Can I come, too? How tourism can include people whose health conditions usually keep them at home

Around 20 per cent of the world’s population suffer from chronic diseases such as diabetes, heart disease, cancer, or mental disorders — a group of people the travel industry needs to accommodate
Around 20 per cent of the world’s population suffer from chronic diseases such as diabetes, heart disease, cancer, or mental disorders — a group of people the travel industry needs to accommodate

Following the disruption of COVID-19, the global tourism industry has largely opened up again; however, travelling remains a severe challenge for a large group of people.

The World Health Organization estimates 20 per cent of the world’s population suffer from non-communicable chronic diseases such as diabetes, heart disease, cancer, or mental disorders.

These conditions can make travelling difficult, while some people may even avoid taking holidays altogether.  

A cross-disciplinary research project from Edith Cowan University has highlighted the impacts this decision can have on people with these health challenges, and outlined the future repercussions for the industry as a whole.

Through collaboration between ECU’s School of Business and Law and its Centre for Precision Health, the project has put forth the concept of ‘travel therapy’, which sees tourism as a means of improving mental health and wellbeing.

Researcher Dr Jun Wen said it is vital the tourism industry catered more to vulnerable people with physical or psychological disorders, a market he described as important but too often overlooked.

“Most are able to travel but remain vulnerable during trips and need intensive services,” he said.

“The world has an ageing population, so there will be more and more people dealing with the challenges that brings, like dementia, physical limitations and so on.

“There are also more people being diagnosed with mental health issues, such as depression and anxiety.

“Tourism needs to be able to accommodate vulnerable travellers such as these for the industry’s survival — but also because health is important and as our previous work has shown, tourism can help support health.”

What the industry can do

Dr Wen said there are numerous initiatives which could make destinations more accessible for vulnerable people.

Strategies could be implemented throughout the tourism industry chain (food, accommodation, transportation, travel, shopping, and entertainment) and could include considerations or allowances for caregivers who may need to accompany travellers.

Dr Wen said education was critical.

“Staff and stakeholders need training to be made aware of vulnerable travellers’ needs and demands,” he said.

“This can include developing manuals to standardise services for vulnerable travellers, enhancing accessible infrastructure and equipping professional emergency and care facilities appropriately, such as with first-aid tools.

“The industry can also customise services for different traveller segments, such as people with dementia, depression or anxiety.”

Dr Wen said technological advances could also play a great role in bringing the benefits of tourism to more people.

“Not everyone can take physical trips,” he said.

“The tourism industry should develop virtual products that enable all travellers to be present in a destination and to enjoy fun and health-related benefits.”

Most people hospitalized with the flu have a chronic illness

Leading health organizations are urging people to get a flu shot if they haven’t already done so. Compared to last year’s mild flu season,[1] the U.S. has already seen more than three times the number of flu-related deaths.[2] While seasonal influenza activity shows a declining trend,[3] flu season is expected to continue well into spring.  The American Heart Association®, the American Lung Association® and the American Diabetes Association® are teaming up to send a message to people who have not yet received this season’s flu vaccine: It’s not too late to protect yourself and others, some of whom are more vulnerable to the dangers of the flu, by getting your flu shot.  While no one wants to experience the misery of the flu, for many people with chronic conditions, the flu causes serious complications, leading to hospitalization or in some instances death. According to the Centers for Disease Control and Prevention, in recent years, about 9 out of every 10 people who were in the hospital due to the flu had at least one underlying medical condition.[4]  The underlying health conditions that commonly put adults at higher risk of complications from the flu include heart disease, history of stroke, type 1 or type 2 diabetes, obesity and chronic lung disease such as asthma, cystic fibrosis and chronic obstructive pulmonary disease (COPD).[5]  “Adults who have cardiovascular disease face a significant risk of complications if they contract the flu,” said Eduardo Sanchez, M.D., M.P.H., FAHA, the American Heart Association’s chief medical officer for prevention. “For example, if you have heart disease and you’re not vaccinated against the flu, you are six times more likely to have a heart attack within a week of infection. The flu vaccine can be doubly protective—from bad flu and from its complications. While earlier in the season is ideal, we have a lot of flu season left, and it’s better to get one now than not at all.”  With the U.S. flu season typically peaking mid-to late winter, between December and February,[6] experts say those who haven’t gotten the flu shot yet should do so as soon as possible. By getting vaccinated, individuals are not only protecting themselves but those around them who may not be able to get vaccinated or who have a weakened immune response to vaccines.  “Even a minor respiratory virus can be hard on someone with lung disease, and the flu is especially challenging,” said Dr. Albert Rizzo, M.D., chief medical officer for the American Lung Association. “We want to reiterate that not only should people with any chronic illness get a flu shot, but their loved ones and friends should also protect them by getting the flu vaccine. It’s imperative that we slow the spread of the flu this year as much as possible to continue to decrease the number of cases and hospitalizations, and to protect our most vulnerable loved ones.”  Many of these same chronic conditions also put individuals at higher risk of complications from COVID-19, so it is important to also stay up to date on the COVID vaccine. Health professionals recommend the flu shot for anyone 6 months of age and older, and say it is safe to get a flu vaccine along with a COVID-19 booster. They also urge those 65 and older to ask about the flu vaccines recommended for their age and get the best one that’s available at that location at that time.  “In recent years, almost a third of the people hospitalized due to the flu had diabetes,”[7] said Robert Gabbay, M.D., chief scientific and medical officer for the American Diabetes Association. “The impact from any illness can pose a threat to someone with diabetes, especially considering many people who live with diabetes have other complications like heart disease and kidney disease. Staying up to date on all annual vaccines and the COVID-19 vaccine is recommended for everyone who is eligible, especially those living with diabetes and other chronic illness.”
Leading health organizations are urging people to get a flu shot if they haven’t already done so. Compared to last year’s mild flu season,


