
<li>collectively developing and endorsing a social contract </li>
<li>provision of a safe space<br></li>
<li>effective and continuous communication<br></li>
<li>organisational commitment<br></li>
<li>mutual support, sharing and collaboration.</li>
</ul>
<h2>The power of networking</h2>
<p>COVID-19 exposed the vulnerabilities and fragility of disenfranchised populations globally. But it also highlighted the role of networking in coordinating resources and aiding those in need. </p>
<p>The restrictions limited face-to-face interaction. Still, our findings show that human agency and solidarity through networking were valuable in addressing the psycho-social and economic challenges in poor communities. In times of crisis, this is a vital resource.</p>
<p>The <a href="http://siba-ese.unisalento.it/index.php/cpgp/article/viewFile/22478/19762">study</a> indicates that networks create connections and build capacity. They bring together resources to improve and nurture relationships between groups.</p>
<p>The network partners discovered that different organisations working in silos reached a small number of vulnerable people. It was important to understand what everyone was doing, and how they could address social issues collectively. </p>
<p>Through collective efforts in addressing common community challenges, they were able to generate positive and sustainable change. For example, through the City of Cape Town’s <a href="https://joub.co.za/woman-for-change-program-available-at-cape-town-learnership/">Women for Change Programme</a>, the city provided part-time jobs for local women. They also received training by other network partners, and were recruited into mentoring programmes run by others. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-covid-19-is-likely-to-slow-down-a-decade-of-youth-development-in-africa-159288">How COVID-19 is likely to slow down a decade of youth development in Africa</a>
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<p>The study also highlighted the importance of effective communication channels to share information about meetings, events, resources, jobs and study opportunities. This was important because staff shortages made it difficult to attend monthly networking meetings. The network partners used WhatsApp Web Messenger as a networking tool. </p>
<p>Through the network partners, residents were able to access essential services. These included referrals for counselling and substance abuse treatment, education, social welfare, safe houses, and emergency healthcare. </p>
<p>The network collectively applied ingenuity to find innovative ways to support vulnerable people. For example, various task teams were formed to provide food hampers and run soup kitchens.</p>
<p>For network partners working in communities where overburdening challenges are common and progress is slow, the networking meetings and communication platforms provided a safe and supportive space. The space gave affirmation and emotional support to network partners to help them deal with overwhelming challenges they face in such poor environments, and also to share gains.</p>
<h2>Value of networks</h2>
<p>Our <a href="http://siba-ese.unisalento.it/index.php/cpgp/article/viewFile/22478/19762">study findings</a> show the possibilities and value of creating and sustaining local networks that allow people to participate and collaborate. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/pandemic-underscores-gross-inequalities-in-south-africa-and-the-need-to-fix-them-135070">Pandemic underscores gross inequalities in South Africa, and the need to fix them</a>
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<p>Through networking, local organisations maintained connections during COVID-19. They also encouraged a humanising ethos, and mobilised local resources to help the most vulnerable. </p>
<p>The study shows that people are more likely to be able to develop shared responsibility for others during a crisis if they focus on actively building social networks and connectivity.</p><img src="https://counter.theconversation.com/content/168143/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Naiema Taliep receives funding from the University of South Africa and the South African Medical Research Council. </span></em></p><p class="fine-print"><em><span>Ghouwa Ismail receives funding from the University of South Africa and the South African Medical Research Council. </span></em></p>The network collectively applied ingenuity to provide essential care and support to vulnerable people.Naiema Taliep, Senior Researcher, University of South AfricaGhouwa Ismail, Senior Researcher at the Institute for Social and Health Sciences , University of South AfricaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1662532021-09-28T11:57:01Z2021-09-28T11:57:01ZSocial media gives support to LGBTQ youth when in-person communities are lacking<figure><img src="https://images.theconversation.com/files/423023/original/file-20210923-21-1fxtf5g.jpg?ixlib=rb-1.1.0&rect=0%2C4%2C3000%2C2991&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Social media can provide ways for LGBTQ youth to learn more about, and stay connected to, their identities.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/celebrating-pride-on-social-media-royalty-free-illustration/1250449474">miakievy/DigitalVision Vectors via Getty Images</a></span></figcaption></figure><p>Teens today have <a href="https://theconversation.com/yes-online-communities-pose-risks-for-young-people-but-they-are-also-important-sources-of-support-158276">grown up on the internet</a>, and social media has served as a space where LGBTQ youth in particular can develop their identities.</p>
<p>Scholarship about the online experiences of LGBTQ youth has traditionally focused on <a href="https://dx.doi.org/10.1007%2Fs40653-017-0175-7">cyberbullying</a>. But understanding both the risks and the benefits of online support is key to helping LGBTQ youth thrive, both on- and offline.</p>
<p>I am a <a href="https://scholar.google.com/citations?user=ZuHbDP0AAAAJ&hl=en">senior research scientist</a> studying the benefits and challenges of <a href="https://www.wcwonline.org/Youth-Media-Wellbeing-Research-Lab/youth-media-wellbeing-research-lab">teen social technology and digital media use</a>. My colleagues, <a href="https://wellesley.academia.edu/RachelHodes">Rachel Hodes</a> and <a href="https://www.wcwonline.org/Research-Associates/amanda-richer">Amanda Richer</a>, and I recently <a href="https://doi.org/10.2196/26207">conducted a study</a> on the social media experiences of LGBTQ youth, and we found that online networks can provide critical resources for them to explore their identities and engage with others in the community.</p>
<h2>Beyond cyberbullying</h2>
<p>The increased risk of cyberbullying that LGBTQ youth face is well-documented. LGBTQ youth are <a href="https://www.glsen.org/news/out-online-experiences-lgbt-youth-internet">almost three times more likely</a> to be <a href="https://dx.doi.org/10.1016%2Fj.chiabu.2014.08.006">harassed online</a> than their straight, cisgender peers. This can result in increased rates of <a href="https://doi.org/10.1080/19361653.2011.649616">depression and feelings of suicide</a>: 56% of sexual minorities experience depression, and 35% experience suicidal thoughts as a direct result of cyberbullying.</p>
<p>However, the digital landscape may be shifting.</p>
<p>Our 2019 survey of 1,033 children ages 10 to 16 found <a href="https://doi.org/10.2196/26207">no difference</a> between the amount of cyberbullying reported by straight versus sexual minority youth residing in a <a href="https://transgenderlawcenter.org/equalitymap">relatively progressive part of the U.S.</a> known for legalizing gay marriage. Some social media platforms like <a href="https://theconversation.com/theres-something-queer-about-tumblr-73520">Tumblr</a> are considered a safer haven for sexual minorities than others, especially during the <a href="https://theconversation.com/how-young-lgbtqia-people-used-social-media-to-thrive-during-covid-lockdowns-156130">COVID-19 lockdown</a>. This is despite past <a href="https://www.newsweek.com/twitter-blocked-searches-lgbt-terms-bisexual-and-called-it-error-703550">censorship of LGBTQ content</a> on certain platforms due to biases in the algorithm.</p>
<p>LGBTQ youth tend to have <a href="https://doi.org/10.2196/26207">smaller online social networks</a> than their straight peers. We found that LGBTQ youth were significantly less likely than their straight peers to engage with their online friends. Conversely, LGBTQ youth are more likely to have friends they know only online, and to perceive these online friends as <a href="https://doi.org/10.1016/j.chiabu.2014.08.006">significantly more socially supportive</a> than their in-person friends. </p>
<p>The LGBTQ youth we surveyed in our study were more likely to join an online group in order to <a href="https://doi.org/10.2196/26207">reduce social isolation or feelings of loneliness</a>, suggesting that they were able to reach out to and engage with social media networks outside of their in-person peer circles in supportive and fortifying ways.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/423024/original/file-20210923-17-8xjgek.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Person lying down with rainbow sock-clad legs resting on the back of a sofa." src="https://images.theconversation.com/files/423024/original/file-20210923-17-8xjgek.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/423024/original/file-20210923-17-8xjgek.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/423024/original/file-20210923-17-8xjgek.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/423024/original/file-20210923-17-8xjgek.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/423024/original/file-20210923-17-8xjgek.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/423024/original/file-20210923-17-8xjgek.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/423024/original/file-20210923-17-8xjgek.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">LGBTQ youth are less likely to be friends with family members online and more likely to join social media sites their parents would disapprove of.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/teenager-lyiing-down-with-her-legs-resting-on-the-royalty-free-image/1324272422">Vladimir Vladimirov/E+ via Getty Images</a></span>
</figcaption>
</figure>
<p>Despite living in an area with higher levels of acceptance toward sexual minorities, our study participants felt a need to keep parts of their identities separate and hidden online. They were less likely than non-LGBTQ kids to be friends with family members online and more likely to join social media sites their parents would disapprove of. And about 39% said they had no one to talk to about their sexual orientation at all.</p>
<h2>Not just surviving, but thriving online</h2>
<p>Despite the risk of online harassment and isolation, social media can give LGBTQ youth space to explore their sexual identities and promote <a href="https://doi.org/10.1016/j.chb.2016.07.051">mental well-being</a>.</p>
<p>In 2007, Australian researchers conducted one of the earliest studies on how <a href="https://doi.org/10.1177%2F1363460707072956">internet communities serve as safe spaces for LGBTQ youth</a> who face hostile environments at home. Their surveys of 958 youth ages 14 to 21 found that the anonymity and lack of geographic boundaries in digital spaces provide an ideal practice ground for coming out, engaging with a communal gay culture, experimenting with nonheterosexual intimacy and socializing with other LGBTQ youth.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/423031/original/file-20210923-23-ggu04o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Illustration phone with rainbow heart on the screen, surrounded by positive reaction symbols." src="https://images.theconversation.com/files/423031/original/file-20210923-23-ggu04o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/423031/original/file-20210923-23-ggu04o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=814&fit=crop&dpr=1 600w, https://images.theconversation.com/files/423031/original/file-20210923-23-ggu04o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=814&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/423031/original/file-20210923-23-ggu04o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=814&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/423031/original/file-20210923-23-ggu04o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1023&fit=crop&dpr=1 754w, https://images.theconversation.com/files/423031/original/file-20210923-23-ggu04o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1023&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/423031/original/file-20210923-23-ggu04o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1023&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Some LGBTQ youth use social media to engage with and support social causes.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/diversity-on-social-media-royalty-free-illustration/1325416830">gobyg/DigitalVision Vectors via Getty Images</a></span>
</figcaption>
</figure>
<p>The internet also <a href="https://doi.org/10.1177%2F1363460707072956">provides critical resources</a> about LGBTQ topics. LGBTQ youth may <a href="https://doi.org/10.1016/j.chb.2016.06.009">use online resources</a> to educate themselves about sexual orientation and gender identity terminology, learn about gender transition and find LGBTQ spaces in their local community. The internet can also be a useful tool to identify LGBTQ-friendly <a href="https://doi.org/10.1007/978-3-319-69638-6_4">physicians, therapists and other care providers</a>.</p>
<p>Finally, online platforms can serve as springboards for LGBTQ activism. A <a href="https://www.glsen.org/news/out-online-experiences-lgbt-youth-internet">2013 report by the Gay, Lesbian & Straight Education Network</a> surveying 1,960 LGBTQ youth ages 13 to 18 found that 77% had taken part in an online community supporting a social cause. While 68% of LGBTQ youth also volunteered in-person, 22% said they only felt comfortable getting involved online or via text. This signals that online spaces may be critical resources to foster civic engagement.</p>
<p>While social media is not without its dangers, it can often serve as a tool for LGBTQ youth to build stronger connections to both their local and virtual communities, and communicate about social issues important to them. </p>
<p>[<em>Insight, in your inbox each day.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=insight">You can get it with The Conversation’s email newsletter</a>.]</p><img src="https://counter.theconversation.com/content/166253/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Linda Charmaraman receives funding from the National Institutes of Health.</span></em></p>While online communities may not fully address the isolation LGBTQ youth face in-person, they can serve as an important source of social support and a springboard for civic engagement.Linda Charmaraman, Director of Youth, Media & Wellbeing Research Lab, Wellesley CollegeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1654432021-08-09T12:25:55Z2021-08-09T12:25:55ZPeople living with HIV face harmful stigma daily – DaBaby’s rant was just more public than most<figure><img src="https://images.theconversation.com/files/414424/original/file-20210803-25-pwt48e.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C4256%2C2822&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">HIV stigma manifests in many ways, including microaggressions that could lead to a higher risk of depression, PTSD and suicidality.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/awareness-royalty-free-image/1282556694">ASphotowed/iStock via Getty Images Plus</a></span></figcaption></figure><p><a href="https://apnews.com/article/entertainment-music-arts-and-entertainment-dababy-248557a1d881dbb6e1f0c7bbc2ccd589">Rapper DaBaby drew sharp criticism</a> after he delivered a rant during a concert on July 25, 2021, insulting people living with HIV or sexually transmitted illnesses. He not only disrespected women and same-gender-loving men, but also falsely equated HIV with a death sentence.</p>
<p>As an <a href="https://scholar.google.com/citations?user=IG4tFvMAAAAJ&hl=en">associate professor of psychology and a clinical psychologist</a> at the University of Miami, I investigate and develop strategies to address the psychosocial and structural factors driving HIV health disparities. My research shows that not only were his comments disrespectful, but also directly harmful and dangerous to people living with HIV.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1419745351163076612"}"></div></p>
<h2>HIV is a chronic illness, but stigma rages on</h2>
<p>HIV is a chronic illness. As a result of <a href="https://www.cdc.gov/hiv/clinicians/treatment/index.html">highly effective medications</a> that first became available over 20 years ago, people living with HIV can take just <a href="https://www.cdc.gov/hiv/risk/prep/index.html">one pill per day</a> and live healthy and long lives. I know many advocates, colleagues and friends who have been living fulfilling lives with HIV for decades. Further, HIV medication can reduce the amount of virus in someone’s body to levels so low that it’s suppressed or <a href="https://www.niaid.nih.gov/diseases-conditions/10-things-know-about-hiv-suppression">undetectable</a> - this means that a person cannot transmit HIV to someone else.</p>
<p>While ongoing medical advances have made living normal lives and thriving with HIV possible, stigma, racism and homophobia are persistent forces harming both people currently living with HIV as well as people who may contract HIV in the future. </p>
<p><a href="https://www.cdc.gov/hiv/basics/hiv-stigma/index.html">HIV stigma</a> appears in a variety of ways, including harmful words and behaviors; hostile home, work and social environments; and discriminatory policies and laws. One way stigma manifests is through <a href="https://www.npr.org/2020/06/08/872371063/microaggressions-are-a-big-deal-how-to-talk-them-out-and-when-to-walk-away">microaggressions</a>, which include subtle words and behaviors that insult and demean a marginalized group.</p>
<p>These microaggressions often cut across the multiple identities that people have. Examples are comments suggesting that women living with HIV look a certain way (“She doesn’t look like she has HIV”) or acting surprised when women with HIV are thriving in work, relationships and other areas of life. Such words and behaviors can negatively affect the mental and physical well-being of people living with HIV. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/8q21PG1CdNs?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Medication can lower the levels of HIV in someone’s blood until it’s undetectable and therefore untransmissible to other people. This concept is called U=U.</span></figcaption>
</figure>
