How I support my autistic son to build an independent life

How I support my autistic son to build an independent life

Like quite a few moms and dads with younger autistic youngsters, my emphasis all of a sudden modified when my son acquired the analysis of autism spectrum ailment (ASD). Right after a very long and arduous diagnostic course of action, I shifted from wanting to know if he experienced autism to seeking for the services he necessary to learn, expand, and manage autism-associated problems. This bundled in-property remedy, university-based mostly services, and dietary therapies.

Since of the time invested in investigating and utilizing a variety of therapies, and the work invested in advocating for my son, I did not have the mental bandwidth to think way too significantly into the long run.

But as he grew, I realized that even however he had knowledgeable incredible progress all through his journey, the difficulties affiliated with autism would most likely not finish when he grew to become a legal adult. This realization designed arranging for his long run a new and urgent precedence.

Autism advocates, together with the Autistic Self Advocacy Network (ASAN), have termed for a transform from “Autism Recognition Month” to “Autism Acceptance Thirty day period” to stimulate inclusion and maximize assistance and options for autistic people.

Like lots of autistic students in the United States, my son’s educational journey from pre-college to higher faculty graduation was mapped out with an Individualized Educational System (IEP). An IEP is a lawfully binding document formulated and instituted when a baby satisfies the general public school’s requirements for specialized education and learning.

This document outlines the child’s demands and layouts an academic plan to meet individuals wants most effective, no matter if by speech and language therapy, occupational treatment, or the addition of support people today like paraprofessionals to assist the boy or girl during the working day.

With an IEP in place, a child’s educational journey does not have to finish at 18. As a substitute, the youthful man or woman and their mom and dad can come to a decision to proceed attending university up to age 21.

This 18–21 period is deemed one particular of “transitions”— and is made to change the youthful human being from educational-centered to grownup-oriented learning. Much of this features teaching independent residing and work abilities.

In the United States, data counsel that 500,000 youthful older people with autism will transition into adulthood over the next 5 a long time.

Regretably, numerous educational facilities really don’t have the means to create transitions packages that absolutely handle the desires of autistic students coming into the grownup earth.

A Centers for Sickness Handle and Prevention (CDC) survey working with mother or father-reported data from the Nationwide Study of Children’s Wellbeing identified that autistic students were considerably less probable to acquire changeover planning than kids with other psychological or behavioral circumstances.

On top of that, even if a transitions software exists, it might not go over all the gaps in expert services that suddenly arise when the child reaches 18 several years old. Mom and dad frequently refer to this sudden loss of solutions as the autism cliff.

When confronted with a unexpected reduction or reduction of solutions, parents of autistic youngsters will have to build a bridge in excess of that gap. And they may possibly not normally have the information and sources required to construct it, which leaves them unsure about what to do following.

Thankfully, my son’s encounter has been diverse owing to the charter school for autism he attends. His school, Lakeland STAR University/Academy, was developed in 2018 by a team of committed dad and mom, instructional gurus, and group members and supported by generous donors. STAR serves assorted learners in grades 7–12 and has a transitions-focused curriculum.

However, because autism charges proceed to rise, the school has witnessed large progress. As place to enroll new college students became constrained, a require for a separate transitions application emerged.

To handle this require, Lakeland STAR is now creating a transitions middle with the assistance of neighborhood-centered corporations, which include Aspirus Overall health, Lakeland Union Significant College (LUHS), the Howard Young Basis (HYF), and the HYF Women’s Legacy Council.

Scheduled to open up in the drop of 2022, the heart will provide transitions-primarily based education, which include impartial living capabilities, career expertise training, and associated companies. The new middle will help my son and other autistic younger grown ups bridge the hole over the autism cliff and into the grownup earth.

Still, by my experiences, I’ve discovered that transitioning is more than just transition courses. It also incorporates essential legal aspects of turning out to be an grownup relating to health care and finances.

Relying on the stage of assistance the youthful individual requirements, these legal aspects may incorporate determining whether or not to pursue authorized guardianship, fiscal electrical power of attorney (POA), or ability of health (POH). In the U.S., a guardian have to entire these paperwork right before the younger adult’s 18th birthday.

More than the many years, I’ve heard numerous mom and dad and caregivers make clear the incredible worries of navigating funds and health care just after their autistic child reaches adulthood. And this is particularly genuine if there are no legal paperwork in position that makes it possible for mom and dad to have some oversight in their child’s decision-making following they convert 18.

Lawful files may be necessary due to the fact autism often influences government performing, expressive and receptive language skills, and social skills — leading to unexpected issues in the adult environment.

For instance, govt operating issues could make it hard for an autistic individual to arrange their finances and spend payments on time. This could guide to decline of housing or referrals to credit card debt selection agencies.

Autistic folks could also have a larger danger of exploitation and victimization from other people because of to social difficulties. For the reason that of this, they could experience fraud or other economical abuse without having vital legal safeguards in spot.

Also, expressive and receptive language worries could guide to miscommunication with authorities, resulting in unwarranted legal problems.

Challenges with health care can also occur. For occasion, in the U.S., health-related experts can’t focus on an adult’s health-related situation with parents or caregivers without having guardianship or energetic electricity of attorney for health care. So, an autistic particular person could not have the help they need in a medical emergency.

Whilst autistic grownups who have to have minimum aid can normally deal with many facets of adult life on their personal, it is not normally quick to decide this by the time they flip 18. For that reason, it’s often in the child’s finest fascination to set up lawful paperwork till guidance individuals can thoroughly recognize the young person’s talents.

For some moms and dads in the U.S., specially people who assist an autistic youngster with substantial verbal interaction challenges, guardianship is the solution to this legal dilemma. Even so, acquiring this degree of authorized oversight can be a intricate method.

