關於 poor mental health中文 ，我們在網路上蒐集到這些相關的討論、資訊與評價

今早為Asian Medical Students Association Hong Kong (AMSAHK)的新一屆執行委員會就職典禮作致詞分享嘉賓，題目為「疫情中的健康不公平」。
感謝他們的熱情款待以及為整段致詞拍了影片。以下我附上致詞的英文原稿：

It's been my honor to be invited to give the closing remarks for the Inauguration Ceremony for the incoming executive committee of the Asian Medical Students' Association Hong Kong (AMSAHK) this morning. A video has been taken for the remarks I made regarding health inequalities during the COVID-19 pandemic (big thanks to the student who withstood the soreness of her arm for holding the camera up for 15 minutes straight), and here's the transcript of the main body of the speech that goes with this video:

//The coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, continues to be rampant around the world since early 2020, resulting in more than 55 million cases and 1.3 million deaths worldwide as of today. (So no! It’s not a hoax for those conspiracy theorists out there!) A higher rate of incidence and deaths, as well as worse health-related quality of life have been widely observed in the socially disadvantaged groups, including people of lower socioeconomic position, older persons, migrants, ethnic minority and communities of color, etc. While epidemiologists and scientists around the world are dedicated in gathering scientific evidence on the specific causes and determinants of the health inequalities observed in different countries and regions, we can apply the Social Determinants of Health Conceptual Framework developed by the World Health Organization team led by the eminent Prof Sir Michael Marmot, world’s leading social epidemiologist, to understand and delineate these social determinants of health inequalities related to the COVID-19 pandemic.

According to this framework, social determinants of health can be largely categorized into two types – 1) the lower stream, intermediary determinants, and 2) the upper stream, structural and macro-environmental determinants. For the COVID-19 pandemic, we realized that the lower stream factors may include material circumstances, such as people’s living and working conditions. For instance, the nature of the occupations of these people of lower socioeconomic position tends to require them to travel outside to work, i.e., they cannot work from home, which is a luxury for people who can afford to do it. This lack of choice in the location of occupation may expose them to greater risk of infection through more transportation and interactions with strangers. We have also seen infection clusters among crowded places like elderly homes, public housing estates, and boarding houses for foreign domestic helpers. Moreover, these socially disadvantaged people tend to have lower financial and social capital – it can be observed that they were more likely to be deprived of personal protective equipment like face masks and hand sanitizers, especially during the earlier days of the pandemic. On the other hand, the upper stream, structural determinants of health may include policies related to public health, education, macroeconomics, social protection and welfare, as well as our governance… and last, but not least, our culture and values. If the socioeconomic and political contexts are not favorable to the socially disadvantaged, their health and well-being will be disproportionately affected by the pandemic. Therefore, if we, as a society, espouse to address and reduce the problem of health inequalities, social determinants of health cannot be overlooked in devising and designing any public health-related strategies, measures and policies.

Although a higher rate of incidence and deaths have been widely observed in the socially disadvantaged groups, especially in countries with severe COVID-19 outbreaks, this phenomenon seems to be less discussed and less covered by media in Hong Kong, where the disease incidence is relatively low when compared with other countries around the world. Before the resurgence of local cases in early July, local spread of COVID-19 was sporadic and most cases were imported. In the earlier days of the pandemic, most cases were primarily imported by travelers and return-students studying overseas, leading to a minor surge between mid-March and mid-April of 874 new cases. Most of these cases during Spring were people who could afford to travel and study abroad, and thus tended to be more well-off. Therefore, some would say the expected social gradient in health impact did not seem to exist in Hong Kong, but may I remind you that, it is only the case when we focus on COVID-19-specific incidence and mortality alone. But can we really deduce from this that COVID-19-related health inequality does not exist in Hong Kong? According to the Social Determinants of Health Framework mentioned earlier, the obvious answer is “No, of course not.” And here’s why…

In addition to the direct disease burden, the COVID-19 outbreak and its associated containment measures (such as economic lockdown, mandatory social distancing, and change of work arrangements) could have unequal wider socioeconomic impacts on the general population, especially in regions with pervasive existing social inequalities. Given the limited resources and capacity of the socioeconomically disadvantaged to respond to emergency and adverse events, their general health and well-being are likely to be unduly and inordinately affected by the abrupt changes in their daily economic and social conditions, like job loss and insecurity, brought about by the COVID-19 outbreak and the corresponding containment and mitigation measures of which the main purpose was supposedly disease prevention and health protection at the first place. As such, focusing only on COVID-19 incidence or mortality as the outcomes of concern to address health inequalities may leave out important aspects of life that contributes significantly to people’s health. Recently, my research team and I collaborated with Sir Michael Marmot in a Hong Kong study, and found that the poor people in Hong Kong fared worse in every aspects of life than their richer counterparts in terms of economic activity, personal protective equipment, personal hygiene practice, as well as well-being and health after the COVID-19 outbreak. We also found that part of the observed health inequality can be attributed to the pandemic and its related containment measures via people’s concerns over their own and their families’ livelihood and economic activity. In other words, health inequalities were contributed by the pandemic even in a city where incidence is relatively low through other social determinants of health that directly concerned the livelihood and economic activity of the people. So in this study, we confirmed that focusing only on the incident and death cases as the outcomes of concern to address health inequalities is like a story half-told, and would severely truncate and distort the reality.