<p>My team and I in the <a href="https://shine.psy.miami.edu">SHINE Research Program</a> found that among Black women living with HIV, those who endured more microaggressions about being Black and female tended to experience more <a href="https://doi.org/10.1089/apc.2018.0258">barriers to HIV care</a>, <a href="https://doi.org/10.1007/s11524-020-00432-y">depression</a>, <a href="https://doi.org/10.1037/tra0000467">PTSD symptoms</a> and <a href="https://doi.org/10.1007/s40615-021-01009-4">suicidality</a>. Similarly, higher levels of HIV-related discrimination were associated with higher levels of depression, PTSD symptoms and barriers to HIV care. </p>
<p>The COVID-19 pandemic and racial unrest further increased distress from microaggressions, according to <a href="https://dx.doi.org/10.1007%2Fs10461-021-03321-w">preliminary findings</a> in our <a href="https://news.miami.edu/as/stories/2019/10/dale-project-mmagic.html">Monitoring Microaggressions and Adversities to Generate Interventions for Change (MMAGIC) study</a>. We found that the likelihood that a Black women living with HIV would experience distress because of microaggressions about her HIV status, race, gender or LGB identity increased by 28% from the start of the COVID-19 pandemic in March 2020 through July 2020. Conversely, women who had suppressed levels of HIV were 64% less likely to experience microaggressions than those without suppressed levels. This may be because microaggressions can <a href="https://www.wiley.com/en-us/Microaggression+Theory%3A+Influence+and+Implications-p-9781119420040">adversely affect mental health</a> and make it <a href="https://dx.doi.org/10.2105%2FAJPH.2017.303744">more difficult for people to take their daily medication</a>.</p>
<p>Microaggressions can also have a negative effect on the lives and well-being of both people living with and without HIV. HIV stigma is the No. 1 challenge my team faces when we engage individuals in HIV testing and provide information about the HIV prevention pill <a href="https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis">PrEP</a>. Because of <a href="https://www.glaad.org/endhivstigma">widespread stigma and inaccurate information about HIV</a>, some people are anxious about getting an HIV test or even being seen near an HIV testing vehicle.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/414425/original/file-20210803-25-weevn1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="People participating in the 2017 Keep the Promise Concert & March in Fort Lauderdale for National Black HIV/AIDS Awareness Day" src="https://images.theconversation.com/files/414425/original/file-20210803-25-weevn1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/414425/original/file-20210803-25-weevn1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/414425/original/file-20210803-25-weevn1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/414425/original/file-20210803-25-weevn1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/414425/original/file-20210803-25-weevn1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/414425/original/file-20210803-25-weevn1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/414425/original/file-20210803-25-weevn1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">One way people living with HIV deal with stigma is participating in advocacy efforts.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/AHFHostsKeepthePromiseConcertMarchinFtLauderdaleforNationalBlackHIVAIDSAwarenessDay/670e6dff5bff4e2b81a5b491ce16877a">AP Photo/Jesus Aranguren</a></span>
</figcaption>
</figure>
<h2>Larger systemic issues drive stigma</h2>
<p>Based on my work with people living with HIV, I found DaBaby’s words problematic and hurtful because he used his platform to further reinforce HIV stigma. This jeopardizes the well-being and lives of people living with HIV and the LGBTQ community. However, his individual words are a reflection of larger systemic issues including <a href="https://www.cdc.gov/hiv/policies/law/states/exposure.html">HIV criminalization</a>, <a href="https://www.hrc.org/press-releases/2021-officially-becomes-worst-year-in-recent-history-for-lgbtq-state-legislative-attacks-as-unprecedented-number-of-states-enact-record-shattering-number-of-anti-lgbtq-measures-into-law">anti-LGBTQ policies and laws</a> and <a href="https://www.nbcnews.com/nbc-out/out-health-and-wellness/-will-shut-us-hiv-prevention-clinics-brace-gilead-reimbursement-cuts-rcna1346">inadequate financial support</a> behind efforts to tackle HIV stigma and empower people living with HIV, members of the LGBTQ community and women.</p>
<p>In the face of stigma and discrimination, however, many people living with HIV use <a href="https://doi.org/10.1037/cdp0000165">adaptive coping strategies</a>. One way Black women living with HIV have <a href="https://www.positivelyaware.com/articles/weathering-many-storms">coped with stigma</a> is through <a href="https://doi.org/10.1080/09540121.2018.1503225">social support</a> from their peers, friends, family and health care providers, and by seeking mental health services. Some women also <a href="https://doi.org/10.1037/cdp0000165">selectively disclose their HIV status</a> and <a href="https://doi.org/10.1037/cdp0000165">strategically avoid harmful spaces and individuals</a>. In addition, women actively fight against stigma by <a href="https://doi.org/10.1037/cdp0000165">sharing accurate information about HIV</a>, <a href="https://doi.org/10.1037/cdp0000165">engaging in advocacy</a> and claiming their power to not let HIV stigma dictate their lives.</p>
<p>Accountability and change are needed at the structural, institutional, interpersonal and individual levels to combat stigma. And centering the voices of people living with HIV, the LGBTQ community and women is required to achieve sustainable and meaningful change.</p>
<p>[<em>Insight, in your inbox each day.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=insight">You can get it with The Conversation’s email newsletter</a>.]</p><img src="https://counter.theconversation.com/content/165443/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sannisha Dale receives funding from the National Institute of Health. </span></em></p>Microaggressions are more subtle than outright discrimination. But they can directly affect HIV treatment outcomes.Sannisha Dale, Associate Professor of Psychology, University of MiamiLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1632642021-06-24T03:34:30Z2021-06-24T03:34:30ZIt takes a village: why sending your kid to childcare isn’t ‘outsourcing parenting’<figure><img src="https://images.theconversation.com/files/408065/original/file-20210624-21-l73xh4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-children-playing-educational-toys-1240622437">Shutterstock</a></span></figcaption></figure><p>A Coalition <a href="https://www.theguardian.com/australia-news/2021/jun/23/female-coalition-mps-fire-up-after-party-room-told-working-women-are-outsourcing-parenting">party room meeting this week</a> debated the A$1.7 billion childcare package announced in the budget, which would increase subsidies for families with more than one child in care and remove a cap on subsidies for higher-income families. </p>
<p>Some MPs reportedly argued childcare shouldn’t be the only type of care being subsidised and parents should also get help for staying at home with kids. One MP <a href="https://www.theguardian.com/australia-news/2021/jun/23/female-coalition-mps-fire-up-after-party-room-told-working-women-are-outsourcing-parenting">reportedly suggested</a> working women were “outsourcing parenting” by sending their kids to childcare.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1407190050538868738"}"></div></p>
<p>Leaving aside the fact sending your kid to childcare doesn’t preclude you from parenting at home when your kid isn’t in childcare, early childhood education and care – which includes childcare and preschool – is an <a href="https://education.unimelb.edu.au/__data/assets/pdf_file/0006/2929452/E4Kids-Report-3.0_WEB.pdf">important part</a> of a child’s development.</p>
<p>Parents are thought to be a <a href="https://earlychildhood.qld.gov.au/early-years/activities-and-resources/resources-parents/read-and-count/families-as-first-teachers">child’s first and most influential</a> educator. But children are also raised in the community. They learn important social, emotional, physical and cognitive skills and abilities during the critical time of their development. The course of human history over millennia shows raising a child takes a village. </p>
<h2>It takes a village</h2>
<p>Both nature and nurture influence successful development in children. Nature stems from biological factors children inherit from parents. Nurture is the environment children are exposed to. This is influenced by parents, siblings and caregivers in the home, as well as educators and peers in early education and care settings, and the broader community. </p>
<p>Young children need relationships with parents and <a href="http://46y5eh11fhgw3ve3ytpwxt9r-wpengine.netdna-ssl.com/wp-content/uploads/2007/03/InBrief-The-Science-of-Early-Childhood-Development2.pdf">other caregivers</a> in society to develop important social and cognitive skills. Australia’s early childhood learning framework (equivalent to a curriculum) is called <a href="https://www.acecqa.gov.au/nqf/national-law-regulations/approved-learning-frameworks">Belonging, Being and Becoming</a>. This highlights its focus on children’s relationships, social skills and becoming members of society. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/increasing-the-childcare-subsidy-will-help-struggling-families-and-the-economy-142557">Increasing the childcare subsidy will help struggling families — and the economy</a>
</strong>
</em>
</p>
<hr>
<p>There is no one size fits all guide for parenting as each family is different. </p>
<p>At times, parenting can be challenging with competing demands and responsibilities. Many of these can have an effect on children, and families could need support. Parents with mental and physical health challenges may sometimes be <a href="https://www.aihw.gov.au/getmedia/6af928d6-692e-4449-b915-cf2ca946982f/aihw-cws-69-print-report.pdf.aspx?inline=true">less able than others to engage</a> their child in typical childhood activities without assistance from the community.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/408073/original/file-20210624-25-b9dn0i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Father on the phone in front of his laptop while holding kid who is trying to touch everything on the desk." src="https://images.theconversation.com/files/408073/original/file-20210624-25-b9dn0i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/408073/original/file-20210624-25-b9dn0i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/408073/original/file-20210624-25-b9dn0i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/408073/original/file-20210624-25-b9dn0i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/408073/original/file-20210624-25-b9dn0i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/408073/original/file-20210624-25-b9dn0i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/408073/original/file-20210624-25-b9dn0i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Parenting can be challenging and childcare is is a valuable support, a part of the village.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-working-father-talking-on-phone-1657938115">Shutterstock</a></span>
</figcaption>
</figure>
<p>The community includes many important supports to raise children such as relatives, health and parenting services. </p>
<p>For instance, a <a href="https://theconversation.com/1-in-3-new-mums-struggle-to-get-their-baby-to-sleep-but-some-women-have-a-tougher-time-102269">study of women</a> who required admission to residential parenting services (around 80% needed help to settle the child) found over half had a history of mental health issues. The study’s authors noted Australian women were not routinely receiving the psychological and social help they needed. They wrote:</p>
<blockquote>
<p>Parents have lost the village it takes to raise a child and increasingly feel isolated and unsupported.</p>
</blockquote>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/1-in-3-new-mums-struggle-to-get-their-baby-to-sleep-but-some-women-have-a-tougher-time-102269">1 in 3 new mums struggle to get their baby to sleep, but some women have a tougher time</a>
</strong>
</em>
</p>
<hr>
<p>Early childhood education and care centres are one important part of our village. </p>
<p>They form a <a href="https://www.acecqa.gov.au/nqf/national-quality-standard/quality-area-6-collaborative-partnership-with-families-and-communities">support network established</a> to ensure parents’ and children’s lifelong success. Around three in five Australian children (925,900 children) aged 0-4 <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/education/early-childhood-education">attended some form of childcare</a> in 2017. And nearly 296,000 (90%) of eligible children were enrolled in a preschool program in the year before full-time school.</p>
<p>Typically, the centres open at 6am and close at 6pm. Children can start <a href="https://www.dese.gov.au/key-official-documents-about-early-childhood/early-childhood-and-child-care-reports/child-care-australia/child-care-australia-report-december-quarter-2020">enrolment from birth</a> and will enter the nursery with an educator to child ratio of 1:4. </p>
<p>For parents who have experienced challenges parenting at home, or who may need help due to other commitments such as work, the option of early childhood education and care is precious. In 2015, the <a href="https://www.pc.gov.au/inquiries/completed/childcare/report/childcare-overview.pdf">Productivity Commission estimated</a> around 165,000 Australian parents would like to work more, but were prevented due to poor accessibility or affordability of suitable childcare.</p>
<h2>Is there such a thing as too much childcare?</h2>
<p>The <a href="https://www.dese.gov.au/key-official-documents-about-early-childhood/early-childhood-and-child-care-reports/child-care-australia/child-care-australia-report-december-quarter-2020">average weekly attendance</a> in early education and care centres per child was 26.1 hours in December 2020. For long day care, the average was 30.5 hours per child, or around three days per week. This suggests parents still have many hours per week for parenting their children at home.</p>
<p>Evidence shows participation in quality early childhood education for at least 15 hours per week <a href="https://www.thefrontproject.org.au/images/downloads/Cost-benefit%20analysis_brochure.pdf">benefits children’s</a> overall development and provides them with important social and emotional skills.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/408076/original/file-20210624-21-1kh6mmi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Mum reading book with daughter in a living room tent." src="https://images.theconversation.com/files/408076/original/file-20210624-21-1kh6mmi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/408076/original/file-20210624-21-1kh6mmi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=416&fit=crop&dpr=1 600w, https://images.theconversation.com/files/408076/original/file-20210624-21-1kh6mmi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=416&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/408076/original/file-20210624-21-1kh6mmi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=416&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/408076/original/file-20210624-21-1kh6mmi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=523&fit=crop&dpr=1 754w, https://images.theconversation.com/files/408076/original/file-20210624-21-1kh6mmi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=523&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/408076/original/file-20210624-21-1kh6mmi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=523&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Children spend around 26 hours per week in childcare, leaving a lot of time for parenting at home.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/family-bedtime-mom-child-daughter-reading-1060676333">Shutterstock</a></span>
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<p>But there are some families who do require a lot more childcare. In 2008, a <a href="https://www.brisbanetimes.com.au/lifestyle/children-in-care-60-hours-a-week-20080729-gea6jq.html">census of childcare services found </a> 757 children across Australia were attending long daycare services for at least 60 hours a week. And a further 9,426 children were in care for between 50 and 60 hours a week at the time of the census in May 2006. </p>
<p>More recently, <a href="https://www.abs.gov.au/statistics/people/education/childhood-education-and-care-australia/jun-2017">ABS data show</a> 28,200 children attended long daycare for 45 hours or more in 2017.</p>
<p>In 2018, a Canadian study published some worrying findings about <a href="https://ifstudies.org/blog/measuring-the-long-term-effects-of-early-extensive-day-care">risks of too many hours of full time childcare</a>. Statistical analysis showed significant differences in increased levels of hyperactivity, anxiety and aggression for children who attended more than 30 hours per week of childcare, in comparison to those who attended ten hours per week.</p>
<p>We would need more research to show the ways these risks depend on the nature and nurture of the child, the quality of the centre and staff, and influences of the community, government and funding. </p>
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Read more:
<a href="https://theconversation.com/preschool-benefits-all-children-but-not-all-children-get-it-heres-what-the-government-can-do-about-that-117660">Preschool benefits all children, but not all children get it. Here's what the government can do about that</a>
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</em>
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<p>We also don’t know why some children attend long hours at childcare. It may be for many reasons, including being in the child support system and parental health. In all these circumstances, as already discussed, childcare is an important and necessary social support.</p>