Frequently, you need to have a clinical experienced to declare that the autistic young particular person is not able to make their possess choices and then go by way of a detailed court docket approach.

In addition, starting to be your child’s guardian requires managing their funds and clinical desires as a different person. Other dad and mom have instructed me that taking care of guardianship is like a comprehensive-time work, but most consider it a labor of appreciate.

However, for numerous autistic grownups, an energetic energy of attorney for healthcare and funds is enough simply because it lets some oversight on choices still leaves individuality and conclusion-producing intact. These documents are drawn up by a law firm and signed by the autistic man or woman before long following reaching the age of 18.

In my son’s situation, although he wants small guidance, he was welcoming of the thought of giving his father and myself the means to help him financially and medically when essential.

This acceptance of help may be partly thanks to his self-awareness — a little something that started evolving shortly right after I was clear with him about his prognosis at a youthful age. I imagine this understanding has assisted him comprehend himself superior and much more very easily discover places in his lifetime where he might have to have a lot more support.

Autistic individuals have numerous strengths that make work or attending college or university extra than attainable. Nonetheless, study from 2017 suggests that about 38{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of autistic adults are unemployed. In addition, estimates reveal that only 17{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of autistic students graduating from high university show up at a 4-calendar year college.

Even now, a transitions application can enable raise employment and write-up-secondary attendance for autistic persons.

In my son’s problem, his school has served by looking out position encounters in the group. However, these career ordeals are slightly different than a common work experience.

For case in point, the employer is informed their new worker has ASD and will make accommodations to guidance their requires. In other conditions, a occupation mentor will accompany the autistic worker when they begin their task and slowly withdraw support as desired.

Luckily, our neighborhood has been extremely supportive of autistic staff. For example, no nearby enterprise has turned down the chance to take part in the Lakeland STAR job experience system.

In addition to employment, attending faculty or a technical faculty might also be an alternative for my son. Like many autistic friends, he has certain interests and passions that can completely transform into a rewarding vocation. His come about to be heritage and the visible arts, such as filmmaking and developing documentaries.

Even so, just like neurotypical people, autistic persons have numerous pursuits and skillsets. For instance, some of my son’s schoolmates are fascinated in automobile mechanics, laptop coding, or the culinary arts.

Thankfully, post-secondary faculties are getting extra accommodating to autistic college students, creating college or university a additional attainable objective. Having said that, I am just commencing to navigate this system, which incorporates strategies to call numerous visual arts and filmmaking schools to inquire about their autism-particular support companies.

Stats advise that about 87{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of autistic older people live with or have lived with a guardian at some stage in their life. Nevertheless, even when living independently, some autistic grown ups nonetheless require help.

Mainly because unbiased living necessitates quite a few techniques, my son’s father and I have begun the process of educating my son matters like doing laundry, spending expenses, and procuring for and making ready food. In addition, his school’s impartial living lessons have addressed these expertise, which will continue when he attends the new transition middle.

Also, with the help of others, I was privileged more than enough to get a modest household near to me. This dwelling will at some point provide as my son’s house while adjusting to adult lifestyle and discovering to stay independently.

On the other hand, I notice that my son’s condition is not usual, as the fact continues to be that housing for grown ups with ASD is complicated to come across. Thus, long run aims for our local community incorporate a plan for supportive housing that caters to persons with specific wants like autism.

As for me, my son, and his father — we are just starting to make a bridge in excess of the “autism cliff.” And so significantly, I’d say we have an superb basis to aid its building.

Even now, because of the ongoing difficulties linked with ASD, I am not confident this bridge will ever be full. Instead, we may perhaps have to modify it as our son’s needs change.

With any luck ,, sometime before long, each individual autistic youthful particular person will have a perfectly-outlined route to cross as they transition into adulthood.

To be most efficient, this pathway wants to contain changeover applications, expanded employment chances, and correct and supportive housing.

While it looks like a momentous process, I have realized that it is possible. Specifically with the support of good friends, loved ones, and group customers focused to developing a environment exactly where autism is recognized and woven by the fabric of culture — as I imagine it really should be.

‘It’s Life or Death’: The Mental Health Crisis Among U.S. Teens

‘It’s Life or Death’: The Mental Health Crisis Among U.S. Teens

How the reporter Matt Richtel spoke to adolescents and dad and mom for this sequence

In mid-April, I was talking to the mother of a suicidal teen whose struggles I’ve been carefully adhering to. I requested how her daughter was doing.

Not perfectly, the mother mentioned: “If we cannot come across something drastic to aid this kid, this kid will not be listed here extensive-time period.” She started off to cry. “It’s out of our palms, it’s out of our manage,” she reported. “We’re making an attempt all the things.”

She additional: “It’s like waiting around for the stop.”

Above nearly 18 months of reporting, I obtained to know a lot of adolescents and their people and interviewed dozens of health professionals, therapists and experts in the science of adolescence. I read wrenching tales of suffering and uncertainty. From the outset, my editors and I talked over how best to handle the identities of people today in crisis.

The Moments sets a substantial bar for granting sources anonymity our stylebook phone calls it “a very last resort” for cases where by important information cannot be revealed any other way. Normally, the resources could face a menace to their profession or even their security, regardless of whether from a vindictive manager or a hostile governing administration.

In this case, the need to have for anonymity had a different vital: to shield the privateness of youthful, vulnerable adolescents. They have self-harmed and tried suicide, and some have threatened to try out yet again. In recounting their stories, we experienced to be conscious that our to start with duty was to their security.

If The Moments posted the names of these adolescents, they could be conveniently determined several years later on. Would that harm their work alternatives? Would a teenager — a lawful minor — later regret obtaining exposed his or her id during a time period of discomfort and battle? Would observing the story revealed amplify ongoing crises?

