By David F. Brand
April 4, 2016

When I began working as a case manager at a supportive housing site for formerly homeless adults with mental illness in East Harlem, I quickly noticed that the large majority of tenants experienced a preventable physical health problem related to obesity. I later learned that their endemic deconditioning reflects broader social trends. In fact, individuals with serious mental illness die, on average, 25 years earlier than the general population. These premature deaths do not result from some quirk of brain chemistry. Instead, the majority stem from preventable health conditions such as cardiovascular disease, diabetes and respiratory problems. Poor nutrition, cigarette smoking, obesity and lack of exercise — risk factors associated with poverty — contribute to and exacerbate those maladies.