<p>We all play a role in raising children. It’s not a matter of outsourcing.</p><img src="https://counter.theconversation.com/content/163264/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laurien Beane does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Early childhood education and care centres, which includes childcare and preschool, are part of our village. They form a support network established to ensure parents’ and children’s lifelong success.Laurien Beane, Course Coordinator, Queensland Undergraduate Early Childhood, Australian Catholic UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1599842021-06-23T12:25:12Z2021-06-23T12:25:12ZTransgender medicine – what care looks like, who seeks it out and what’s still unknown: 3 essential reads<figure><img src="https://images.theconversation.com/files/403000/original/file-20210526-19-1fpvwx6.jpg?ixlib=rb-1.1.0&rect=0%2C227%2C5229%2C3316&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Access to transgender medical care has been under attack in many places in the U.S., and protesters, like those seen here in Texas, are pushing back. </span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/TexasRallyProtectTransgenderTexans/9dda18a8eacd4a89b9fec8fab459d59f/photo?Query=transgender%20medical%20care&mediaType=photo&sortBy=&dateRange=Anytime&totalCount=42&currentItemNo=0">Erich Schlegel/AP Images for Human Rights Campaign</a></span></figcaption></figure><p>Transgender people continue to be the focus of political culture wars in the U.S. In the spring of 2021, lawmakers in many states sought to limit or <a href="https://www.msn.com/en-us/news/us/gender-affirming-medical-would-be-considered-child-abuse-under-texas-senate-bill/ar-BB1g9swS">ban transgender youth from accessing gender-affirming care</a>. The laws proposed – and <a href="https://www.cnn.com/2021/04/15/politics/anti-transgender-legislation-2021/index.html">in some cases passed</a> – were written to have a direct effect on transgender people’s ability to access physical and mental health care. </p>
<p>For many people, the medical options available to transgender people may seem foreign or new – unless you know someone who is transgender, you may not know about this type of care. So to better understand who is getting this care and the evidence that supports it, in recent months, The Conversation reached out to three experts who work with and study transgender youth medicine. Here is a roundup of what these experts had to say.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/403001/original/file-20210526-17-zjuyu8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A doctor speaking with a young transgender person and their mother." src="https://images.theconversation.com/files/403001/original/file-20210526-17-zjuyu8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/403001/original/file-20210526-17-zjuyu8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=405&fit=crop&dpr=1 600w, https://images.theconversation.com/files/403001/original/file-20210526-17-zjuyu8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=405&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/403001/original/file-20210526-17-zjuyu8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=405&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/403001/original/file-20210526-17-zjuyu8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=508&fit=crop&dpr=1 754w, https://images.theconversation.com/files/403001/original/file-20210526-17-zjuyu8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=508&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/403001/original/file-20210526-17-zjuyu8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=508&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Good transgender medical care is as much about social and emotional interventions as it is drugs or surgery.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/TransgenderTeenJourneyPart1/d8bc6e1f3b9b4169be30831e858dca28/photo?Query=transgender%20AND%20doctor&mediaType=photo&sortBy=&dateRange=Anytime&totalCount=44&currentItemNo=0">AP Photo/Lynne Sladky</a></span>
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<h2>1. Medical options available to transgender youth</h2>
<p>The first question we sought to answer was: What does medical care look like for transgender youth? </p>
<p>To answer this, we contacted <a href="https://theconversation.com/profiles/mandy-coles-1218812">Mandy Coles</a>, a clinical associate professor of pediatrics and co-director of the <a href="https://www.bmc.org/transgender-child-adolescent-center">Child and Adolescent Trans/Gender Center for Health</a> at Boston University and Boston Medical Center. When young people want to see a doctor and have questions about their gender, they go to someone like Coles.</p>
<p><a href="https://theconversation.com/im-a-pediatrician-who-cares-for-transgender-kids-heres-what-you-need-to-know-about-social-support-puberty-blockers-and-other-medical-options-that-improve-lives-of-transgender-youth-157285">In her article</a>, Coles explains that medical care for transgender youth who suffer from gender dysphoria – when a person’s gender identity does not match the sex assigned at birth – is much more than just hormones or surgery. Social support can have as big an impact on health as physical interventions and “an important first step is to help <a href="https://doi.org/10.1016/j.jadohealth.2013.07.019">parents become allies and advocates</a>,” says Coles.</p>
<p>But, for many of her patients, physical interventions – including puberty blockers, hormone treatments or surgery – are the best way they can align their physical bodies with their gender identity. For transgender people seeking care who haven’t started puberty or are still in its early stages, puberty blockers are often an initial treatment. As Coles explains, “These medications work like a pause button on the physical changes caused by puberty. They are well studied, safe and <a href="https://doi.org/10.1210/js.2019-00036">completely reversible</a>.”</p>
<p>Puberty blockers are only one option available to transgender youth before other, more serious interventions. Taking testosterone, estrogen or other drugs can produce changes in a person’s body that help them look more masculine, feminine or nonbinary – whichever it is the person wants. Every patient is different and “my colleagues and I personalize their treatments to meet their specific need,” says Coles. </p>
<p>Surgery is the most permanent treatment available. It comes with risks and lies at the center of much of the political fighting around transgender care, but as one patient told Coles, gender-affirming care “literally saved my life. I was free <a href="https://theconversation.com/im-a-pediatrician-who-cares-for-transgender-kids-heres-what-you-need-to-know-about-social-support-puberty-blockers-and-other-medical-options-that-improve-lives-of-transgender-youth-157285">from dysphoria</a>.”</p>
<p><iframe id="BOPHR" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/BOPHR/4/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<h2>2. Younger people are seeking care earlier</h2>
<p>With an explanation of what kind of medical care exists, the next question is: Who is getting this care and when?</p>
<p>If you have the sense that young people today are more likely to transition than, say, 20 years ago, in a sense you would be correct. But it is a <a href="https://theconversation.com/trans-youth-are-coming-out-and-living-in-their-gender-much-earlier-than-older-generations-156829">bit more complicated</a> than simply saying more young people are transgender than older people, says <a href="https://www.jaepuckett.com/">Jae A. Puckett</a>. </p>
<p>Puckett, an assistant professor of psychology at Michigan State University, recently surveyed nearly 700 trans people and <a href="https://doi.org/10.1037/sgd0000391">published a paper</a> exploring generational differences in when and how fast people reach milestones of their transgender identity and how this relates to mental health. Milestones include identifying as trans, living in an affirmed gender some or all the time and, for some, accessing trans medical care. </p>
<p>Puckett wrote a <a href="https://theconversation.com/trans-youth-are-coming-out-and-living-in-their-gender-much-earlier-than-older-generations-156829">story for The Conversation</a> that explains that younger generations are more diverse in gender than older generations. Nearly a quarter of Gen Z participants “identified as nonbinary, whereas only 7.4% of boomers identified this way,” Puckett writes. Another interesting generational difference is the age at which people began to pass through the milestones of coming out. On average, people in every generation realized they “felt different” at around 10 to 13 years old. But “boomers reported reaching the other major milestones later than younger groups,” Puckett explains. “For example, boomers were, on average, around age 50 when they were living in their affirmed gender all the time. In contrast, Gen X was 34, millennials were 22 and Gen Z was 17.”</p>
<p>Better access to medical care and greater social acceptance today, compared with the past, might be one reason for this disparity, they write.</p>
<p>Puckett sees a similar trend in how fast people made transitions. “Gen Z and millennials also reported much shorter gaps between reaching milestones. For instance, the boomers group reported an average 24-year delay between starting to identify as trans and living in their affirmed gender. There was just a two- and three-year gap for Gen Z and millennials, respectively.”</p>
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<a href="https://images.theconversation.com/files/403002/original/file-20210526-15-uqphk7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A question mark on a piece of paper next to a stethoscope." src="https://images.theconversation.com/files/403002/original/file-20210526-15-uqphk7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/403002/original/file-20210526-15-uqphk7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/403002/original/file-20210526-15-uqphk7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/403002/original/file-20210526-15-uqphk7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/403002/original/file-20210526-15-uqphk7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/403002/original/file-20210526-15-uqphk7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/403002/original/file-20210526-15-uqphk7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Research on transgender medicine is limited, and there is still a lot of uncertainty in the field.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/medical-question-royalty-free-image/171274095?adppopup=true">blackred/E+ via Getty Images</a></span>
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<h2>3. Uncertainty in care</h2>
<p>This increase in young people seeking transgender care means more doctors are being asked to provide it. At the bottom of the political and legal fight across the U.S. around transgender medicine, a fundamental – and often avoided – medical question remains: Does this care work?</p>
<p><a href="https://scholar.google.com/citations?user=NfXLxIgAAAAJ&hl=en&oi=ao">stef m. shuster</a> is an assistant professor of sociology at Michigan State University. They recently wrote a <a href="https://nyupress.org/9781479899371/trans-medicine/">book exploring the emergence of trans medicine</a> over the last century and how it is practiced today. In an <a href="https://theconversation.com/doctors-treating-trans-youth-grapple-with-uncertainty-lack-of-training-159186">article for The Conversation</a>, they explain how the contentious social and political fights over transgender care are <a href="https://theconversation.com/doctors-treating-trans-youth-grapple-with-uncertainty-lack-of-training-159186">drowning out much needed nuance</a> in research as well as the care transgender people receive.</p>
<p>[<em>Get our best science, health and technology stories.</em> <a href="https://theconversation.com/us/newsletters/science-editors-picks-71/?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=science-best">Sign up for The Conversation’s science newsletter</a>.]</p>
<p>“Blocking people from accessing gender-affirming care creates <a href="https://doi.org/10.1089/trgh.2015.0008">increased risks</a> for social isolation, suicide ideation and depression,” writes shuster. But they also explain that <a href="https://nyupress.org/9781479899371/trans-medicine">“little scientific evidence</a> exists to support the use of current trans medical treatments, therapy or decision-making that <a href="https://www.wpath.org/publications/soc">meets evidence-based standards</a>.” </p>
<p>The key phrase there is “evidence-based standards.” One of the reasons for this lack of evidence that care works is pretty simple, according to shuster. “Randomized controlled trials have been implausible, given that <a href="https://ajph.aphapublications.org/doi/10.2105/AJPH.2016.303578">only 0.6% of the population identifies as trans or nonbinary</a>.” This isn’t to say that doctors are flying blind. As Mandy Coles explains, there is a good and ever-growing amount of evidence gathered in other ways to <a href="https://doi.org/10.1542/peds.2019-1725">support many types of interventions</a>. But compared with other medical interventions, guidance is murky, says shuster. As they put it: “How might someone who is trained to manage illness and disease ‘treat’ someone’s gender identity, which is neither an illness nor a disease?”</p>
<p>This lack of clear clinical guidelines is compounded by a lack of training. A study in 2016 found that most medical providers only get <a href="https://doi.org/10.1111/soc4.12432">one day of training</a> on transgender issues. All this adds up to medical providers feeling a lot of uncertainty in the care they give, shuster found in their research.</p>
<p>So what happens next? shuster acknowledges that some portion of the concerns voiced by lawmakers are legitimate. But bans on transgender medical care or polarizing political fights aren’t going to help people that currently experience very high rates of <a href="https://doi.org/10.1016/j.jadohealth.2015.04.027">depression, anxiety, self–harm and suicide</a>. The way forward, shuster argues, is through more funding for studies on transgender care and more training for medical providers that are facing complicated situations.</p>
<p><em>Editor’s note: This story is a roundup of articles from The Conversation’s archives.</em>
</p><hr><p></p>
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<a href="https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=343&fit=crop&dpr=1 600w, https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=343&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=343&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=431&fit=crop&dpr=1 754w, https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=431&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=431&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<p><em><strong>Transgender youth.</strong> This article is part of <a href="https://theconversation.com/us/topics/trans-youth-2021-102529">a series</a> exploring the social and medical issues of transgender children and their families. Sign up for a <a href="https://theconversation.com/us/newsletters/transgender-youth-77/">four-email newsletter “course”</a> to learn about the latest research on trans youth.</em></p><img src="https://counter.theconversation.com/content/159984/count.gif" alt="The Conversation" width="1" height="1" />
Across the US, politicians, activists and transgender people are fighting over the right to access transgender medical care. Rarely is the care itself actually discussed. This is that discussion.Daniel Merino, Associate Breaking News Editor and Co-Host of The Conversation Weekly PodcastLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1597892021-05-19T12:25:45Z2021-05-19T12:25:45ZPregnancy during COVID-19 lockdown: How the pandemic has affected new mothers<figure><img src="https://images.theconversation.com/files/401389/original/file-20210518-23-1qc1bjf.jpg?ixlib=rb-1.1.0&rect=714%2C511%2C2281%2C1482&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Isolation and other pandemic stresses can harm pregnant women's mental health, with effects on their babies too.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/kelsey-powell-five-months-pregnant-sits-for-a-portrait-at-a-news-photo/1223719121">Jahi Chikwendiu/The Washington Post via Getty Images</a></span></figcaption></figure><p>For the millions of women who celebrated their first Mother’s Day in May 2021, their transition into motherhood occurred in the shadow of the COVID-19 pandemic.</p>
<p>Preparing for childbirth can be joyful and exciting, but COVID-19 restrictions disrupted many women’s prenatal care and forced some mothers to <a href="https://www.todaysparent.com/pregnancy/giving-birth/giving-birth-during-coronavirus/">deliver their infants</a>, <a href="https://www.washingtonpost.com/lifestyle/2020/04/30/i-gave-birth-by-myself-during-covid-pandemic-i-wasnt-alone/">without partner or family support</a>. Others faced <a href="https://www.insider.com/postpartum-depression-rates-high-in-covid-moms-separated-from-newborns-2021-4">separation from their newborns immediately after birth</a>.</p>
<p>Expectant parents also missed out on many celebrations and rituals that commemorate the transition into parenthood: baby showers, bris and christening ceremonies, neighbors dropping by with a meal, or <a href="https://www.nbcphiladelphia.com/news/coronavirus/grandparents-in-the-pandemic-a-lost-year-but-now-some-hope/2750005/">grandparents traveling to meet the newest family member</a>. </p>
<p>Over the past seven years, <a href="https://dornsife.usc.edu/nestlab">our lab</a> has studied new parents, following couples from pregnancy across the first year postpartum. COVID-19 lockdowns last spring stopped our in-person data collection when our campus closed. But even as it stopped our usual research in its tracks, the pandemic created an opportunity to investigate a unique form of prenatal stress in real time.</p>
<h2>Effects of prenatal stress can last throughout life</h2>
<p>A tragic natural experiment helped spark study in the field researchers call “fetal origins of adult disease,” which explores links between pregnancy stress and later health.</p>
<p>At the tail end of World War II, the Nazi army cut off food supplies to the Netherlands, plunging the country into famine during the winter of 1944-1945. Babies in utero during what became known as the “<a href="https://en.wikipedia.org/wiki/Dutch_famine_of_1944%E2%80%9345">Dutch Hunger Winter</a>” showed <a href="https://doi.org/10.1073/pnas.1012911107">lifelong differences in cardiometabolic health</a>. Because this was a clearly demarcated period of starvation, it even allowed researchers to investigate trimester-specific effects, finding that babies exposed to famine early in pregnancy showed outcomes different from those exposed late in pregnancy.</p>
<p>Scientists have linked other <a href="https://www.theatlantic.com/family/archive/2019/03/how-natural-disasters-impact-pregnant-mothers/584173/">large-scale societal crises</a> – like the <a href="https://www.theguardian.com/science/neurophilosophy/2011/sep/09/pregnant-911-survivors-transmitted-trauma">Sept. 11 attacks</a>, <a href="https://doi.org/10.1007/s10995-009-0486-x">Hurricane Katrina</a> and the <a href="https://www.wired.com/2010/03/big-earthquakes-cause-premature-births/">2005 earthquake in Chile</a> – with long-term health consequences for mother and child. </p>
<p>The COVID-19 pandemic shares many similarities with these events, including widespread loss of life. But it’s also unique. Communities often unite to grieve and rebuild after natural disasters. The need to maintain social distance during the pandemic kept many people isolated from one another – especially many pregnant women, a high-risk population that may have elected to stick with stricter social distancing measures.</p>
<p>What happens when an expectant mother’s in-person social network shrinks or disappears overnight? </p>