As a consequence, some young adults are identified by initially preliminary only some of their mothers and fathers are discovered by initially name or original. Above months, I obtained to know M, J and C, and in Kentucky, I came to know battling adolescents I recognized only by their ages, 12, 13 and 15. In some stories, we did not publish exactly exactly where the families lived.

Every person I interviewed gave their personal consent, and mom and dad had been ordinarily current for the interviews with their adolescents. On a couple of situations, a mother or father provided to leave the space, or an adolescent requested for privacy and the mother or father agreed.

In these content, I listened to grief, confusion and a desperate lookup for solutions. The voices of adolescents and their dad and mom, whilst shielded by anonymity, deepen an comprehending of this mental wellbeing crisis.

Exercise may protect brain health by keeping insulin, BMI levels low

Exercise may protect brain health by keeping insulin, BMI levels low

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How does exercise protect brain health? New research sheds light. Suhaimi Abdullah/NurPhoto via Getty Images
  • Existing studies show that exercise helps protect brain cells through mechanisms that researchers do not yet fully understand.
  • Researchers know that exercise increases brain glucose metabolism, which correlates with improved brain function.
  • Studies show that exercise affects insulin resistance and has a complex relationship with body mass index (BMI) levels.
  • A new study suggests that exercise plays a role in maintaining insulin and BMI levels, which may help stave off dementia by protecting gray matter volume in the brain.

A new study investigates the mechanisms involved in the relationship between exercise and brain health.

Previous research had shown that larger gray matter volume can help protect against dementia by improving brain function.

The new study shows that insulin resistance and BMI mediate the relationship between larger and smaller brain gray matter volumes (the part of the brain involved in processing information).

The research is published in the April 2022 online issue of Neurology, the medical journal of the American Academy of Neurology.

The corresponding author of the study was Dr. Geraldine Poisnel, of the Inserm Regional Research Center, in Caen, Normandy, France.

The study involved 134 people with an average age of 69 who had no memory problems. The participants filled out a physical activity survey covering the past 12 months. They also had brain scans to measure glucose metabolism and brain volume.

The metabolism of glucose in the brain provides fuel for the brain by generating adenosine 5′-triphosphate (ATP) — a key molecule for maintaining the health of neurons and other cells. ATP is also key for generating neurotransmitters. Reduced glucose metabolism in the brain can be seen in people with dementia.

Gray matter development peaks at age 2–3 years. It begins to decrease afterward in some areas of the brain, but the density of the gray matter increases. From an evolutionary perspective, the higher processing ability of the human brain and its development are due to this increase in density.

In some studies, larger total brain volume, estimated by magnetic resonance imaging (MRI), has a weak correlation with higher intelligence in men and a very weak correlation in women with the ability to do well in intelligence tests.

In contrast, brain tissue deterioration and loss of volume is a significant contributor to lower cognitive ability later in life.

In the new study, researchers included 134 people with an average age of 69 who had no memory problems. The participants filled out a physical activity survey covering the past 12 months. They also had brain scans to measure glucose metabolism and brain volume.

In the new study, researchers gathered formation on cardiovascular risk factors including BMI and insulin levels, as well as cholesterol, blood pressure, and other factors.

The researchers examined the relationship between insulin and cardiovascular disease. The metabolic abnormalities that insulin causes raise the risk of cardiovascular complications, which in turn affect brain function.

Researchers found that insulin and BMI levels did not affect the metabolism of glucose in the brain.

The research demonstrated that the amount of amyloid plaque in the brain that contributes to Alzheimer’s Disease was not affected by exercise.

Medical News Today contacted Dr. Raeanne Moore, associate adjunct professor of psychiatry at UCSD in La Jolla, CA.

Dr. Moore, who was not involved in the study, was asked about the study results. She shared with MNT:

“This study adds to the growing body of research on the positive benefits of staying active on brain health, especially as we age.”

“[T]here is an urgent need to identify markers of cognitive decline,” added Dr. Moore. “Decreasing insulin levels and losing weight are modifiable factors that can be improved with a healthy diet and exercise.”

She added, “It was not surprising that higher physical activity was not associated with how much amyloid plaque people had in their brains. There is growing evidence that vascular risk factors on cognitive function are mediated by the amount of tau pathology in the brain and not an amyloid burden.”

MNT also spoke with Dr. Sheldon Zablow, assistant professor of medicine at University of California San Diego Medical School in La Jolla, CA. Dr. Zablow shared his comments about this study:

“Exercise has often been called food for the brain with many studies showing the benefit of exercise for improving brain health and reducing the risk of dementia.”

“This current research study states that physical activity improves cognitive brain function by reducing BMI and improving insulin metabolism. Improvement in weight control can limit the rate of brain volume loss, a known risk factor for dementia.”

“This study will help physicians reinforce the importance of regular exercise in reducing BMI as a low-cost means of limiting cognitive decline.”

– Dr. Zablow

Dr. Moore’s final remarks were, “The literature clearly demonstrates that cardiovascular risk factors are associated with cognitive decline and risk for Alzheimer’s disease and related dementias.”

“Studies investigating subtle brain changes prior to the development of dementia are critical to optimizing brain health and staving off cognitive decline.”

“Strengths of this study include a sample of cognitively normal older adults and the use of multimodal imaging methods to explore the role of CVD risk factors in the association between physical activity and neuroimaging biomarkers,” said Dr. Moore.

“[T]his methodology can move the field forward by helping to identify important markers of risk for cognitive decline.”

“A limitation to the study was the use of a self-report of physical activity […] which the authors acknowledged as a limitation. Self-report of physical activity is prone to retrospective recall bias, and objective tools to measure physical activity, such as fitness trackers, are more accurate.”