Leading health organizations are urging people to get a flu shot if they haven’t already done so. Compared to last year’s mild flu season,[1] the U.S. has already seen more than three times the number of flu-related deaths.[2] While seasonal influenza activity shows a declining trend,] flu season is expected to continue well into spring.

The American Heart Association®, the American Lung Association® and the American Diabetes Association® are teaming up to send a message to people who have not yet received this season’s flu vaccine: It’s not too late to protect yourself and others, some of whom are more vulnerable to the dangers of the flu, by getting your flu shot.

While no one wants to experience the misery of the flu, for many people with chronic conditions, the flu causes serious complications, leading to hospitalization or in some instances death. According to the Centers for Disease Control and Prevention, about 9 out of every 10 people in the hospital due to the flu had at least one underlying medical condition in recent years.[4]

The underlying health conditions that commonly put adults at higher risk of complications from the flu include heart disease, history of stroke, type 1 or type 2 diabetes, obesity and chronic lung disease such as asthma, cystic fibrosis and chronic obstructive pulmonary disease (COPD).[5]

“Adults who have cardiovascular disease face a significant risk of complications if they contract the flu,” said Eduardo Sanchez, M.D., M.P.H., FAHA, the American Heart Association’s chief medical officer for prevention. “For example, if you have heart disease and you’re not vaccinated against the flu, you are six times more likely to have a heart attack within a week of infection. The flu vaccine can be doubly protective—from bad flu and from its complications. While earlier in the season is ideal, we have a lot of flu season left, and it’s better to get one now than not at all.”

With the U.S. flu season typically peaking mid-to late winter, between December and February,[6] experts say those who haven’t gotten the flu shot yet should do so as soon as possible. By getting vaccinated, individuals are not only protecting themselves but those around them who may not be able to get vaccinated or who have a weakened immune response to vaccines.

“Even a minor respiratory virus can be hard on someone with lung disease, and the flu is especially challenging,” said Dr. Albert Rizzo, M.D., chief medical officer for the American Lung Association. “We want to reiterate that people with any chronic illness should get a flu shot, and their loved ones and friends should also protect them by getting the flu vaccine. It’s imperative that we slow the spread of the flu this year as much as possible to continue to decrease the number of cases and hospitalizations, and to protect our most vulnerable loved ones.”

Many of these chronic conditions also put individuals at higher risk of complications from COVID-19, so it is important to stay up to date on the COVID vaccine. Health professionals recommend the flu shot for anyone 6 months of age and older, saying it is safe to get a flu vaccine and a COVID-19 booster. They also urge those 65 and older to ask about the flu vaccines recommended for their age and get the best one that’s available at that location at that time.

“In recent years, almost a third of the people hospitalized due to the flu had diabetes,”[7] said Robert Gabbay, M.D., chief scientific and medical officer for the American Diabetes Association. “The impact from any illness can pose a threat to someone with diabetes, especially considering many people who live with diabetes have other complications like heart disease and kidney disease. Staying up to date on all annual vaccines and the COVID-19 vaccine is recommended for everyone who is eligible, especially those living with diabetes and other chronic illness.”

Vitamin D supplementation may lower diabetes risk for the more than 10 million adults with prediabetes

Vitamin D supplementation may lower diabetes risk for the more than 10 million adults with prediabetes
Vitamin D supplementation may lower diabetes risk for the more than 10 million adults with prediabetes


A review of clinical trials has found that higher vitamin D intake was associated with a 15 percent decreased likelihood for developing type 2 diabetes in adults with prediabetes. The review is published in Annals of Internal Medicine.

Vitamin D is a fat-soluble vitamin available in or added to some foods, as a supplement, or produced by the body when ultraviolet rays from sunlight strike the skin. Vitamin D has many functions in the body, including a role in insulin secretion and glucose metabolism. Observational studies have found an association between having a low level of vitamin D in the blood and high risk for developing diabetes.