Truth be told, health inequality does not only appear after the pandemic outbreak of COVID-19, it is a pre-existing condition in countries and regions around the world, including Hong Kong. My research over the years have consistently shown that people in lower socioeconomic position tend to have worse physical and mental health status. Nevertheless, precisely because health inequality is nothing new, there are always voices in our society trying to dismiss the problem, arguing that it is only natural to have wealth inequality in any capitalistic society. However, in reckoning with health inequalities, we need to go beyond just figuring out the disparities or differences in health status between the poor and the rich, and we need to raise an ethically relevant question: are these inequalities, disparities and differences remediable? Can they be fixed? Can we do something about them? If they are remediable, and we can do something about them but we haven’t, then we’d say these inequalities are ultimately unjust and unfair. In other words, a society that prides itself in pursuing justice must, and I say must, strive to address and reduce these unfair health inequalities. Borrowing the words from famed sociologist Judith Butler, “the virus alone does not discriminate,” but “social and economic inequality will make sure that it does.” With COVID-19, we learn that it is not only the individuals who are sick, but our society. And it’s time we do something about it.

Thank you very much!//

Please join me in congratulating the incoming executive committee of AMSAHK and giving them the best wishes for their future endeavor!

Roger Chung, PhD
Assistant Professor, CUHK JC School of Public Health and Primary Care, @CUHK Medicine, The Chinese University of Hong Kong 香港中文大學 - CUHK
Associate Director, CUHK Institute of Health Equity

【玳瑚師父出差錄】 地靈人傑
It takes a remarkable place to produce great people (English version below)

上星期四，我到一佛教道場義務勘察風水。爲何義務呢？

一， 是佛菩薩的意思；

二， 履行我要弘揚佛法和玄學的發願；

三，一份貢獻給三寶和衆生。

這是個風水很差的一個地方。慶幸負責人相信風水能補助法務，如果我沒有到來，將來的發展會不堪設想。

一個道場若風水不好，面臨的問題如：

一， 名聲不好，信眾稀少；

二， 捐款不足，無法維持開銷；

三， 人事紛爭，無法成辦事情；

四， 來共修者，道心難堅固；

五， 法務發展，坎坎坷坷，諸多阻擾；

六， 工作人員，健康與精神每況愈下；

等等等。

如果所投進的資源和心血都因爲爛的風水而功虧一篑，那是多麽可惜啊！

在新加坡，烏節路、總統府、新加坡國立大學和光明山普覺禪寺能夠屹立在地靈深厚的地方絕非巧合。

一個地方爲什麽有富豪、寡婦、名人、獎學金得主、流氓、雙胞胎等，就是因爲地靈的孕育。沒有好的地靈，如何能生出人傑？沒有地靈的地，是一塊庸地。庸地長出來的就是庸才，如何行法？ 古時，佛教的祖師爺和道家的仙師，在深山閉關的岩洞都是風水寳地，即藏風聚氣又地靈深厚。得到地靈之氣，修行的努力才能更早開花結果，否則一概付之流水。

好的風水能夠產生出心地善良的人，歡喜地學習佛法、佛法才得以弘揚。如果不懂得運用風水的力量來協助法務，得不到「天時地利人和」中的地利，太可惜，太遺憾了！

附上的照片是一幅文殊師利菩薩的曼陀羅。 八大菩薩中，文殊師利菩薩以智慧第一聞名。玄學是上天憐憫世人而傳下來的一個古老智慧，助世人改善命運。祈願菩薩的智慧劍能砍斷衆生的無明，讓更多人明白風水能夠補助弘法的珍貴。

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Last Thursday, I visited a Buddhist cultivation center and did a Feng Shui analysis at no charge.

Why? You may ask. For 3 good reasons:

1. It is a directive from the Buddhas and Bodhisattvas

2. It is a fulfillment of my vow to propagate the Dharma and the Chinese Metaphysics.

3. It is my offering to the Three Jewels (the Buddha, the Dharma and the Sangha) and the sentient beings.

The Feng Shui of this place is poor. It is heartening to know that the person-in-charge believes in the use of Fengshui to better aid the propagation of the Dharma. Had I not have the affinity to visit, the future development of cultivation center is unthinkable.

Typical problems that will besiege a place of worship with poor Fengshui:

1. Poor reputation with very few worshippers

2. Insufficient incoming donation to cover operating expenses

3. Constant conflicts among the members, hindering the operation of the place

4. Shaky faith among worshipers

5. Multiple challenges hampering the progress of Dharma propagation

6. Degeneration of the physical and mental health of the staff

etc.

Can you imagine how wasteful that all the efforts and resources are going down the drain because of poor Feng Shui?

Why are some places famed (for the better or worse) for having wealthy millionaires, widows, celebrities, academics, gangsters, twins etc? It is predominantly down to the ground energy in the land formation. A land with poor ground energy and formation is not capable of producing men and women of high calibre. It is but a waste land and a waste land only yields weeds of mediocre people who will not practice, much less propagate, the Dharma. In ancient times, our great Buddhist and Taoist masters seeked their own private retreats for their spiritual practices. These enclaves in the deep mountains were gems, harnessing the positive energy from the land and greatly accelerating the progress of these masters. Without this ground energy, years of diligent cultivation would have come to a naught.

It is not by chance that in Singapore, Orchard Road, the Istana, NUS and Kong Meng San Phor Khar See Monastery are all located on land with very powerful energies underneath.

A place with good Feng Shui can produce men and women of kindred souls and good consciences, who will enjoy the practice and accelerate propagation of the Dharma. As the Chinese saying goes, we need to be at the Right Place, with the Right People and at the Right Time. The power of geomancy creates the 'Right Place' condition and it is a great pity and shame if we fail to harness this to aid the propagation of the Dharma.

The photo attached with this post shows a Mandala with the Manjusri Bodhisattva, renowned for His transcendent wisdom, in the center. The Chinese metaphysics is an ancient wisdom bestowed by the Heaven, out of empathy, to aid sentient beings in improving their lives. May His sword of wisdom cuts away the ignorance of sentient beings, so that more can realize the true gem in utilizing Feng Shui to aid Dharma propagation.