“These findings that insulin and BMI fully mediated the relationship between physical activity and whole-brain gray matter volume — and specifically hippocampal gray matter volume — provide further evidence that targeting these modifiable CVD risk factors could improve brain health.”

Climate change: The impact on health

Climate change: The impact on health

The consensus among scientists is that we are in an era of global heating and extreme weather events, primarily due to the devastating effects of human action on the environment. Why are researchers concerned, and what are the implications for health?

The Lancet Countdown team is a group of over 120 leading experts on climate, public health, economy, and political science — among others — who have committed to monitoring climate change, particularly its impact on global health.

Since 2015, the year of the Paris Agreement, the experts affiliated with the Lancet Countdown commission have published yearly reports assessing this situation and keeping signatory governments and decision-makers accountable for the commitments they have taken on following the Agreement.

The latest report, which appeared in The Lancet in October 2021, records “deepening inequities” across all regions as global heating remains a concern. The report discusses the impact of climate change in the context of the COVID-19 pandemic, and it emphasizes the concern caused by extreme heat events and related natural disasters that have occurred over the past 2 years.

Among the issues outlined in the Lancet Countdown report 2021, there is the impact of climate change on the livelihood of communities around the world, its direct and indirect effect on mental and physical health, and the way in which it contributes to the spread of infectious diseases.

These findings largely coincide with those outlined by another set of landmark reports on climate change — those of the Intergovernmental Panel on Climate Change (IPCC).

According to the IPCC 2022 reports, at present, extreme weather events caused by human action are surpassing the resilience of some ecological and human systems, sometimes with irreversible effects.

The reports show that weather extremes related to climate change have affected the productivity of various food sectors — including agricultural, forestry, and fishery sectors — around the world, thus exacerbating food insecurity.

They also emphasize the impact of climate change on mental health, and the ways in which it contributes to the spread of vector-borne communicable diseases.

In our latest installment of the In Conversation podcast, we discuss these aspects at length with two key experts. One of them is Prof. David Pencheon, honorary professor of health and sustainable development at the University of Exeter in the United Kingdom, and founder of the Sustainable Development Unit for National Health Services England and Public Health England.

Our other interviewee is Dr. Marina Romanello, a research fellow at the University College London Institute for Global Health, research director of the Lancet Countdown on Health and Climate Change, and one of the co-authors of the latest Lancet Countdown reports.

You can listen to our podcast in full below, or on your preferred streaming platform.

According to the Lancet Countdown report 2021, “[t]he world is now 1.2 [degrees Celsius] warmer than in the pre-industrial period (1850–1900),” with the past few years recorded as the hottest yet — 2016 has seen the highest levels of heat around the world.

The IPCC reports 2022 record the current global heat level as even higher, placing it at 1.5 degrees Celsius (34.7 degrees Fahrenheit) hotter compared with the pre-industrial period.

According to data from the National Aeronautics and Space Administration (NASA), most of the global heating has occurred abruptly over the past 40 years as a result of human activity that has led to an increase in greenhouse gas levels.

“[G]reenhouse gases that have been accumulating in the atmosphere due to human activity are gases like carbon dioxide [and] methane. And what these gases do is [that they] basically absorb the heat, and they don’t allow heat that comes from the Sun into the Earth [to] be reflected back into space,” Dr. Romanello explained.

“So what happens [as a result] is that, as heat from the Sun reaches the Earth, they act like a blanket, they trap the heat inside the Earth’s atmosphere, and that makes the temperatures go up. And that is part of what climate change is, because that generates cascading effects in terms of increasing [the] temperatures of the water. That alters hydrological cycles and generates other impacts on the climate [and] on our environment that add to the whole combo that we call ‘climate change’.”

– Dr. Marina Romanello

But what does this mean for health? For one, climate change puts in motion a complex “domino effect” that ultimately impacts people’s livelihoods, their access to food security, and to clean water, all of which are crucial to human health.

One example is that of melting glaciers. Research published in Nature in 2021 confirms that glaciers, melting due to the steady rise in global temperatures, have driven approximately 21{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the rise in sea levels over the previous 20 years.

Global heating also leads to marine heatwaves, which in conjunction with the rise in sea levels impact marine ecosystems. Such effects can alter fishing practices and reduce the availability of marine resources for coastal communities.

Moreover, rising sea levels also increase the risk of catastrophic floods that endanger the lives of those residing in coastal areas.

The IPCC reports 2022 also emphasize the ways in which global heating has impacted agricultural productivity over the past 50 years, particularly in low- and middle-income countries, which were already struggling with food insecurity. According to IPCC data:

“Crop yields are compromised by surface ozone. Methane emissions have negatively impacted crop yields by increasing temperatures and surface ozone concentrations. Warming is negatively affecting crop and grassland quality and harvest stability. Warmer and drier conditions have increased tree mortality and forest disturbances in many temperate and boreal biomes, negatively impacting provisioning services.”

Dr. Marinello also stressed the impact of climate change on water and food security, noting that the people who are likely to be most affected are those who are already facing these issues in the first place.

“I think that one of the things that we get more worried about when we think about climate change is precisely food and water insecurity, especially because the most vulnerable in the world are at such increased level of risk from climate change that [it] adds on top of their already pretty frail food and water systems,” she told us.

“We’re seeing, on the one hand, changed precipitation patterns with increased floodings, increased droughts in different areas, we see extreme weather events that also lead to crop failure, […] all of that undermining not only crop productivity, but also crop supply chains and food supply chains,” she noted.