<h2>Social connection, mental health and COVID-19</h2>
<p>Scientists know <a href="https://doi.org/10.1089/jwh.2007.CDC10">social support buffers the risk for mental health problems</a> in mothers. So our lab wondered how the sudden isolation of lockdowns – coupled with the economic and health worries of the pandemic – might affect pregnant women.</p>
<p>We sought to answer this question by recruiting 760 expectant parents (641 pregnant women and 79 fathers or partners) between early April and July of 2020 to participate in our <a href="https://dornsife.usc.edu/labs/usc-ccf/morris-research-brief">Coronavirus, Health, Isolation and Resilience in Pregnancy (CHIRP) study</a>. The week of April 7, 2020 – coincidentally, the same week we launched our study – <a href="https://www.washingtonpost.com/graphics/2020/national/map-us-still-staying-home-coronavirus/">represented the peak of “sheltering in place” behavior in the U.S.</a>, with Americans spending 93% of their time at home. We converted our usual in-lab battery of questionnaires into an online format and posted on social media and online parenting and pregnancy groups. Our preliminary findings are currently undergoing peer review at an academic journal.</p>
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<p>Only about 5% of the pregnant women who responded to our survey had a suspected or confirmed case of COVID-19 as of spring 2020, and a similar number – 4.7% – had experienced the death of someone close to them due to the pandemic.</p>
<p>However, 97% reported that their community had issued a stay-at-home or shelter-in-place order. Moreover, 61% of women reported that the pandemic had had “very” or “somewhat” negative impacts on their social relationships. A majority of women estimated that at the time of the survey they had much less contact than before the start of the pandemic with neighbors and community members, co-workers, close friends and family members. On the other hand, 42% reported much more time spent with their partner than before the pandemic. </p>
<p>These changes in social contact appeared to take a mental health toll: almost two-thirds of respondents said they had experienced at least some loneliness over the previous week. A similar number felt more lonely than usual because of the pandemic. Moreover, about three-fourths of our sample reported that the COVID-19 pandemic had an overall negative effect on their mental health.</p>
<p>To investigate further, we asked our respondents the questions on the Beck Depression Inventory, a tool that mental health care providers use to assess symptoms of depression. We were surprised to see that the average score for pregnant women in our sample was higher than the threshold that clinicians typically use as an indicator for depression.</p>
<p>Half of the women in the sample reported clinically significant symptoms of depression. Similarly, more than half – 62% – said they were experiencing clinically significant anxiety symptoms. These proportions are more than twice as high as what we’ve seen in our pre-pandemic sample.</p>
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<p>Our findings are not unique: <a href="https://doi.org/10.1016/j.jad.2020.07.126">Several other studies</a> <a href="https://doi.org/10.3389/fgwh.2020.00001">of pregnant and postpartum women</a> have <a href="https://doi.org/10.1038/d41586-021-00578-y">reported heightened distress during the pandemic</a>. For example, <a href="https://psyarxiv.com/3vsxc/">a not-yet-peer-reviewed study of pregnant women in the San Francisco Bay Area</a> also found 51% of their sample scored above the clinical cutoff for depression, compared with 25% of a demographically matched pre-pandemic sample. </p>
<h2>COVID-19 stress could have long-term effects</h2>
<p>Given evidence that maternal stress during pregnancy can affect fetal development and shape long-term mother and infant health, our preliminary results are cause for concern. We are currently collecting birth charts from our sample to measure gestational outcomes, like birth weight and preterm birth, that have been linked with prenatal stress.</p>
<p>It remains to be seen whether the stress of the pandemic’s first wave will have enduring mental health effects. Some new mothers experienced <a href="https://theconversation.com/covid-19s-silver-lining-creating-a-caregiver-friendly-work-culture-145096">silver linings of the pandemic</a>, like greater ability to work from home after birth and sustain a breastfeeding relationship. At the same time, the pandemic took a greater toll on communities already affected by <a href="https://theconversation.com/racism-at-the-county-level-associated-with-increased-covid-19-cases-and-deaths-150077">structural racism</a> and <a href="https://theconversation.com/doctors-cant-treat-covid-19-effectively-without-recognizing-the-social-justice-aspects-of-health-138787">poverty</a>. Our research might find different trajectories of mental health, with pandemic lockdowns exacerbating some risk factors while perhaps exerting protective effects on other families. </p>
<p>In the meantime, our first batch of results suggests that these pandemic infants and their parents are a special population to follow into the future. Currently pregnant women may face an easier transition into parenthood now that delivery-room restrictions have eased and social routines are returning to normal. But <a href="https://www.ama-assn.org/delivering-care/public-health/pandemic-enters-year-2-mental-health-burden-becomes-clearer">uncertainty, fear and grief from the many losses of the pandemic</a> may linger even as the world reopens.</p>
<p>[<em>Like what you’ve read? Want more?</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=likethis">Sign up for The Conversation’s daily newsletter</a>.]</p>
<p>Compelling evidence suggests that <a href="https://doi.org/10.1001/jama.2018.20865">counseling interventions such as talk therapy can</a> not only relieve but also prevent mood disorders in the period immediately before and after birth. Situations in which <a href="https://doi.org/10.1017/S1463423618000348">primary care and mental health care are integrated</a> and expectant mothers can access psychotherapy through their OB-GYN practices can help treatments reach mothers most in need. The pandemic eased many barriers to telehealth, as health care providers shifted to online visits; this format may also show promise reaching families who are still reluctant to make in-person visits. </p>
<p>We are continuing to follow our participants at three, six and 12 months after their baby’s birth to see how their mental health changes over time, with plans to extend the follow-up past the first year. Although infants born in 2020 may not remember the pandemic firsthand, its effects may shape their early lives in ways that we are just beginning to measure.</p><img src="https://counter.theconversation.com/content/159789/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Darby Saxbe receives funding from the National Science Foundation, the Social Science Research Council and the University of Southern California's Zumberge Fund. </span></em></p><p class="fine-print"><em><span>Alyssa Morris receives funding from the National Science Foundation, the Social Science Research Council and the University of Southern California's Zumberge Fund.</span></em></p>Pregnant women’s experiences can affect their babies’ health, even into adulthood. Researchers know societywide stresses can lead to these long-term consequences – and the pandemic likely fits the bill.Darby Saxbe, Associate Professor of Psychology, USC Dornsife College of Letters, Arts and SciencesAlyssa Morris, Ph.D. Student in Clinical Psychology, USC Dornsife College of Letters, Arts and SciencesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1459182021-05-12T12:47:02Z2021-05-12T12:47:02ZPregnant women’s brains show troubling signs of stress – but feeling strong social support can break those patterns<figure><img src="https://images.theconversation.com/files/399485/original/file-20210507-19-lqcsp.jpg?ixlib=rb-1.1.0&rect=970%2C1389%2C5772%2C3928&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Just feeling that there's someone out there she can count on can help a mom-to-be.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/beautiful-young-pregnant-woman-relaxing-on-balcony-royalty-free-image/999890406">d3sign/Moment via Getty Images</a></span></figcaption></figure><p>Even before the pandemic, there was plenty for expectant mothers to worry about. Pregnant women must withstand a barrage of arguably well-intentioned, but often hyperbolic, <a href="https://www.healthline.com/health/pregnancy/things-not-to-do-while-pregnant#dont-eat-these-foods">warnings about their health and what’s to come</a>, including concerns about everything from what to eat, to what to wear, to how to feel. Health professionals know that <a href="https://adaa.org/find-help-for/women/perinatalmoodisorders">mothers-to-be experience predictable increases in anxiety levels</a> before infants are born. <a href="https://www.apa.org/news/press/releases/stress/2021/one-year-pandemic-stress-parents">Maternal mental health has been steadily deteriorating</a> in the U.S., particularly among poor and minority women.</p>
<p>The calls to “be afraid, be very afraid” are, of course, countered by the equally strong cautions for pregnant women to not worry too much, lest it lead to long-term negative outcomes for them and their infants.</p>
<p>Such warnings are not entirely off base. Maternal stress hormones cross the placenta and <a href="https://doi.org/10.1210/jc.2017-02140">affect the vulnerable fetus</a>. Fetal exposure to the stress hormone cortisol has been linked to an array of <a href="https://doi.org/10.1080/00207450701820944">negative outcomes</a>, including miscarriage and preterm birth, and irritable temperament for the child and increased risk of emotional problems during childhood. One thing researchers know is that <a href="https://www.sciencedirect.com/science/article/abs/pii/S0890856709625478">anxious mothers tend to have anxious children</a>. This common, albeit not prescriptive, phenomenon is likely due to numerous factors, both pre- and postpartum.</p>
<p><a href="https://scholar.google.com/citations?user=l2DzSjIAAAAJ&hl=en&oi=ao">In our laboratory</a>, we focus on what happens when women start their pregnancies already worried or anxious and what clues we can uncover about how to help them and their children. Our research suggests that worry during pregnancy can have long-term impacts on how mothers’ brains communicate – but also that there might be some simple steps that can help rein in the effects.</p>
<h2>Maternal brains change during pregnancy</h2>
<p>The fetal brain isn’t the only one that is vulnerable during pregnancy. There’s evidence that <a href="https://doi.org/10.1038/nn.4458">the maternal brain reorganizes</a> in ways that likely prepare a pregnant woman to care for another human being. The experience of stress during pregnancy can thus hijack a period of change meant to allow for positive adaptations and instead open the door for anxiety problems.</p>
<p>We are interested in whether there might be easy, approachable ways to offset some of these negative effects. So we invite pregnant women into our lab, where we can record their naturally occurring brain activity using electroencephalography. This EEG technique gives us a great sense of how quickly and how strongly brains react to particular stimuli.</p>
<p>In a recent study from our lab, we <a href="https://doi.org/10.1111/psyp.13647">measured pregnant women’s neural reactivity</a> while they viewed emotional and nonemotional pictures. For most people, including pregnant women, their brains show more activity when they’re presented with a negative image or sound – like a crying baby – than with a neutral image or sound – such as a blanket.</p>
<p>We found that for some women in their third trimester of pregnancy, this effect was disrupted; instead of reacting more strongly to a negative image, expectant mothers’ brains showed the same response to negative and neutral pictures. Basically these mothers-to-be did not, at the neural level, distinguish neutral from negative images.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/399494/original/file-20210507-13-1s9x3ev.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="visualization of brain electrical activity over time" src="https://images.theconversation.com/files/399494/original/file-20210507-13-1s9x3ev.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/399494/original/file-20210507-13-1s9x3ev.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=412&fit=crop&dpr=1 600w, https://images.theconversation.com/files/399494/original/file-20210507-13-1s9x3ev.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=412&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/399494/original/file-20210507-13-1s9x3ev.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=412&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/399494/original/file-20210507-13-1s9x3ev.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=517&fit=crop&dpr=1 754w, https://images.theconversation.com/files/399494/original/file-20210507-13-1s9x3ev.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=517&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/399494/original/file-20210507-13-1s9x3ev.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=517&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Using EEG, researchers recorded the electrical activity of women’s brains when they saw neutral (in black) and negative (in red) images and compared the responses over time.</span>
<span class="attribution"><span class="source">Tristin Nyman and Rebecca Brooker</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>We can’t be sure whether what we observed was these women’s brains reacting to neutral pictures as though they were negative, or to negative pictures as though they were neutral. But we did see that the difference between the two emotional categories was smaller compared to what we would expect.</p>
<p>In the context of our interest in worry and anxiety, this finding is concerning. It looks like these women are at risk of responding to even nonthreatening information as though it is problematic. That is, the line between what is worrisome and what should not be becomes blurred, even at the level of neural activity. Other research suggests that this may <a href="https://doi.org/10.1016/j.infbeh.2018.09.003">hurt the mother-infant relationship over time</a>. Researchers found that when women’s brains were more reactive to neutral information, similar to what we think may be happening in our study, mothers reported more difficulty interpreting emotions in their infant.</p>
<p>Critically, though, we saw this mixed-up reaction only in pregnant women who reported having low levels of social support. We asked our volunteers to create lists of people they felt they could talk to if they were in a difficult situation or needed help. We also asked them to tell us if they thought, as they reflected on these lists, that the social support available to them was adequate. When women reported more satisfaction with their social support networks, the neural response was just as we expected, with a clear distinction between negative and neutral information.</p>
<p>Our findings are consistent with <a href="https://doi.org/10.1016/j.neuroimage.2007.01.038">studies of nonpregnant individuals</a>, suggesting that adequate social support calms the body’s responses to stress. Our work identifies social support as a specific and easily targeted step for protecting pregnant women in ways that can influence neural function during a sensitive period of reorganization.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/399787/original/file-20210510-5687-1no81ba.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="family portrait of multiple generations with pregnant woman in the center" src="https://images.theconversation.com/files/399787/original/file-20210510-5687-1no81ba.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/399787/original/file-20210510-5687-1no81ba.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/399787/original/file-20210510-5687-1no81ba.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/399787/original/file-20210510-5687-1no81ba.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/399787/original/file-20210510-5687-1no81ba.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/399787/original/file-20210510-5687-1no81ba.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/399787/original/file-20210510-5687-1no81ba.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">What mattered was whether a woman felt that she was supported during pregnancy, not an objective reality of how many people were on standby to help her.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/portrait-of-family-relaxing-at-home-royalty-free-image/961476054">Cavan Images/Cavan via Getty Images</a></span>
</figcaption>
</figure>
<h2>Adequate support is in the eye of the beholder</h2>
<p>What especially caught our eye in these findings is that we used a measure of social support that was based on a woman’s perception about how much backup was available to her should she need it. Whether or not her belief is accurate is unknown.</p>
<p>However, more and more neuroscientific evidence underscores the degree to which people live in their own subjective realities. It is intuitive, and supported by <a href="https://www.age-of-the-sage.org/psychology/social/hastorf_cantril_saw_game.html">decades of work</a> in sociology <a href="https://www.macmillanlearning.com/college/us/product/Social-Psychology/p/1319191789">and social psychology</a>, that people base their thoughts, feelings and actions on what they believe to be true about the world regardless of whether it’s accurate.</p>
<p>In this case, a woman’s feelings about her available social support are based on how good she feels about that network rather than whether anyone else thinks she has enough people to talk to if a problem arises.</p>
<p>It follows, then, that changing a mom-to-be’s perception that she has sufficient social support can change the way that her brain processes emotional information to make it more closely resemble typical, healthy function.</p>
<p>Our research suggests there’s an easy and inexpensive way to support pregnant mothers that can alter neural reactivity to negative information and may serve to protect both maternal and child outcomes – simply help mom feel more supported. That doesn’t need to mean encouraging women to join clubs or groups or find new friends or therapists. Rather, pregnant women may benefit from simply recognizing the power and benefit of the networks they already have in place.</p>
