Excess rates of mortality and physical comorbidity are highly prevalent among people with severe mental illness (SMI) and pose new challenges and obligations to health professionals. A number of factors, such as self-neglect, side effects of medication and limited concern with personal health and well-being, tend to be associated with poor lifestyles. These factors are shared both by people with mental illness and by disadvantaged people as a whole, and are associated with unhealthy diet, lack of exercise, smoking and excessive consumption of alcohol and drugs. In geographical terms, such groups of people are more likely to live in deteriorated neighbourhoods with crime and safety problems, further hindering an active life. This chapter discusses the global context of these problems in countries with different levels of income. An exploratory study encouraged the authors to design a comprehensive evaluation, and this is described.
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