“And on the other hand, with the extreme heat exposure, we’re already seeing that that starts undermining crop productivity directly as well by changing the maturation times of different crops. So that also is posing limits on […] food productivity,” stressed Dr. Romanello.

But climate change, particularly extreme heat and extreme weather events, can have a more direct impact on the human body, sometimes in surprising ways.

A recent study from the Karolinska Institute in Sweden showed that more and more people are getting hospitalized with hyponatremia — abnormally low sodium levels — due to high outdoor temperatures.

“Oversimplified, hyponatremia can be the result of sodium deficiency (low intake or high losses) or excess water,” study co-author Dr. Jakob Skov told Medical News Today.

“[T]here are two plausible explanations for heat-related hyponatremia — salt loss from sweating resulting in a sodium deficit or excessive hydration due to an exaggerated fear of dehydration,” he explained.

There is also some evidence that temperature variations might influence the way in which the immune system reacts to pathogens, such as viruses. For example, a study that appeared in PNAS in 2019 looked at how efficiently the immune systems of mice reacted to influenza viruses under different temperature conditions.

The researchers found that mice that they had exposed to high ambient temperatures — of 36 degrees Celsius (96.8 degrees Fahrenheit) — had a dampened immune response to the influenza virus.

Moreover, as Prof. Pencheon and Dr. Romanello told us, heating and sudden temperature variations are also linked to other health risks. One unexpected effect might be on digestive health, as Dr. Romanello observed.

“[E]xtreme heat exposure [increases] the permeability of the digestive barriers, and therefore […] the susceptibility […] [to] infections through the digestive system,” she told us.

She also noted that “there’s a link between heat exposure and kidney disease, particularly in outdoor workers, in people working in the fields.”

“And there’s also some evidence of neurological disease being exacerbated by extreme heat exposure, like for example, [in] people that have seizures or other neurological problems,” she added.

One systematic review from August 2021 indeed showed that there was a link between increasing ambient temperatures and a worsening of symptoms of neurological conditions, from Alzheimer’s disease and Parkinson’s to epilepsy and migraine.

The review analyzed no fewer than 84 studies looking at climate change and neurological health, and it concluded that global heating may indeed contribute to worsening symptoms, a higher number of hospitalizations, and a higher risk of death related to these conditions.

Another particularly concerning issue in the context of the COVID-19 pandemic is the effect that climate change has on the spread of infectious diseases.

The Lancet Countdown 2021 report emphasizes that “the changing environmental conditions are also increasing the suitability for the transmission of many water-borne, air-borne, food-borne, and vector-borne pathogens,” undermining the efforts of medical scientists and public health organizations to mitigate this threat.

According to the Lancet Countdown report, some of the diseases whose transmissibility has increased due to climate change-related factors include malaria and diseases caused by arboviruses like dengue, Zika, and chikungunya. All these are vector-borne diseases.

Research has shown that climate change affects the environment where pathogen-carrying vectors — such as insects, particularly mosquitoes — live, impacting their migration and life cycle patterns. This can lead to the vectors carrying pathogens to different regions than the ones they initially inhabited, for example.

Climate change can also influence how long pathogen-carrying vectors survive, and it can impact the incubation period of certain viruses through temperature fluctuations.

“One of the most cited examples of how infectious diseases are changing [is] in so-called arthropod-borne diseases. These are diseases that are spread by insects [like] mosquitoes […], and of course, a lot of these insects are exquisitely sensitive to which ecosystems they can survive in,” Prof. Pencheon told us.

Because of this, he explained, malaria and other transmissible disease are spreading faster and farther around the world.

There are fears that, even as we are still navigating the COVID-19 pandemic, more epidemics — or even other pandemics — may soon arise, and climate change will, at least in part, be to blame.

In November 2021, Australian Academy of Science Fellow Prof. Edward Holmes expressed his worry that climate change will be responsible for the next pandemic:

“[Pandemics are] going to happen more and a key driver of this is climate change. As climates change animals will change their distribution; they’ll probably group together more allowing viruses to jump more easily between them. With more humans living closer to wildlife, this opens the gate for potentially deadly viruses to then jump to human hosts.”

It is increasingly clear that human health and the health of our global environments are crucially interconnected, and that we cannot have one without the other.

Yet, the Lancet Commission 2021 report found governments and decision-makers lacking in their efforts to stop climate change and mitigate its negative impacts.

“Governments with the fiscal capacity have responded to the COVID-19 pandemic with massive spending packages, to cushion the impacts of the crisis and start to bring about economic recovery. But […] the response to climate change, and commensurate investment, remains inadequate,” it concludes.

“With government leaders more engaged with the health dimensions of climate change than ever before, countries across the globe should pursue low-carbon economic recovery pathways, implementing policies that reduce inequities and improve human health,” its authors advise.

And there are also smaller-scale steps that organizations and health services can take to pull their weight in terms of becoming more eco-friendly, according to Prof. Pencheon and Dr. Romanello.

“One of the things [health systems should do] is to realize that health systems are big medical-industrial complexes, and they are themselves part of the problem. Health services are essentially rescue services, […] really. So we’ve got to get our own house in order,” said Prof. Pencheon.

According to him, health services could help set the tone in terms of how we address the climate crisis, and how we understand its effect on public health.

“[I] f we treat climate change as a health issue, and not just as an environmental issue, it makes it much more immediate to everybody.”

– Prof. David Pencheon

Dr. Romanello agreed. “It is fundamentally a health crisis that we have [on] our hands,” she emphasized, explaining that “much of what we talk about when we talk about climate change action [and] climate change mitigation has to do with healthier lifestyles, with reducing the burden of disease through more physical activity, through healthier, more plant-based diets, through reduced exposure to air pollution and other environmental determinants that damage our health.”