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<p class="fine-print"><em><span>Rebecca Brooker receives funding from the National Institutes of Health. Research discussed in the article was supported by the National Institute of Mental Health and the National Institute of General Medical Sciences. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. </span></em></p><p class="fine-print"><em><span>Tristin Nyman receives funding from the the National Institute of Mental Health of the National Institutes of Health. The content she shares here is solely her responsibility and does not necessarily represent the official views of the National Institutes of Health.</span></em></p>Fetal brains are changing rapidly over the course of pregnancy, but so are the brains of mothers-to-be. Neuroscience research shows one way worry can start taking hold – and a simple way to help.Rebecca Brooker, Associate Professor of Psychological and Brain Sciences, Texas A&M UniversityTristin Nyman, Ph.D. Student in Psychological & Brain Sciences, Texas A&M UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1493482020-12-29T14:19:35Z2020-12-29T14:19:35ZGroup exercise may be even better for you than solo workouts – here’s why<figure><img src="https://images.theconversation.com/files/374565/original/file-20201212-22-1nagota.jpg?ixlib=rb-1.1.0&rect=280%2C452%2C5676%2C3558&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">During the pandemic, exercise classes and groups need to take social distancing guidelines into account.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/people-attend-an-outdoor-soulcycle-class-at-the-hudson-news-photo/1271598743">Noam Galai/Getty Images Entertainment via Getty Images</a></span></figcaption></figure><p>Group exercise is very popular: Nearly 40% of regular exercisers participate in group fitness classes. In advance of the coronavirus pandemic, the American College of Sports Medicine predicted that group fitness would be <a href="https://dx.doi.org/10.1249/FIT.0000000000000526">one of the top three fitness industry trends in 2020</a> – for good reason.</p>
<p>Exercise has clear benefits for your <a href="https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf">health and well-being</a>, and the side effects – think lowered blood pressure, improved glycemic control, better sleep – are overwhelmingly positive. And <a href="https://doi.org/10.7556/jaoa.2017.140">exercising in groups</a> may have particularly beneficial effects.</p>
<p>If you’ve been considering joining an online group class – or been encouraged to by others – here are some research-based reasons why that might be a great idea.</p>
<h2>Everyone else is doing it, why not you?</h2>
<p>Other people <a href="https://doi.org/10.1186/1479-5868-7-86">influence your attitudes and emotional responses to exercise</a>. That is, they can affect how you feel about exercising, which is critical for determining whether you do it or not. If you get to know others who exercise regularly, you start to perceive exercise as <a href="https://doi.org/10.1186/1479-5868-7-86">more positive, common, desirable and doable</a>. </p>
<p><a href="https://scholar.google.com/citations?user=TU08z8YAAAAJ&hl=en&oi=ao">Psychology and exercise researchers</a> <a href="https://scholar.google.com/citations?user=75fzUgIAAAAJ&hl=en&oi=ao">like us</a> know that people are influenced by those around them in a few different ways. Knowing other people who lift weights or take a spin class <a href="https://doi.org/10.1080/17437199.2019.1618726">influences your explicit and implicit attitudes</a> – your thoughts and feelings – about exercise.</p>
<p>It also molds what are called social norms: your perceptions about whether other people exercise and if you think you should.</p>
<h2>Fun with friends is motivating</h2>
<p>Even if you’ve already decided exercising is something you want to do and intend to do, there are <a href="https://doi.org/10.1177/0146167217733068">different kinds of motivation</a> that can determine if you are successful at <a href="https://doi.org/10.1111/j.1464-0597.2007.00325.x">beginning and maintaining exercise</a>. Exercising with others can <a href="https://doi.org/10.1186/1479-5868-7-86">boost those motivations</a>. </p>
<p>The highest quality or type of motivation is called <a href="https://doi.org/10.1037/0003-066X.55.1.68">intrinsic motivation</a> – you’re doing something because the behavior itself is enjoyable, satisfying or both. If you enjoy exercise and not just the positive feelings you get after you’ve worked out, you are more likely to stick with it. <a href="https://doi.org/10.1037/spy0000157">Exercising with other people</a> <a href="https://www.livescience.com/40977-exercise-enjoyment-friends.html">can supply that enjoyment</a>, even if the activity itself is difficult or otherwise not something you love. Group exercise can turn working out into a fun social activity, which could lead to you continuing to do it.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/374563/original/file-20201212-15-1ch39gr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="people stretching while socially distanced in stadium seats" src="https://images.theconversation.com/files/374563/original/file-20201212-15-1ch39gr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/374563/original/file-20201212-15-1ch39gr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/374563/original/file-20201212-15-1ch39gr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/374563/original/file-20201212-15-1ch39gr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/374563/original/file-20201212-15-1ch39gr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/374563/original/file-20201212-15-1ch39gr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/374563/original/file-20201212-15-1ch39gr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Exercising together – whether online or safely in person – can help you stick to the program.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/people-participate-in-a-morning-yoga-session-on-august-22-news-photo/1228159941">Mark Makela/Getty Images News via Getty Images</a></span>
</figcaption>
</figure>
<p><a href="https://www.essence.com/lifestyle/health-wellness/fitness-accountability-partner-helps/">Exercising with others</a> can also <a href="https://doi.org/10.1080/1612197X.2017.1280835">satisfy some basic psychological needs</a>. Any kind of exercise can help someone feel in control of their choices, but the social support from a group can <a href="http://dx.doi.org/10.1080/2159676X.2017.1354059">reinforce a sense of autonomy</a>. Similarly, group exercise can increase feelings of mastery – thanks to growing competence, for example, at spinning or step aerobics. And it will certainly increase your connectedness with others. People <a href="https://doi.org/10.1093/geroni/igy007">naturally choose to keep up</a> fulfilling behaviors in the long term and they promote mental health – a win-win.</p>
<p>In contrast, exercise feels less compelling if your <a href="https://doi.org/10.1037//0003-066X.55.1.68">motivation is extrinsic</a> – for instance, someone else is telling you to exercise, or you’re primarily doing it to lose weight. In this case, sticking to a fitness regimen becomes less likely and less rewarding. Similarly, if the extrinsic factors go away – maybe you lose weight or decide you don’t care anymore about the number on your scale – then the motivation to exercise likely disappears as well.</p>
<h2>Buddies help make it a habit</h2>
<p>Exercising with others can make the whole process easier and more habitual. Friends can be your cue as well as your reward for exercising.</p>
<p>First, you look to other people to learn how to do things, and it’s a human tendency to model your behavior after those you see around you. When you <a href="https://doi.org/10.1016/j.psychsport.2009.05.010">observe others breaking a sweat</a>, it can start to <a href="https://doi.org/10.1037/hea0000085">build your confidence in your own ability to exercise</a> – psychologists call this belief in yourself self-efficacy. You may then <a href="https://doi.org/10.1123/jsep.30.1.56">tend to model your behavior</a> after others’, too. This is very important for starting a new exercise routine, because how much you believe in your own ability to take on that yoga class or try some new equipment at the gym will predict whether you give it a shot.</p>
<p>Second, friends can remove some of the barriers to exercising. A workout buddy can provide reminders and encouragement to exercise, hold you accountable and even help with tangible logistics, like giving you a ride or sending links for Zoom class opportunities.</p>
<p>And don’t discount the competitive urge. A little friendly <a href="https://www.nbcnews.com/better/health/why-you-should-work-out-crowd-ncna798936">competition provided by your group</a> can also boost the intensity of your effort.</p>
<p><a href="https://doi.org/10.1016/j.psychsport.2019.03.005">Habits are automatic behaviors</a> that you don’t have to spend a lot of energy forcing yourself to do – they’re your default, preferred behavior. You do them consistently and frequently without using up all your willpower. Exercise pals can help here, too. Habits need a cue to trigger the behavior, and a friend regularly texting that she’ll see you at the pool on your usual day to get together could do the trick.</p>
<p>Habits also require a reward to maintain, and intrinsic motivation that comes from exercising with others can be the payoff that <a href="https://doi.org/10.1037/hea0000249">keeps exercise part of your daily routine</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/374564/original/file-20201212-20-183ohth.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="people working out outdoors with instructor" src="https://images.theconversation.com/files/374564/original/file-20201212-20-183ohth.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/374564/original/file-20201212-20-183ohth.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=409&fit=crop&dpr=1 600w, https://images.theconversation.com/files/374564/original/file-20201212-20-183ohth.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=409&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/374564/original/file-20201212-20-183ohth.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=409&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/374564/original/file-20201212-20-183ohth.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=514&fit=crop&dpr=1 754w, https://images.theconversation.com/files/374564/original/file-20201212-20-183ohth.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=514&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/374564/original/file-20201212-20-183ohth.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=514&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The people in your group become an asset to help you get going and stick with it.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/people-take-an-outdoor-class-at-pylo-fitness-with-workout-news-photo/1227956484">Valerie Macon/AFP via Getty Images</a></span>
</figcaption>
</figure>
<h2>Sticking with each other and exercise</h2>
<p>Group exercise appears to hold some benefits that individual exercise may not.</p>
<p><a href="https://doi.org/10.1037/amp0000103">Getting engaged</a> in group exercise may also <a href="https://pubmed.ncbi.nlm.nih.gov/10902087/">lead to a more consistent and resilient</a> exercise experience. Past research has shown that people who <a href="https://doi.org/10.1249/JES.0000000000000177">feel more connected</a> in their exercise class attend more sessions, arrive on time, are less likely to drop out, are more resistant to disruption and are more likely to have greater mental benefits from the exercise. Since quitting exercise programs is common and disruptions may easily throw people off their exercise routine, getting involved with a group exercise class might be a particularly good way to head off these problems. </p>
<p>When choosing an exercise group to join, <a href="https://doi.org/10.1249/JES.0000000000000177">consider how similar the other participants are to you</a> – think about age, gender, interests. You’re likely to form a <a href="https://doi.org/10.1007/BF02879901">more cohesive group with people you identify with</a>, and these interconnected groups are more likely to stick together and continue exercising.</p>
<h2>Group support while safely distant</h2>
<p>So exercising with others can provide all the elements needed for a successful, enjoyable and active lifestyle. Especially if you’re feeling isolated by the pandemic and its effects, now could be the perfect time for you to give remote group exercise a try. If the weather works, maybe you can find a yoga class that meets outdoors with plenty of space between participants, or a running club whose members stay masked.</p>
<p>Virtual classes may function as a substitute for in-person group exercise classes. Yes, they may take a little more motivation to find and access, or call for equipment you don’t already have at home. But remote classes have additional potential benefits, including flexibility in schedule, diversity in activities and exercise types, and connecting with others who are physically distant.</p><img src="https://counter.theconversation.com/content/149348/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Your most important piece of exercise gear may be the friends you buddy up with to work out.L. Alison Phillips, Associate Professor of Psychology, Iowa State UniversityJacob Meyer, Assistant Professor of Kinesiology, Iowa State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1496052020-11-06T14:34:46Z2020-11-06T14:34:46ZKeep calm and carry on – but how? A psychologist offers 10 tips to manage uncertainty and stress around the midterm elections<figure><img src="https://images.theconversation.com/files/367960/original/file-20201106-23-1tctq5b.jpg?ixlib=rb-1.1.0&rect=617%2C605%2C7316%2C4881&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Doomscrolling is not going to help.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/young-woman-laying-in-bed-and-using-smart-phone-royalty-free-image/1173571335">ArtistGNDphotography/E+ via Getty Images</a></span></figcaption></figure><p>Well-meaning advice for people stressing out about current events often includes encouragement to be patient, stay calm and keep the faith – but how on Earth are you supposed to do that when the onslaught of troubling news seems never to stop?</p>
<p>As a practicing clinical psychologist and professor who studies how to <a href="https://scholar.google.com/citations?user=zYSMPmcAAAAJ&hl=en&oi=ao">manage anxiety and tolerate uncertainty</a>, I offer 10 suggestions to make it through this highly stressful period.</p>
<h2>1. Put the phone down!</h2>
<p>While it is tempting to stay glued to your devices, never-ending doomscrolling and screen-refreshing can become overwhelming and keep you in a state of tension and constant vigilance. Excessive consumption of news and social media <a href="https://doi.org/10.1016/j.jpsychires.2017.12.006">predicts poorer long-term mental health</a> during times of crisis.</p>
<p>Plan some breaks where you can engage in activities that take your mind off politics and the uncertainties we face, and allow things to feel a little more normal for a while.</p>
<h2>2. Uncertainty doesn’t equal catastrophe</h2>
<p>It’s hard not to know things – outcomes of elections, for instance. But not knowing doesn’t mean you should assume the worst-case scenario has occurred. When anxious – as many in the U.S. are right now – people tend to assign <a href="https://doi.org/10.1016/j.brat.2007.01.009">threatening meanings to ambiguous situations</a>. But this tendency is neither reliably accurate nor helpful. Jumping to catastrophic conclusions is like setting off a series of false alarms that keep you on edge and exaggerate your sense of threat.</p>
<h2>3. Don’t retreat into bed</h2>
<p>The feeling of deep disappointment about election results you don’t like, or apprehension about reducing greenhouse gas emissions, can trigger a desire to withdraw and hole up. While that response is natural, it tends to be counterproductive. Staying engaged in activities that <a href="https://doi.org/10.1111/j.1468-2850.2009.01178.x">give you a sense of accomplishment, pleasure or meaning</a> can make managing this time far less painful.</p>
<h2>4. Remember, it won’t always feel this intense</h2>
<p>It’s normal and understandable to feel overwhelmed by current events. Focus on what will help you manage this day without punishing yourself for being upset or feeling depleted. Attending to what’s happening in the moment while also recognizing it’s not permanent can help you stay both present and hopeful. While in many ways it is true that we’re living in a unique and unprecedented era, it’s also the case that <a href="https://doi.org/10.1016/j.cpr.2018.05.008">human beings tend to be remarkably resilient</a>, even in the face of tremendous stress and trauma.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/367962/original/file-20201106-23-1tpvdz1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="woman smiling on phone while cooking in kitchen" src="https://images.theconversation.com/files/367962/original/file-20201106-23-1tpvdz1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/367962/original/file-20201106-23-1tpvdz1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/367962/original/file-20201106-23-1tpvdz1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/367962/original/file-20201106-23-1tpvdz1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/367962/original/file-20201106-23-1tpvdz1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/367962/original/file-20201106-23-1tpvdz1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/367962/original/file-20201106-23-1tpvdz1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Even video chatting can be a way to connect over a shared activity.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/smiling-woman-using-phone-while-cooking-in-kitchen-royalty-free-image/960879178">Cavan Images/Cavan via Getty Images</a></span>
</figcaption>
</figure>
<h2>5. Don’t go through this time alone</h2>
<p>Feeling isolated, whether physically or emotionally, can make a hard time feel worse. When people experience acute stress, they cope much better <a href="https://doi.org/10.1111/j.1467-9280.2006.01832.x">if they have social support</a>.</p>
<p>So reach out and stay connected – whether that means texting about the latest vote count with a friend or purposefully taking a break from ruminating on current events. It’s a great time to deeply discuss what you think about Taylor Swift’s new album.</p>
<h2>6. Stay regular</h2>
<p>No, I am not referring to your bowels – maintain regular and healthy eating, sleep and exercise patterns. While self-care may seem unimportant, attending to those basic bodily needs can go a long way toward keeping your internal resources sufficiently replenished so you can meet the high demands of this time. There is increasing evidence that <a href="https://doi.org/10.5665/sleep.2810">poor sleep is closely connected</a> to many mental and emotional health difficulties.</p>
<p>So stop refreshing your feed in the wee hours and try to sleep.</p>
<h2>7. Help others</h2>
<p>It may feel odd to be asked to support others when you feel so depleted yourself, but <a href="https://doi.org/10.1097/01.PSY.0000079378.39062.D4">helping others is linked to benefits in your own mental health</a>. </p>