Researchers from Tufts Medical Center conducted a systematic review and meta-analysis of three clinical trials comparing vitamin D supplement impacts on diabetes risk. The authors found that over a three-year follow-up period, new-onset diabetes occurred in 22.7 percent of adults who received vitamin D and 25 percent of those who received placebo, which is a 15 percent relative reduction in risk. According to the authors, extrapolating their findings to the more than 374 million adults worldwide who have prediabetes suggests that inexpensive vitamin D supplementation could delay the development of diabetes in more than 10 million people.

In an accompanying editorial, authors from University College Dublin and Food Safety Authority of Ireland, highlight that previous data have demonstrated significant adverse effects for high vitamin D intake. They argue that professional societies promoting vitamin D therapy have an obligation to warn physicians about both required vitamin D intake and safe limits. They advise that this very-high-dose vitamin D therapy might prevent type 2 diabetes in some patients but may also cause harm.

Being married may help people maintain lower blood sugar levels

Even cohabiting relationships under strain may help people avoid high glycemic levels, a study suggests

People living with a spouse seem to have a higher likelihood of being healthy in terms of maintaining lower blood sugar levels regardless of how harmonious or acrimonious their relationship is, suggests a study published online in the journal BMJ Open Diabetes Research & Care.

Researchers believe that having a spouse or cohabitating partner may be an important relationship and source of social support and/or strain for adults in mid to later life for their health.

Previous studies have suggested there are health benefits from marriage and/or cohabiting, particularly for older adults. There are also various studies that have concluded that type 2 diabetes risk is associated with a number of social health dimensions including social isolation, loneliness, living arrangements, social support, and social network size.

However, the effects of each specific social health dimension are complex, so a team of researchers from Luxembourg and Canada set out to investigate if there was an association between marital status and marital quality with average glycemic levels in older adults.

They used biomarker data from the English Longitudinal Study of Ageing (ELSA) – a population-based sample of adults aged 50 years and older and their partners, who live in England, from whom data are collected every second year, with biomarker data collected in every other wave.

The data used for the study was on 3,335 adults aged 50 to 89 years old without previously diagnosed diabetes over a period from 2004 to 2013.

The sample was people without pre-existing diabetes between the ages of 50 and 89 years in wave 2 (2004-05) – when biomarker data were first available in ELSA. Pre-existing diabetes was determined by self-reporting.

Participants were invited to have a nurse visit following the main interview in waves 2 (2004-05), 4 (2008-09) and 6 (2012-13) and blood samples were taken to measure their HbA1c (average glycemic or blood glucose) levels.

Respondents were also asked if they had a husband, wife, or partner with whom they lived and asked questions designed to measure the level of social strain and social support within the marital/cohabitating relationship.

Information on several factors was also gathered such as details about age, income, employment, smoking, being physically active, depression, body mass index (BMI), and having other social relationship types in their social network (child, other immediate family, friend).

The data showed that in wave 2 (2004-05), about three quarters (76%) of the respondents were married/cohabiting.

Analysis of the data over time showed that people who experienced marital transitions (eg. divorce) also experienced significant changes in their HbA1c levels and odds of pre-diabetes.

However, the quality of the relationship did not make a significant difference to the average levels of blood glucose, suggesting that having a supportive or strained relationship was less important than just having a relationship at all.

This was an observational study, and as such, can’t establish cause. Indeed, the study had some limitations such as the fact that there was a sizeable number of people who dropped out of the ELSA between waves with biomarker data. More than half of the wave 2 sample had no follow-up data so were excluded. There was also the possibility that those people in worse health were more likely to get divorced. 

Nevertheless, the authors argued that their study’s strengths included the use of HbA1c as an outcome measure versus self-reported diagnoses – the former being a more accurate and precise measure when used in population-based surveys than diagnosed medical conditions, which are dependent on participants having accessed appropriate healthcare prior to study enrollment.

The researchers concluded: “Overall, our results suggested that marital/cohabitating relationships were inversely related to HbA1c levels regardless of dimensions of spousal support or strain. Likewise, these relationships appeared to have a protective effect against HbA1c levels above the pre-diabetes threshold.

“Increased support for older adults who are experiencing the loss of a marital/cohabitating relationship through divorce or bereavement, as well as the dismantling of negative stereotypes around romantic relationships in later life, may be starting points for addressing health risks, more specifically deteriorating glycemic regulation, associated with marital transitions in older adults.”

An autistic boy was kept in a mental hospital for a month after his mum asked for help with care – why is this happening?

'It was like a prison': Autistic boy kept in hospital for month after mum  asked for help with care | ITV News


ITV News has uncovered more evidence of how some people with learning disabilities are isolated in mental hospitals. After our first report into the anguish of families desperate to help loved ones who have been locked away, others came forward to talk to us. You may find parts of Peter Smith’s report upsetting.