“[B]y increasing communication from the health system, by promoting healthier lifestyles, we on the one hand promote behavior shifts that determine low-carbon transitions and facilitate those low-carbon transitions. And on the other hand, we reduce the burden of disease, we reduce the pressure on the NHS, we reduce the carbon footprint that comes from the health systems which we saw during the [COVID-19] pandemic […] [It] is fundamental that we do shift our attention towards what we need to be doing to protect our health, to deliver those healthcare benefits, and to deliver healthier futures as well.”

– Dr. Marina Romanello

2 personality traits may influence risk

2 personality traits may influence risk

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New research suggests that certain personality traits are linked to a higher risk of cognitive decline. Ksenia Krondo/Stocksy
  • A new study showed that certain personality traits are associated with risk for cognitive decline in older adults.
  • The study found that high neuroticism and low conscientiousness are associated with a negative impact on cognitive health.
  • Increasing conscientiousness may be a potential strategy to promote healthy cognitive aging.

Personality traits are the consistent internal characteristics that can predict and explain who we are and why we do what we do in certain situations. They consist of the feelings, attitudes, habits, and behaviors that a person displays.

The “Big Five” are factors that represent personality. They include:

  • neuroticism — being anxious and worrisome
  • conscientiousness — being disciplined and organized
  • extraversion — being friendly and outgoing
  • agreeableness — being helpful and forgiving
  • openness — being curious and perceptive

Our personality traits can impact our physical and mental well-being through patterns of helpful or unhelpful thoughts and behaviors. Studies have shown that personality traits can affect our cognitive functioning as we age.

Dr. David A. Merrill, an adult and geriatric psychiatrist, explained to Medical News Today that persistent stress could lead to high cortisol levels. High cortisol levels cause more rapid brain shrinkage, associated with Alzheimer’s risk.

Dr. Merrill is also the director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, CA. He was not involved in the study.

Current literature suggests that people with high neuroticism and low conscientiousness may be at increased risk for mild cognitive impairment (MCI), dementia, or death. The links between extraversion and cognitive impairment in studies were less consistent.

People with MCI have symptoms of memory loss but they can still go about their lives as usual. Having MCI does not interfere with the performance of daily activities, unlike living with dementia. About 12-18{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of people 60 years and older have MCI, with approximately 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} to 15{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} developing dementia each year.

Discerning the association of personality traits with cognitive health is crucial to understanding abnormal aging.

This led researchers from the University of Victoria, Northwestern University, University of Edinburgh, and Rush University to examine the relationship between personality traits and transition from no cognitive impairment (NCI) to MCI, dementia, or death in older adults.

They published their findings in the American Psychological Association Journal of Personality and Social Psychology.

Researchers used data from 1954 older adults enrolled in the Rush Memory and Aging Project. Participants received annual assessments until death.

Determination of cognitive status occurred in 3 stages. The first step measured the level of impairment based on results from a battery of 19 cognitive tests across 5 domains, including:

  • episodic memory: previous experiences with information on when, where, and what happened
  • semantic memory: meaningful and conceptual facts about the world
  • working memory: retention of a small amount of information to use in planning, reasoning, understanding, and problem-solving
  • perceptual speed: speed in comparing or finding figures or symbols or identifying patterns
  • visuospatial ability: identifying, processing, and interpreting visual information of objects in space

In the second step, a neuropsychologist conducted a blinded evaluation of the impairment rating and clinical data. Lastly, an experienced practitioner examined participants who met cognitive impairment criteria in person to confirm the assessment.

Researchers used a personality assessment called the NEO-Five Factor Inventory to score for conscientiousness, extraversion, and neuroticism. Higher scores indicated higher levels of these traits.

The study also adjusted for factors critical to the development of cognitive impairment.

Researchers used an analytic tool called multistate survival modeling to determine the effect of conscientiousness, extraversion, and neuroticism on transitioning through four stages (NCI, MCI, dementia, and death).

Participants with higher conscientiousness had a 22{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} decreased risk of progressing from NCI to MCI. Conversely, participants with higher neuroticism had a 12{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increased risk of transitioning from NCI to MCI.

Participants with higher extraversion had a:

  • 12{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increased probability of improving from MCI to NCI
  • 17{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} decreased likelihood of transitioning from dementia to MCI
  • 12{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increased risk of progressing from dementia to death.

Dr. Tomiko Yoneda, study co-author, previous doctoral candidate at the University of Victoria and current postdoctoral researcher at Northwestern University, spoke to MNT about the study.

She said, “We found that individuals [high in conscientiousness and low in neuroticism] may live as long as other individuals but […] they will have more years without cognitive impairment.”

She explained that for an 80-year-old high in conscientiousness, this translated into a gain of 2 additional years without cognitive impairment.

Dr. Merrill added, “Positive goal-directed behaviors […] will help with your sense of self-discipline and allow you to essentially […] take better care of yourself. [C]onscientiousness [will] help you with these goal-directed behaviors.”

The study analyses did not account for personality changes, potentially limiting findings.

Dr. Yoneda explained, “Personality is relatively stable, but it is not set in stone, and previous research [documented] increases in neuroticism preceding, during, and following an MCI and dementia diagnosis.”

“Individuals can change their personality traits over time through concerted behavioral and thinking modifications (e.g., meditation, engagement in health behaviors).”

She added, “[Increasing] conscientiousness is one potential strategy for promoting healthy cognitive aging.”

Dr. Merrill agreed. “Taking part in psychotherapy is to take a step back from a stressor and try to look at things from a different perspective [to increase] your cognitive flexibility.”

“Increasing cognitive flexibility has been shown to correlate with better overall general health and may be an effective way to help protect your body from accelerated brain aging.”