<p>Moreover, it provides a sense of control. There’s so much during this time that you cannot control – there is no magic wand that speeds up vote counting in critical contested races or makes climate resolutions between countries come sooner. But taking action to improve things now for the people around you both helps others and reminds you that you can make a difference in meaningful ways.</p>
<p>So, bake cookies to drop off on the doorstep of the friend who caught the flu. Offer to take an item off a work colleague’s overwhelming to-do list. If you’re in a position to help, make a donation to a cause you care about. It’s a win-win.</p>
<h2>8. Add to your toolbox</h2>
<p>Each person is different in what helps them to relax or feel more centered. Focusing on and slowing down your breathing, for instance, can help keep you grounded in the present moment and reduce the spiral of upsetting thoughts about what might come next. Others find it helpful to more directly practice taking a different perspective and reevaluating their anxious thoughts.</p>
<p>For many people, online mindfulness or cognitive therapy exercises can make a big difference. Check out <a href="https://onemindpsyberguide.org/">online mental health programs that have been reviewed by experts</a> and pick the resource that’s right for you.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/367963/original/file-20201106-19-13uxzvl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="woman lying on couch with dog" src="https://images.theconversation.com/files/367963/original/file-20201106-19-13uxzvl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/367963/original/file-20201106-19-13uxzvl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/367963/original/file-20201106-19-13uxzvl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/367963/original/file-20201106-19-13uxzvl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/367963/original/file-20201106-19-13uxzvl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/367963/original/file-20201106-19-13uxzvl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/367963/original/file-20201106-19-13uxzvl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Cut some slack for yourself and others – this is a time when good enough is good enough.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/girl-sleeping-on-couch-with-her-golden-retriever-royalty-free-image/1022892336">Klaus Vedfelt/DigitalVision via Getty Images</a></span>
</figcaption>
</figure>
<h2>9. Offer compassion to yourself</h2>
<p>The combination of pandemic stresses, economic worries, social injustices, climate breakdown and more means few of us will be at our best right now as we try to just make it through the day.</p>
<p>There’s a lot of room between performing at 100% of your usual capacity and climbing into bed and hiding under the covers for days on end. Personally, I’m trying to average 80%. People managing greater challenges at this time than I am may shoot for a lower percentage.</p>
<p>No one is making it through this time unscathed, so kindness to ourselves and others is desperately needed.</p>
<h2>10. Reach out if you need additional help</h2>
<p>If recommendations 1-9 aren’t cutting it, there are lots of resources to help people through this difficult period:</p>
<ul>
<li>National Suicide Prevention Lifeline: 988</li>
<li>Crisis Text Line: Text HOME to 741741</li>
<li><a href="https://www.abct.org/Help/?m=mFindHelp&fa=dFindHelp">Find a therapist</a> </li>
<li><a href="https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions">Find culturally competent mental health care</a></li>
<li>Use my research team’s free intervention to reduce anxious thinking: <a href="https://mindtrails.virginia.edu/">MindTrails</a> (part of an online study)</li>
</ul>
<p>Be patient, stay calm and keep the faith is a tall order. I’ll be happy if I can get most of the way there.</p>
<p><em>This is an updated version of an article originally published on Nov. 6, 2020.</em></p><img src="https://counter.theconversation.com/content/149605/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Bethany Teachman receives funding from the National Institute of Mental Health. She is the Director of the MindTrails site.</span></em></p>As uncertainty abounds and anxiety skyrockets, you’ve probably heard advice to be patient, stay calm and keep the faith. Here are 10 concrete tips to help you actually manage the stress.Bethany Teachman, Professor of Psychology, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1382192020-05-14T14:06:43Z2020-05-14T14:06:43ZLocal networks can help people in distress: South Africa’s COVID-19 response needs them<figure><img src="https://images.theconversation.com/files/334699/original/file-20200513-156645-gaokbe.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Social solidarity networks have an edge over government: speed, innovation, and local responsiveness</span> <span class="attribution"><span class="source">Getty Images</span></span></figcaption></figure><p>In South Africa a range of social solidarity networks have emerged to respond to the COVID-19 <a href="https://www.dailymaverick.co.za/article/2020-05-08-hunger-numbers-millions-millions-millions-need-food/">hunger crisis</a>. They are a vital part of the societal response because of their speed, innovation, and local responsiveness. They complement the central role of government. Yet the government is struggling to develop this partnership and risks stifling solidarity networks with bureaucratic control.</p>
<p>Government responses to crises are crucial. But the scale and complexity of the current crisis are too great for the government acting alone. It is constrained by its prior way of working, which emphasises standardisation and control. It also lacks information about who is in need (beyond grant recipients), and it lacks the supply chains to get help to them quickly.</p>
<p>This is not necessarily a criticism of this particular government. All governments are struggling with the fallouts of COVID-19.</p>
<p>We know from the extensive scholarly literature on disasters that governments are inherently constrained in responding rapidly to the local impacts of disasters. For instance, after the <a href="https://siepr.stanford.edu/system/files/shepherd%20and%20williams%202014.pdf">Black Saturday fires</a> in Australia, neighbourhood networks were crucial in alleviating suffering because the aid from the government and other large organisations was slow in coming and often inappropriate for local needs.</p>
<p>We have been participating in or studying a number of such emergent solidarity networks and <a href="https://mitpress.mit.edu/books/spontaneous-venturing">“spontaneous venturing”</a> efforts that are responding to the COVID-19 crisis in South Africa. They include the examples described below, as well as others, such as the responses by the <a href="https://www.southernafricafoodlab.org">Southern Africa Food Lab</a>. These experiences and research have shown us how existing and new networks can play an important role and how this role needs to be strengthened. </p>
<h2>Solidarity networks</h2>
<p>Locally embedded actors can build on local knowledge and relationships developed prior to the crisis.</p>
<p>For example, Christine Fyvie has been working with the NGO <a href="https://boostafrica.com/">Boost Africa</a> for many years in one of Cape Town’s most vulnerable communities, Dunoon. She had set up after-school clubs to help children from particularly vulnerable households. This gave her useful information about which households were at particular risk and how to channel food and other essentials to them.</p>
<p>Even so, ensuring that the food was getting to those most in need has been a challenge. She told us:</p>
<blockquote>
<p>Some individuals or groups make use of distributed food to enhance their power in the community. Others won’t put up their hand even though we know they really need it. It is only possible to navigate these tricky dynamics with some knowledge of the community and with some trust among its members.</p>
</blockquote>
<p>This trust is especially vital in pre-empting competition within communities as the need for food grows. It is also crucial because the need for speedy responses makes traditional accountability mechanisms difficult to adhere to.</p>
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Read more:
<a href="https://theconversation.com/pandemic-underscores-gross-inequalities-in-south-africa-and-the-need-to-fix-them-135070">Pandemic underscores gross inequalities in South Africa, and the need to fix them</a>
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</p>
<hr>
<p>Spontaneous venturing shows how innovation can match the growing need with diverse sources of supply. For example, the social enterprise <a href="https://www.foodflowza.com/">Food Flow</a> has created novel network connections in response to the crisis. It was established just before lockdown started in Cape Town, when Ashley Newell and her partner, Iming Lin, realised that small farmers in their area were losing their customers among hotels and restaurants, while vulnerable households were going hungry.</p>
<p>They came to know about this because of their local knowledge and networks: Iming is a farmer herself and both Ashley and Iming had been actively involved in local social development efforts. </p>
<p>Their response was to use donor funding to buy food from the local farmers and deliver it to local NGOs working in low-income communities.</p>
<p>The initiative struck a chord. They initially hoped to redirect about 150 bags of produce a week. But by the end of their first week, they had raised so much money that they had facilitated the delivery of 3,500. (Each provides for about 10 meals.)</p>
<p>This scaling-up required radical innovation, based on existing relationships. Ashley told us: </p>
<blockquote>
<p>We thought we could use a mobile payment system like Snapscan to enable donations, but it was taking too long. I had a friend at Webtickets (an online events booking company) and they were willing to put us on their site, even though it was meant for something entirely different.</p>
</blockquote>
<p>Our third example is the remarkable emergence of Community Action Networks (CANs) in diverse neighbourhoods in Cape Town (and now also elsewhere in the country). An initial objective of each CAN was to ensure that vulnerable members of the local community would be supported during lockdown. But given social and spatial inequalities in the city, their purpose soon grew to promote and show solidarity across communities. This has been expressed most strongly in the pairing of CANs in poorer and better-off areas, to support the exchange of information and ideas, and to ensure that essentials could be channelled to those most in need.</p>
<p>There are over 2,000 volunteers registered in about 150 such Community Action Networks in the Cape Town metropole, and there are about 20 pairings between CANs. They are connected in an overarching network called <a href="https://www.facebook.com/groups/CapeTownTogether/">Cape Town Together</a>, which emphasises that</p>
<blockquote>
<p>we act locally, while also drawing on our collective experience and energy to share lessons and resources across the city.</p>
</blockquote>
<p>The Community Action Networks have facilitated an impressive exchange of finance, food, and other physical resources. They are also exchanging information about local needs and how best to address them.</p>
<p>But there’s a risk that government could stifle initiatives like this. It has sought to exert control by, among other things, insisting that food parcels adhere to strict requirements and are vetted by <a href="https://www.dailymaverick.co.za/article/2020-05-05-how-red-tape-is-hampering-the-hungry-from-receiving-food-in-south-africa/">local municipalities</a>. </p>
<p>There are good reasons for such regulation. But the risk is that this impulse to control civil society responses ignores the magnitude, complexity, and human costs of the hunger crisis, as well as the inherent constraints that the government faces in responding. The bureaucratic limitations that have made the civil society response necessary may now impose themselves on the response.</p>
<h2>The way forward</h2>
<p>The examples above show the importance of the local knowledge and relationships, the innovation, and the local responsiveness that solidarity networks can bring to addressing the COVID-19 hunger crisis. A first step is to recognise and celebrate these vital contributions.</p>
<p>A second step is for the government and other large organisations to recognise the complementarity between their own efforts and those of emergent solidarity networks. Building this into a partnership requires efforts on both sides.</p>
<p>Protagonists in solidarity networks must show that they are diligent in abiding by strict standards of health and safety. <a href="https://www.facebook.com/groups/CapeTownTogether/">Cape Town Together</a> is showing how this can be done.</p>
<p>Government officials must help rather than hinder solidarity networks by sharing information, by expediting permits to allow appropriate movement, and by generally adopting a supportive posture. Such coordination and collaboration is already happening. But the scale and severity of the hunger crisis require a much stronger and ambitious partnership between the government and civil society.</p>
<p><em>This article has been written in a community of practice including Alecia Sewlal, Ashley Newell, Christine Fyvie, Jenny Soderbergh, Mandy Rapson, Sarita Sehgal, and Thanyani Ramarumo (all research students at the UCT Graduate School of Business).</em></p><img src="https://counter.theconversation.com/content/138219/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Annika Surmeier receives funding from the European Union’s Horizon 2020 Research and Innovation Programme under grant agreement No. 799041.</span></em></p><p class="fine-print"><em><span>Jody Delichte, Ralph Hamann, and Scott Drimie do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>More effort must go into building synergies between emergent local efforts and the government response.Ralph Hamann, Professor, University of Cape TownAnnika Surmeier, Marie Sklodowska-Curie Global Fellow, University of Manchester & University of Cape Town, University of Cape TownJody Delichte, Phd Candidate, Graduate School of Business, University of Cape TownScott Drimie, Adjunct Professor, Stellenbosch UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1325072020-03-18T12:08:04Z2020-03-18T12:08:04ZHow hope can keep you healthier and happier<figure><img src="https://images.theconversation.com/files/318807/original/file-20200305-127932-1k92koa.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C4985%2C3330&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Hope springs eternal -- if you nurture it.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/purple-flower-growing-on-crack-street-soft-focus-royalty-free-image/896570168?adppopup=true">Getty Images / ipopba</a></span></figcaption></figure><p>Hope can erode when we perceive threats to our way of life, and these days, plenty are out there. <a href="https://www.urban.org/policy-centers/cross-center-initiatives/program-retirement-policy/projects/data-warehouse/what-future-holds/us-population-aging">As we age</a>, we may struggle with a tragic loss or chronic disease. As we watch the news, we see our <a href="https://theconversation.com/think-the-us-is-more-polarized-than-ever-you-dont-know-history-131600">political system polarized</a>, hopelessly locked in chaos. The coronavirus <a href="https://www.cdc.gov/coronavirus/2019-ncov/summary.html">spreads wider daily</a>; U.S. markets signaled <a href="https://us.spindices.com/indices/equity/dow-jones-industrial-average">a lack of hope</a> with a Dow Jones free fall. Losing hope sometimes <a href="https://www.apa.org/monitor/2019/03/trends-suicide">leads to suicide</a>. </p>
<p>When there is no hope – when people cannot picture a desired end to their struggles – they lose the motivation to endure. As <a href="https://psychology.vcu.edu/people/faculty/worthington-jr.html">professor emeritus</a> at Virginia Commonwealth University, I’ve studied positive psychology, forgiveness, wellness and the science of hope for more than 40 years. <a href="http://www.evworthington-forgiveness.com/">My website</a> offers free resources and tools to help its readers live a more hopeful life.</p>
<h2>What is hope?</h2>
<p>First, hope is not Pollyannaish optimism – <a href="https://link.springer.com/article/10.1007/s11031-018-9746-7">the assumption</a> that a positive outcome is inevitable. Instead, hope is a motivation to persevere toward a goal or end state, even if we’re skeptical that a positive outcome is likely. <a href="https://www.amazon.com/Psychology-Hope-You-Here-There/dp/0743254449">Psychologists tell us</a> hope involves activity, a can-do attitude and a belief that we have a pathway to our desired outcome. Hope is the willpower to change and the way-power to bring about that change.</p>
<p>With teens and with young or middle-aged adults, hope is a bit easier. But for older adults, it’s a bit harder. Aging often means running up against obstacles that appear unyielding – like recurring health or financial or family issues that just don’t seem to go away. Hope for older adults has to be “sticky,” persevering, a “<a href="http://hopecouples.com/">mature hope</a>.” </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/318810/original/file-20200305-127939-1nv3gw8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/318810/original/file-20200305-127939-1nv3gw8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/318810/original/file-20200305-127939-1nv3gw8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/318810/original/file-20200305-127939-1nv3gw8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/318810/original/file-20200305-127939-1nv3gw8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/318810/original/file-20200305-127939-1nv3gw8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/318810/original/file-20200305-127939-1nv3gw8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Hope is more than just positive thinking.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/woman-thinking-outdoor-royalty-free-image/500841556?adppopup=true">Getty Images / ridofranz</a></span>
</figcaption>
</figure>
<h2>How to build hope</h2>
<p>Now the good news: <a href="https://www.sciencedirect.com/science/article/pii/S259011332030002X?via%3Dihub">this study</a>, from Harvard’s “<a href="https://hfh.fas.harvard.edu/">Human Flourishing Program</a>,” recently published. <a href="https://www.sciencedirect.com/science/article/pii/S259011332030002X?via%3Dihub">Researchers examined</a> the impact of hope on nearly 13,000 people with an average age of 66. They found those with more hope throughout their lives had better physical health, better health behaviors, better social support and a longer life. Hope also led to fewer chronic health problems, less depression, less anxiety and a lower risk of cancer.</p>