– Dr. Merrill

Mental healthcare for marginalized groups: Barriers to access

Mental healthcare for marginalized groups: Barriers to access

Individuals from minoritized ethnic communities are generally less likely to use mental healthcare services than the majority white population. Some of the reasons for disparities in mental health utilization by marginalized ethnic groups include provider discrimination, lack of adequate health insurance, high costs, limited access to quality care, stigma, mistrust of the healthcare system, and limited awareness about mental illnesses.

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Why do people from historically marginalized communities feel put off from accessing mental healthcare? Image credit: Ekaterina Lesnik/EyeEm/Getty Images.

Although the prevalence of mental disorders is lower in Black people than in white people in the United States, the impact of these disorders tends to be more severe in marginalized communities.

For instance, depression is more likely to persist in Black and Hispanic individuals, despite its lower prevalence in these minoritized ethnic groups than in white individuals. Moreover, mental illnesses are more likely to cause disability in people from historically marginalized ethnic groups.

Disparities in the utilization of mental health services could be partly responsible for these differences in outcomes. A 2015 survey found that 48{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of white adults with mental illness utilized any mental health services in the previous year. In contrast, 22{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of Asian Americans and around 31{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of Black and Hispanic individuals with mental illness received mental health services during the same time.

Similarly, other studies have demonstrated the underutilization of mental health services by minoritized ethnic groups in need of mental healthcare. For instance, Black individuals with depression are less likely to adhere to antidepressant treatment than white individuals.

Individuals from marginalized communities who live with a mental illness are also more likely to be misdiagnosed or underdiagnosed and receive a lower quality of care.

These racial and ethnic disparities in the utilization of mental health services are due to a multitude of structural, cultural, and economic factors.

The concept of structural racism describes the inequities that exist due to the interaction between institutional and broader sociocultural factors that continue to operate with stereotypes and racial discrimination at their core.

Structural racism thus refers to laws, practices, and social norms that perpetuate inequities in access to housing, employment, education, healthcare, justice, and finance.

Residential segregation along racial lines is a prominent example of structural racism, and some experts note that it is one of the primary causes of health disparities in the U.S. Federal government policies instituted since the 1930s and rigged lending practices have resulted in residential segregation, which persists to this day.

Residential segregation is associated with high levels of poverty, lack of access to jobs and education, and lower investment in infrastructure. Notably, underinvestment in Black neighborhoods has resulted in fewer hospitals and under-resourced facilities, influencing access to mental health services.

The intergenerational effects of lack of homeownership have resulted in a persistent wealth gap between Black and white residents. The lack of financial resources may also prevent Black individuals from accessing mental health services.

Residential segregation has also affected Latino communities, and individuals residing predominantly in these communities tend to have limited access to specialty mental health professionals.

Systemic racism also encompasses social and cultural norms influenced by racial prejudices, which can lead to unconscious or implicit biases. Implicit biases may manifest themselves in the form of microaggressions, which are subtle verbal or nonverbal slights towards marginalized individuals that may or may not be intentional.

Diagnosed mental disorders require sustained treatment, and the healthcare provider-patient relationship plays a critical role in determining treatment success. Discrimination by healthcare providers in the form of microaggressions or stereotyping can reduce adherence to treatment and lead to the discontinuation of treatment.

There is also a mistrust of mental healthcare services among minoritized ethnic groups, owing to the history of racism in mental healthcare, which involves the categorization of cultural differences as mental illness.

Provider discrimination and mistrust of mental healthcare may discourage individuals from marginalized communities from seeking further treatment.

Mental healthcare providers may also lack awareness about cultural factors that tend to shape the experiences and needs of individuals from minoritized ethnic groups, undermining the patients’ trust in the provider.

A recent study conducted by the 1928 Institute — a non-profit organization researching and representing the experience of British Indians — surveyed 1,747 British Indians to determine what barriers they face in accessing mental healthcare in the United Kingdom.

Kiran Kaur Manku, the co-founder of the 1928 Institute and a research assistant at the University of Oxford, told Medical News Today:

“Many participants gave examples of how their values, philosophies, or spirituality were dismissed in the assessment stage of accessing mental healthcare, resulting in them being told they don’t need or qualify for treatment. Critically, many community members also gave examples of general practitioners being unaware of how we often present with physical symptoms of mental health issues (psychosomatic disorders).”

Similarly, Dr. Benjamin Lê Cook, an associate professor at the Harvard Medical School, told MNT: “At the intake interview, racial and ethnic minority community members have serious reservations about their interactions with specialty mental health care providers out of concern that they may be reported to the police or child protective services if they express feeling unsafe or that they may harm themselves. And they may be asked questions or asked to fill out structured diagnostic interviews that don’t resonate with the pain they are experiencing.”

“Our community partners have also reported that when topics of intergenerational effects of systemic racism are raised, the conversation becomes uncomfortable to the point where some providers recommend seeking help from other providers that have more expertise with effects of racism,” he added.

Cultural factors, such as internalized stigma and language barriers, may also result in marginalized ethnic groups abstaining from or discontinuing treatment.

Some minoritized ethnic groups perceive mental health issues, such as depression, as problems to be overcome using willpower and mental toughness. Among some communities, individuals with mental health issues may thus be erroneously perceived as either posing a danger to community members or having a weak will.

Therefore, some individuals from minoritized ethnic groups may fear being judged or discriminated against by others, or they may internalize these prejudices about mental illness.

The stigma attached to mental illness among some historically marginalized groups may prevent individuals from acknowledging their mental health symptoms until they become severe. Some individuals from minoritized ethnic groups may also have reservations about the benefits of mental health treatment.