<p>So if maintaining hope in the long run is so good for us, how do we increase it? Or build hope if it’s MIA? Here are my four suggestions:</p>
<p>Attend a motivational speech – or watch, read or listen to one online, through YouTube, a blog or podcast. That increases hope, although usually the fix is short-lived. How can you build longer-term hope?</p>
<p>Engage with a religious or spiritual community. This has worked for millennia. Amidst a community of like believers, people have drawn strength, found peace and experienced the elevation of the human spirit, just by knowing there is something or someone much larger than them. </p>
<p>Forgive. Participating in a <a href="http://www.evworthington-forgiveness.com/run-groups">forgiveness group</a>, or completing a forgiveness <a href="https://evworthington.squarespace.com/diy-workbooks">do-it-yourself workbook</a>, builds hope, <a href="https://www.researchgate.net/publication/259454682_Efficacy_of_Psychotherapeutic_Interventions_to_Promote_Forgiveness_A_Meta-Analysis">say scientists</a>. It also reduces depression and anxiety, and increases (perhaps this is obvious) your capacity to forgive. That’s true even with long-held grudges. I’ve personally found that successfully forgiving someone provides a sense of both the willpower and way-power to change.</p>
<p>Choose a “hero of hope.” Some have changed history: Nelson Mandela endured 27 years of imprisonment yet persevered to build a new nation. Franklin Delano Roosevelt brought hope to millions for a decade during the Great Depression. <a href="https://en.wikisource.org/wiki/Ronald_Reagan%27s_Fourth_State_of_the_Union_Speech">Ronald Reagan</a> brought hope to a world that seemed forever mired in the Cold War. From his fourth State of the Union address: “Tonight, I’ve spoken of great plans and great dreams. They’re dreams we can make come true. Two hundred years of American history should have taught us that nothing is impossible.” </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/318811/original/file-20200305-127877-1gieat3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/318811/original/file-20200305-127877-1gieat3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=778&fit=crop&dpr=1 600w, https://images.theconversation.com/files/318811/original/file-20200305-127877-1gieat3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=778&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/318811/original/file-20200305-127877-1gieat3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=778&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/318811/original/file-20200305-127877-1gieat3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=977&fit=crop&dpr=1 754w, https://images.theconversation.com/files/318811/original/file-20200305-127877-1gieat3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=977&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/318811/original/file-20200305-127877-1gieat3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=977&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Surely a hero of hope – NASA mathematician Katherine Johnson at the 89th Academy Awards, February 2017.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/physicist-katherine-johnson-poses-in-the-press-room-at-the-news-photo/645835010?adppopup=true">Getty Images / Jason LaVeris / FilmMagic</a></span>
</figcaption>
</figure>
<h2>Hope gets you unstuck</h2>
<p>Hope changes systems that seem stuck. <a href="https://www.nytimes.com/2020/02/24/science/katherine-johnson-dead.html">Katherine Johnson</a>, the black mathematician whose critical role in the early days of NASA and the space race was featured in the movie “Hidden Figures,” recently died at age 101. The movie (and the book on which it was based) brought to light her persistence against a system that seemed forever stuck. Bryan Stevenson, who directs the <a href="https://justmercy.eji.org/">Equal Justice Initiative</a>, and the subject of the movie “Just Mercy,” has successfully fought to help those wrongly convicted or incompetently defended to get off death row. </p>
<p><a href="https://www.amazon.com/Just-Mercy-Story-Justice-Redemption/dp/081298496X/ref=sr_1_2?crid=36NEVUQYANOX0&keywords=just+mercy+bryan+stevenson&qid=1582732721&sprefix=Just+Mercy%2Caps%2C149&sr=8-2">Stevenson laments</a> that he could not help everyone who needed it; he concluded that he lived in a broken system, and that, in fact, he too was a broken man. Yet he constantly reminded himself of what he had told everyone he tried to help: “Each of us,” he said, “is more than the worst thing we’ve ever done.” Hope changes all of us. By regaining his hope, Bryan Stevenson’s example inspires us.</p>
<p>Regardless of how hard we try, we cannot eliminate threats to hope. Bad stuff happens. But there are the endpoints of persistent hope: We become healthier and our relationships are happier. We can bring about that hope by buoying our willpower, bolstering our persistence, finding pathways to our goals and dreams, and looking for heroes of hope. And just perhaps, one day, we too can be such a hero.</p>
<p>[<em>Insight, in your inbox each day.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=insight">You can get it with The Conversation’s email newsletter</a>.]</p><img src="https://counter.theconversation.com/content/132507/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Everett Worthington receives funding from the Templeton World Charity Foundation studying forgiveness, and in the past from the John Templeton Foundation for research on forgiveness.</span></em></p>Hope can be acquired. How? Here are some suggestions from an expert.Everett Worthington, Emeritus Commonwealth Professor of Psychology, Virginia Commonwealth UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1156242019-07-24T22:23:05Z2019-07-24T22:23:05ZPeople living with HIV struggle to access much-needed dental care<figure><img src="https://images.theconversation.com/files/284926/original/file-20190719-116573-yf7d0w.jpg?ixlib=rb-1.1.0&rect=175%2C325%2C1991%2C1321&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Only three per cent of HIV organizations in British Columbia offer basic dental care to those who need it.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Nearly <a href="https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics">37 million people were living with Human Immunodeficiency Virus (HIV)</a> globally in 2017, according to the World Health Organization. </p>
<p>In Canada, <a href="https://www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2017-43/ccdr-volume-43-12-december-7-2017/ccdr-43-12-ar01-eng.pdf">84,409 cases of HIV</a> have been reported since 1985. The province of Ontario accounted for the most HIV cases reported in 2016 (37.6 per cent), followed by Quebec (25.3 per cent) and Alberta (12 per cent). There are around 2,344 new HIV infections in Canada every year, and this number is rising.</p>
<p>Although there is no cure for HIV to date, <a href="http://doi.org/10.1016/j.antiviral.2009.10.002">the use of antiretroviral therapy (ART) has greatly reduced deaths and co-morbidities from the virus</a>. </p>
<p>However, despite the improved outcomes offered by new drug therapies, people living with HIV still face numerous psycho-social challenges and barriers to accessing care — especially dental care services. </p>
<p>When it comes to dental care, vulnerable populations such as people living with HIV are most profoundly affected. They are at particular risk from oral lesions caused by immunosuppression resulting from uncontrolled HIV-infection. These opportunistic infections have <a href="https://doi.org/10.1111/j.1752-7325.2011.00284.x">plagued people living with HIV since the early epidemic of HIV-infection</a> and continue to impact their overall <a href="https://doi.org/10.1177/2325957416686192">well-being and quality of life</a>. </p>
<h2>The services HIV organizations offer in British Columbia</h2>
<p>Until 2016, there was no data on the availability of oral and general health services or the unmet oral health needs of people living with HIV in Canada. I conducted a two-part study through the University of British Columbia Faculty of Dentistry in a first attempt to <a href="https://doi.org/10.14288/1.0377756">classify the types of services available for those living with HIV in British Columbia, Canada.</a> </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/284931/original/file-20190719-116596-1detxbf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284931/original/file-20190719-116596-1detxbf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=386&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284931/original/file-20190719-116596-1detxbf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=386&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284931/original/file-20190719-116596-1detxbf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=386&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284931/original/file-20190719-116596-1detxbf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=486&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284931/original/file-20190719-116596-1detxbf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=486&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284931/original/file-20190719-116596-1detxbf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=486&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">People sit on the sidewalk along East Hastings street in Vancouver. When it comes to dental care, people of lower socioeconomic status are most profoundly affected.</span>
<span class="attribution"><span class="source">(THE CANADIAN PRESS/Jonathan Hayward)</span></span>
</figcaption>
</figure>
<p>I identified a total of 104 HIV organizations within the six health authorities in the province. Of the 51 cities I examined across B.C., 40 housed one or more organizations providing HIV-related services. </p>
<p>The <a href="http://www.jcda.ca/j1">study identified the following available services</a>: </p>
<ul>
<li><p>59 per cent offered preventive services including sexual-health education.</p></li>
<li><p>15 per cent offered treatment services for HIV-related conditions.</p></li>
<li><p>38 per cent offered support services including social assistance.</p></li>
<li><p>Three per cent offered basic dental care, mostly educational in nature. </p></li>
</ul>
<p>This points to a lack of services related to social support, such as housing and food services, and lack of basic dental services. </p>
<h2>Living with tooth decay and bleeding gums</h2>
<p>The second part of my study was a self-reported survey to identify unmet oral health treatment needs and patterns of dental service use by people living with HIV in B.C. </p>
<p>More than 75 per cent of participants reported untreated dental conditions such as decay, bleeding gums and tooth sensitivity. Approximately 50 per cent of participants avoided recommended dental treatment due to cost. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/284927/original/file-20190719-116569-wpvve0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284927/original/file-20190719-116569-wpvve0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284927/original/file-20190719-116569-wpvve0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284927/original/file-20190719-116569-wpvve0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284927/original/file-20190719-116569-wpvve0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284927/original/file-20190719-116569-wpvve0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284927/original/file-20190719-116569-wpvve0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">With specilized training, dentists could help people living with HIV feel safe and welcomed in their offices.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>The following were identified as the <a href="https://doi.org/10.1111/jphd.12304">main factors preventing people from seeking dental care</a>: </p>
<ul>
<li><p>46 per cent experienced discrimination by dental professionals.</p></li>
<li><p>66 per cent experienced dental anxiety.</p></li>
<li><p>50 per cent did not have dental insurance. </p></li>
<li><p>62 per cent were experiencing difficulties with housing, transportation and food. </p></li>
</ul>
<h2>The need for trauma-informed care</h2>
<p>Three quarters of the surveyed population reported having bleeding gums, tooth sensitivity and tooth decay. Significant numbers of respondents reported they had unmet dental treatment needs and felt discriminated against by dental care providers. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/women-need-health-and-dental-care-to-stay-out-of-prison-84897">Women need health and dental care to stay out of prison</a>
</strong>
</em>
</p>
<hr>
<p>At minimum, this highlights the need for more training for dental care providers about how to better serve this vulnerable population. Non-dental professionals — such as physicians, nurses and nutritionists — also need to promote better oral health for HIV-positive clients. This is especially the case in remote locations where accessing a dental-care provider can be a challenge.</p>
<p>The data also highlights that people living with HIV are lacking supports in several areas. They may be struggling with poverty, homelessness, drug use or lack of social support and could be encountering a variety of interconnected barriers in accessing dental-care services.</p>
<p>Therefore, the next generation of dental professionals should receive a robust training in cultural sensitivity and trauma-informed care to make people living with HIV feel safe and welcomed in their dental offices. </p>
<p>Now based in Saskatchewan, I will be continuing to explore the issues of stigma and discrimination related to the unmet dental treatment needs of people living with HIV in this province.</p>
<p>[ <em><a href="https://theconversation.com/ca/newsletters?utm_source=TCCA&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=thanksforreading">Thanks for reading! We can send you The Conversation’s stories every day in an informative email. Sign up today.</a></em> ]</p><img src="https://counter.theconversation.com/content/115624/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Abbas Jessani does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Research shows that many people living with HIV struggle with tooth decay, bleeding gums and tooth sensitivity – due to the costs of dental care and discrimination by dental professionals.Abbas Jessani, Assistant Professor of Dentistry, University of SaskatchewanLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1104242019-02-15T11:48:48Z2019-02-15T11:48:48ZAdolescents have a fundamental need to contribute<figure><img src="https://images.theconversation.com/files/258333/original/file-20190211-174867-1iu4pe.jpg?ixlib=rb-1.1.0&rect=68%2C163%2C5415%2C3535&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Harnessing adolescents’ readiness to help can be good for them and their communities.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/diligent-volunteers-company-working-hard-while-1201495798">YAKOBCHUK VIACHESLAV/Shutterstock.com</a></span></figcaption></figure><p>No longer children but not yet adults, adolescents need opportunities to learn and prepare for their entrance into the broader society. But, as schooling increasingly extends the adolescent period and teenagers get dismissed as supposedly selfish and irresponsible, has society forgotten an important developmental need of our youth?</p>
<p><a href="https://scholar.google.com/citations?user=MQScMDkAAAAJ&hl=en&oi=ao">As a developmental scientist</a> who <a href="http://adolescence.semel.ucla.edu">focuses on adolescence</a>, I <a href="https://journals.sagepub.com/doi/10.1177/1745691618805437">reviewed dozens of studies</a> and found that <a href="https://doi.org/10.1016/S2352-4642(18)30022-1">this age group</a> has a fundamental need to contribute to others – to provide support, resources or help toward a shared goal. Contributing helps them achieve autonomy, identity and intimacy – important milestones on the way to adulthood.</p>
<p>As teenagers grow up, their brains are developing in ways that appear to support the increasingly complex ways of thinking and behaving that underlie giving to others. And being able to make meaningful contributions predicts better psychological and physical health among youth as well as adults. I believe it’s time to move away from outdated stereotypes of adolescents as only selfish and dangerous risk-takers and to consider how they are ripe for learning about contributing to others and their communities.</p>
<h2>It’s human nature to give, even for adolescents</h2>
<p>For decades, economists and other scientists have asked thousands of people to play experimental games that ask people to give and share money and other resources with one another. These studies have consistently shown that <a href="https://doi.org/10.1007/s10683-011-9283-7">adults generally will provide some resources to others</a> – some estimates put the average at around 30 percent of their allotments – even if they don’t know the recipients and expect nothing in return.</p>
<p>Adolescents are generous, too. Several labs around the world have reported on the tendency for youth to share at least some of their money or rewards with others in these games, even at a cost to themselves. Studies in the Netherlands suggested that adolescents aged 9 to 18 will make a <a href="https://doi.org/10.3389/fpsyg.2014.00291">costly donation to friends</a> between 50 and 75 percent of the time. They’ll donate even to strangers at a cost to themselves between 30 and 50 percent of the time. In research our team has conducted, American adolescents agreed to <a href="https://doi.org/10.1080/17470911003687913">give money to family at a loss to themselves</a> about two-thirds of the time.</p>
<p>Add in the fact that teenagers consistently report their friends as their <a href="https://doi.org/10.1023/A:1005147708827">most frequent source of emotional and social support</a>, and a picture emerges of adolescents as a group primed to contribute to others.</p>
<h2>Brain developments for good</h2>
<p>The adolescent brain gets blamed for a lot of bad behavior, such as delinquency and substance use. But this reputation is <a href="https://theconversation.com/why-its-time-to-lay-the-stereotype-of-the-teen-brain-to-rest-85888">undergoing a rehabilitation</a>.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/258243/original/file-20190211-174867-opczuz.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/258243/original/file-20190211-174867-opczuz.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/258243/original/file-20190211-174867-opczuz.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=508&fit=crop&dpr=1 600w, https://images.theconversation.com/files/258243/original/file-20190211-174867-opczuz.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=508&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/258243/original/file-20190211-174867-opczuz.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=508&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/258243/original/file-20190211-174867-opczuz.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=639&fit=crop&dpr=1 754w, https://images.theconversation.com/files/258243/original/file-20190211-174867-opczuz.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=639&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/258243/original/file-20190211-174867-opczuz.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=639&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Overview of reward structures in the human brain.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Recolored_Overview_of_reward_structures_in_the_human_brain2.png">Oscar Arias-Carrión1, Maria Stamelou, Eric Murillo-Rodríguez, Manuel Menéndez-González and Ernst Pöppel.</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Neuroscience research shows that <a href="https://doi.org/10.1177/0963721413480859">brain regions related to reward</a> – such as the ventral and dorsal striatum – become more sensitive during the teen years. At the same time, they’re strengthening connections to brain areas relevant for cognitive control, like the prefrontal cortex. Together these <a href="https://doi.org/10.1038/nrn3313">developments in the growing brain</a> may be instrumental in the exploratory learning, creativity and cognitive flexibility essential to becoming an adult. </p>
<p>These regions and networks, as well as those relevant for thinking about other people, have been implicated in prosocial and giving behaviors. Our team’s studies have shown that several regions – such as the <a href="https://doi.org/10.1080/17470911003687913">ventral and dorsal striatum</a> and the <a href="https://doi.org/10.1016/j.neuroimage.2011.06.013">dorsolateral and dorsomedial prefrontal cortex</a> – are active when adolescents make costly donations to their family. Among youth who place great importance on helping family, we saw even more activation in additional regions related to social cognition and in the connections between them. Other researchers have obtained <a href="https://doi.org/10.1093/scan/nst077">similar</a> <a href="https://doi.org/10.1093/scan/nsw136">results</a>. </p>
<p>These are the very same neural networks that undergo the most change during the adolescent years. The networks seem to be active during the complex decision-making – to whom, when, how much, do they really need it? – that can be involved in sharing resources, support and effort with others. It’s tricky to work through these kinds of difficult questions. The developing brain may enable youth to learn how to make the computations necessary to answer them.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/258334/original/file-20190211-174887-he8zql.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/258334/original/file-20190211-174887-he8zql.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/258334/original/file-20190211-174887-he8zql.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/258334/original/file-20190211-174887-he8zql.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/258334/original/file-20190211-174887-he8zql.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/258334/original/file-20190211-174887-he8zql.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/258334/original/file-20190211-174887-he8zql.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/258334/original/file-20190211-174887-he8zql.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Volunteering has benefits for the volunteers, too.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/staff-serving-food-homeless-shelter-kitchen-184909757">Monkey Business Images/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>Giving benefits the giver, too</h2>
<p>Contribution helps givers and receivers. More and more evidence links giving and doing things for others with improved psychological and physical health. Volunteering and providing assistance has been correlated with <a href="https://doi.org/10.1111/1467-9280.14461">lower mortality</a>, <a href="https://doi.org/10.1097/PSY.0b013e31829de2e7">fewer health problems</a> and <a href="https://doi.org/10.1177/002214650504600106">less depression</a>.</p>
<p>And of course adolescents experience such benefits, as well. In an intriguing study, researchers randomly assigned one group of youths to participate in a program providing support and companionship to the elderly. Compared to a control group of teens, these adolescents later had <a href="https://doi.org/10.1001/jamapediatrics.2013.1100">lower circulating levels of inflammation</a> – a marker known to be associated with a variety of chronic health problems.</p>
<p><a href="http://dx.doi.org/10.1037/emo0000494">Another study</a> observed that helping others on a daily basis <a href="https://theconversation.com/teens-who-feel-down-may-benefit-from-picking-others-up-101882">improved the mood of youth</a>, particularly for those who suffered from higher levels of depressive symptoms. Our team even observed that adolescents were significantly <a href="http://dx.doi.org/10.1037/a0014728">happier on days in which they helped</a> their families, due in part to their sense of fulfilling an important role in the family.</p>
<h2>Helping meet the need to contribute</h2>
<p>Providing youth with the opportunity to make contributions to others would seem to be a win-win: Youth gain skills and maintain well-being while communities benefit from their efforts. But are adolescents currently offered such opportunities in their daily lives?</p>
<p>First think about the home setting. Do families give adolescents a chance to participate in decision-making that affects themselves and their relatives? Do youth make instrumental contributions to their families, whether through daily chores or in more substantial ways like helping siblings with schoolwork?</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/258331/original/file-20190211-174880-1gsfkqg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/258331/original/file-20190211-174880-1gsfkqg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/258331/original/file-20190211-174880-1gsfkqg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/258331/original/file-20190211-174880-1gsfkqg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/258331/original/file-20190211-174880-1gsfkqg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/258331/original/file-20190211-174880-1gsfkqg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/258331/original/file-20190211-174880-1gsfkqg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/258331/original/file-20190211-174880-1gsfkqg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Teens can help other students outside the classroom.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/couple-classmates-working-together-on-laptop-200191874">antoniodiaz/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>In the school environment, do students feel as if their opinions are valued and their suggestions are considered? Are there enough slots in student leadership and extracurricular activities to give all students the opportunity to participate?</p>
<p>In the broader community, people must be welcoming of adolescents’ unique contributions, even when they may differ from the adults’. Are quality programs – those that allow youth to have a say – equitably available to the ethnically and economically diverse youth of today? <a href="https://doi.org/10.17226/10022">Several national organizations</a> such as Boys and Girls Clubs of America and 4-H aim to make it so, but limited resources can be a significant hurdle.</p>
<p>Figuring out ways to promote youth contribution can be challenging. Decisions need to be made about the appropriate type and amount, and responsible adults sometimes need to limit what adolescents can and should do. For example, participation in student governance would be positive, but taking on excessive job responsibilities that interfere with schooling and sleep would be detrimental. These decisions likely vary according to the norms and values of each community. And people must make a conscious effort to confront parochialism, by which adolescents and adults tend to give and do more for others like themselves.</p>
<p>Nevertheless, at a time in history when many economies no longer depend upon child and adolescent labor, perhaps the understandable desire to protect youth has led many people to forget an important ingredient in the period of life often called the “<a href="https://www.simonandschuster.com/books/Apprenticeship-for-Adulthood/Stephen-F-Hamilton/9781451602364">apprenticeship for adulthood</a>.” Adolescents appear to be primed to give and contribute to others. They and our communities could benefit greatly if we collectively find more opportunities for them to do so in their daily lives.</p><img src="https://counter.theconversation.com/content/110424/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andrew J. Fuligni receives funding from the National Institutes of Health and the National Science Foundation. He is a board member of the Center for the Developing Adolescent.</span></em></p>Teens get a bad rap as selfish, dangerous risk-takers. But neuroscience and psychology research is revising that image: Adolescents are primed to help those around them, with positive benefits for all.Andrew J. Fuligni, Professor of Psychiatry & Psychology, University of California, Los AngelesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1018822018-08-24T10:39:56Z2018-08-24T10:39:56ZTeens who feel down may benefit from picking others up<figure><img src="https://images.theconversation.com/files/232955/original/file-20180821-149466-195vxtr.jpg?ixlib=rb-1.1.0&rect=358%2C515%2C4455%2C2661&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Boosting someone else may deliver a mood boost to you too.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/QqJiA8cZ3Ds">Mohamed Nohassi/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p><em><a href="https://theconversation.com/como-apoyar-a-un-hijo-con-depresion-ensenale-a-ayudar-a-otros-102143">Leer en español</a></em>.</p>
<p>Think about the last time you helped someone out. Maybe you sent a supportive text to a stressed-out friend or gave directions to a lost stranger. </p>
<p>How did it make you feel? </p>
<p>If you said good, happy, or maybe even “warm and fuzzy,” you’re not alone. Research shows that helping others offers a number of important psychological and health benefits.</p>
<p>In daily life, people report better mood on days that they <a href="https://doi.org/10.1177/2167702615611073">assist a stranger</a> or <a href="https://doi.org/10.1037/emo0000084">offer an empathetic ear to a friend</a>. Adults who <a href="https://doi.org/10.1177/002214650704800408">volunteer</a>, <a href="https://doi.org/10.1016/j.paid.2014.05.013">spend money on others</a> and <a href="https://doi.org/10.1111/1467-9280.14461">support their spouses</a> also experience improved well-being and <a href="https://doi.org/10.1111/1467-9280.14461">reduced risk of death</a>.</p>
<p>Helping others is beneficial in part because it <a href="https://www.researchgate.net/profile/Richard_Ryan2/publication/41087502_When_Helping_Helps_Autonomous_Motivation_for_Prosocial_Behavior_and_Its_Influence_on_Well-Being_for_the_Helper_and_Recipient/links/02e7e53274d556c5f8000000.pdf">promotes social closeness and feelings of personal competence</a>. </p>
<p>As <a href="https://scholar.google.com/citations?user=6Y0_gc8AAAAJ&hl=en&oi=ao">a researcher who studies adolescent development</a>, I decided to investigate how all this might play out in teenagers. I’m interested in studying teens’ prosocial behavior – things like helping, comforting and sharing – in the context of their close relationships. Given that adolescence is a time of <a href="https://doi.org/10.1111/desc.12373">heightened emotional intensity</a>, do teens reap mood benefits from helping out others in everyday life?</p>
<h2>Teens and depression</h2>
<p>Looking back on your own high school years, you might recall feeling intensely anxious about looking cool in front of classmates or being liked by your crush. During adolescence, youth become increasingly <a href="https://doi.org/10.1146/annurev-psych-010213-115202">preoccupied with the opinions of their peers</a>, including their friends and romantic partners. Indeed, adolescence is a time when experiences of social exclusion or rejection can <a href="http://doi.org/10.1177/0963721413476512">sting particularly badly</a>.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The teenage years can be a hard time for some adolescents.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/noizephotography/3302465543">Paul De Los Reyes</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>The teenage years are also a high-risk time for developing depressive symptoms. Almost <a href="http://doi.org/10.1542/peds.2016-1878">1 in every 11</a> adolescents and young adults in the U.S. experience a major depressive episode. And, even youth with depressive symptoms who don’t meet criteria for an official diagnosis of depression are <a href="https://doi.org/10.1017/S095457941300093X">at risk for adjustment problems</a>, such as loneliness and romantic relationship difficulties.</p>
<p>Depressed adolescents, in addition to feeling hopeless and lacking self-esteem, often respond to <a href="http://psycnet.apa.org/record/2008-01178-004">social stress</a> with intensified negative emotions. For example, adolescents with major depressive disorder <a href="https://doi.org/10.1093/scan/nst175">take peer rejection harder</a> than do their healthy peers.</p>
<p>If depressed adolescents feel especially bad after negative social encounters, might they feel especially good after positive social encounters? Psychologists know that in general adolescents’ concerns about social approval can make positive interpersonal interactions – like offering a peer support or assistance – <a href="https://doi.org/10.1016/j.dcn.2016.11.008">all the more rewarding</a>. I wanted to see if that held even for teens who were feeling down.</p>
<h2>Did you help someone today?</h2>
<p>In <a href="https://doi.org/10.1037/emo0000494">our 2018 study</a>, <a href="https://dornsife.usc.edu/labs/margolinfamilystudies/graduate-students/">my colleagues and I</a> examined teenagers’ prosocial behavior in their everyday interactions with friends and romantic partners. Our goal was to understand whether giving help is particularly mood-enhancing for youth with depressive symptoms. </p>
<p>We recruited 99 late adolescents from the community around us in Los Angeles. Most of them were high school students or recent high school graduates. First we assessed their depressive symptoms in the lab so we could find out how they’d been feeling the prior couple weeks.</p>
<p>Then we asked them to complete 10 consecutive days of short surveys at home. Each of the 10 days, participants told us whether they helped out their friends or romantic partners – things like doing them a favor, or making them feel important. They also reported their own mood.</p>
<p>On days that teens helped their friends or dating partners, they experienced increased positive mood. Even if their mood wasn’t great the day before or if they themselves didn’t receive any social support that day, helping someone else was still related to a boost in their spirits.</p>
<p>But does helping help some teens more than others? The positive effects of day-to-day prosocial behavior on mood that we saw were strongest for teens with higher levels of depressive symptoms. So youth with elevated emotional distress reaped the greatest mood benefits from lending their peers a helping hand. </p>
<p>While we often talk about the importance of receiving social support when we’re feeling down, these findings highlight the unique value of providing support to others.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Teens felt better when they supported a friend.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/gRj8fOks0eg">Justin Groep/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h2>Helping others helps yourself</h2>
<p>This study provides a glimpse into the potential benefits of help-giving for teens, particularly those experiencing depressive symptoms. Our finding builds upon previous research demonstrating that prosocial behavior is most rewarding for people experiencing <a href="https://doi.org/10.1037/a0027761">social anxiety</a>, <a href="https://doi.org/10.1111/jopy.12299">neuroticism</a> and <a href="https://doi.org/10.1016/j.paid.2017.10.042">body dissatisfaction</a>.</p>
<p>Although we did not test for underlying mechanisms for why this might be, it’s possible that providing help can make individuals feel <a href="https://doi.org/10.1371/journal.pone.0051380">appreciated by others</a> or promote <a href="https://doi.org/10.1080/17439760.2016.1209541">their sense of purpose</a> and <a href="https://doi.org/10.1016/j.adolescence.2017.04.002">self-esteem</a>. For youth with high levels of social-emotional distress, opportunities to strengthen social connections and feel competent within close relationships might be especially important for improving mood.</p>
<p>Many studies linking prosocial behavior to mood, ours included, are correlational — we cannot conclude that helping friends or romantic others causes more positive mood. Experimental studies that <a href="https://doi.org/10.1037/a0027761">randomly assign some participants to engage in acts of kindness</a> and others to engage in non-helping social activities will help rule out the possibility that it’s actually positive mood that drives subsequent prosocial behavior.</p>
<p>It’s also important to keep in mind that very few of our participants were clinically depressed. Research still needs to determine whether prosocial behavior is similarly linked to positive mood among adolescents with a diagnosed depressive disorder. An interesting question is whether some depressed youth experience emotional “burnout” from very frequent help-giving.</p>
<p>Although the word “adolescence” may conjure up images of reckless teens experiencing interpersonal conflict and emotional turmoil, the adolescent years are a time of great social opportunity and growth. Understanding when, how and why teens behave prosocially – and for whom help-giving most promotes well-being – can contribute to our understanding of adolescent social development.</p><img src="https://counter.theconversation.com/content/101882/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This material is based upon work supported by a National Science Foundation SBE Postdoctoral Research Fellowship awarded to Dr. Hannah L. Schacter under Grant No. 1714304.
This project is also based on work supported by NSF BCS-1627272 (Dr. Gayla Margolin, PI) and NIH-NICHD R21-HD072170 A1 (Dr. Gayla Margolin, PI).
Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author and do not necessarily reflect the views of the National Science Foundation or the National Institutes of Health.</span></em></p>Psychology researchers found that daily acts of kindness were linked to increases in positive mood – especially for teens who felt depressed.Hannah L. Schacter, Postdoctoral Research Fellow in Psychology, USC Dornsife College of Letters, Arts and SciencesLicensed as Creative Commons – attribution, no derivatives.