Stereotypes such as the model minority myth, often ascribed to Asian Americans, can adversely impact whether or not individuals access mental healthcare. The model minority myth regards individuals from historically marginalized groups, particularly Asian Americans, as exclusively hardworking, intelligent, and law-abiding.

While, on the surface, this may appear to be a positive assessment, this stereotype is associated with higher levels of pressure to succeed, which can result in mental distress. Moreover, espousing this positive stereotype may also deter Asian Americans from seeking treatment for mental illnesses.

Language may also act as an obstacle for first-generation Hispanic and Asian migrants in scheduling an appointment or communicating their problems to a therapist.

Dr. Wooksoo Kim, a professor at the University of Buffalo, explained for MNT that:

“Language is a persistent and consistent barrier to mental health service use as well as other basic services for newcomers. When you belong to multiple minority statuses, it is even worse. For example, if you are a member of a cultural minority group with low English proficiency, the access to mental health services is even more limited. Simply having an interpreter in the room does not solve the incompatibility of language. Even when interpreters are available, linguistic challenges may still be present due to the inherent difficulties of translating from English to native languages and vice versa.”

“Given the translation difficulties in combination with a lack of understanding about mental health and persistent stigmas around mental health issues, we can only imagine the number of barriers piled up before they get proper help,” Dr. Kim pointed out.

Health literacy, which refers to the ability to obtain basic information about medical conditions and utilize it to seek the necessary care, may also contribute to disparities in mental healthcare access. Individuals from minoritized ethnic groups tend to have lower health literacy levels than white individuals.

That may be partly due to internalized stigma around mental health, and partly because of the complexities associated with health insurance and the healthcare system in the U.S.

Lower mental health literacy levels are associated with higher rates of mental illnesses such as depression and anxiety, lower adherence to medication, and underutilization of mental health services.

Although the passage of the Affordable Care Act in the U.S. improved healthcare coverage among all ethnic groups, Black and Hispanic individuals are still more likely to be uninsured or lack adequate insurance than their white counterparts.

The high costs of treatment and insufficient health insurance are major obstacles to the utilization of mental health services by minoritized ethnic groups.

Dr. Cook explained: “The way that healthcare systems and payments are set up now is incredibly unwelcoming for individuals that need help for their mental health challenges. It is even more unwelcoming for many individuals and families from racial and ethnic minority backgrounds.”

“If you do not have health insurance, then mental health treatment is too expensive. If you do have health insurance, the co-pays and deductibles are unaffordable. Insurance often covers only a small number of visits,” he continued.

“To gain access to a specialty mental health provider, you often have to first visit a primary care provider for a referral and wade through a lot of paperwork. If that hurdle is overcome, the waitlist for specialty mental health providers is incredibly long, a year in length at times, to the point where some primary care providers have stopped making referrals.”

“If one does find a specialty provider, the provider is likely to practice in a community that can be a number of bus rides away during a time when full-time employees work or when caregivers need to care for their children,” added Dr. Cook.

Dr. Kim pointed out that:

“It is a structural failure of our society if we do not actively intervene in these issues within vulnerable communities. In many cases, we have seen victim blaming where their cultures and lack of knowledge of the patients are discussed as the major barriers to mental health services. The barriers exist on both [the] provider and patient sides.”

Addressing how cultural barriers to mental healthcare use can be overcome, Dr. Kim noted that “[i]n practice, we need to have a two-pronged approach to address disparities in mental health for minority groups.”

“First, at the systems level,” she said, “a simple yet reliable mental health screening routine in the primary care setting would promote greater recognition of mental health problems and increase service use among minority populations. At the same time, the cultural competence of healthcare professionals can be improved by their willingness to learn. Cultural competence is a continuous process rather than a single goal.”

“Second, one size doesn’t fit all,” Dr. Kim added. “We need to focus on developing culturally responsive ways for each minority group to help them. It should be a two-way street: We need to focus on educating the minority communities, decreasing cultural stigmas, and providing a resource list.”

“If there is a strong stigma around mental health issues, we should design and implement culturally appropriate educational programs for the community. If there is a language barrier, we should secure extra resources to develop a multilingual mental health workforce as well as equitable language access through interpreter services.”

– Dr. Wooksoo Kim

Similarly, Manku noted about the situation in the U.K. that “[i]t is critical that the [National Health Services] adopt a multidimensional approach to address disparities in mental healthcare.”

“In our report, we found over 95{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of British Indians called for healthcare professionals to embody curiosity, compassion, and cultural nuance. These principles, with recognition of bio-psycho-socio-spiritual components of health and geopolitical histories, have the potential to overcome disparities in access to mental healthcare,” she emphasized.

“These disparities could be overcome through targeting training that is co-created with the community and innovative models of monitoring and evaluation,” added Manku.

These recommendations need to be backed by increased funding for research to understand the effects of cultural factors and other barriers to the use of mental health services.

Expanding health insurance coverage could increase access to mental health services, but studies show that this may not be sufficient to increase the use of mental health services. Access to health insurance thus needs to be combined with approaches that enhance the engagement of minoritized ethnic groups.

Some researchers have suggested that telemedicine and mobile health clinics that provide mental health screening and basic care could help improve access.

“[T]he changes that are necessary on the payer side are improving coverage for psychiatric services and reducing the gatekeeping role of primary care providers,” Dr. Cook also went on to explain. “Healthcare systems need to find a way of improving the supply of specialty mental health providers that practice with cultural humility and awareness, placing them in communities where there is high need, at hours that match the community’s time.”

“Providers need to work with community members and peers with lived experience in order to better understand systemic and intergenerational racism and structural barriers and how these can lead to psychological distress. Teams that include peers specialists, primary care providers, social workers, psychologists, and psychiatrists are needed to provide appropriate wraparound care for individuals in distress,” he advised.