What comes to mind when you think of self-care? Golf, spa days, hanging out with friends, milkshakes, or shopping? Certainly, but outside of feel-good, one-off activities, self-care can also deeply impact our long-term health and health care systems. To enable sustainable, positive health outcomes, we need to stop looking at self-care as a singular process that only relies on oneself, and as more of an integrated process that connects to the health care system.
What is “self-care”?
The World Health Organization defines “self-care” as “the ability of individuals, families and communities to promote health, prevent disease, maintain health and cope with illness and disability with or without the support of a health worker.” Building off of this definition, the Global Self-Care Foundation believes that “self-care involves making healthy lifestyle choices and avoiding unhealthy habits; making responsible use of both prescription and nonprescription medicines; recognizing symptoms of common illnesses and diseases; managing one’s own treatment of colds, coughs, and other minor ailments; and self-monitoring, self-testing, and self-management of health conditions. Self-care products may include nonprescription medicines, dietary supplements, vitamins, and simple medical devices and tests designed for home use.”
Going from illustration to effect, a study by the Global Self-Care Foundation found that self-care practices are incredibly impactful, leading to nearly $120 billion in savings each year for global health care systems, 40.8 billion productive days saved for health practitioners and individuals, and a gain of 22 million quality-adjusted life years.
From the data showing self-care works to the good feeling we get post-massage or time with a friend, it’s evident that self-care is good for us. Still, the practice of seeking self-care continues to be sporadic rather than habitual. This is also seen in the health care system in which many studies of patients with heart failure have found that patients have inadequate self-care practices.
Systems of care to support self-care
The Theory of Interdependence and Modularity is helpful to this dilemma. It tells us that when performance isn’t good enough (performance in this case as the ability to carry out “self-care,”) we need to integrate systems. In order to actualize the impact of self care, we need buy-in from ourselves but also from health workers, health facilities, and policymakers. Individuals need to be able to depend on health workers and health facilities for guidance on how to care for themselves, and health workers, health facilities, and policymakers need to work together to create an environment that enables and develops self-care interventions and tools.
Said differently by Catherine Duggan, the CEO of the International Pharmaceutical Federation, “Policymakers play a critical role: in order for self-care to be embedded in a society, it must be institutionalized via direct changes to public policy advancing self-care programs. Consumers and health care providers both have a symbiotic role to play in the self-care ecosystem — consumers need health care provider support to feel confident in adopting self-care behaviors, and health care providers need consumers to adopt self-care behaviors to reap the maximum benefits of health promotion and chronic disease treatment plans.” She goes on to offer examples of the role pharmacists have in supporting self-care like, “[a]s collaborators, pharmacists link into health systems and community care teams[,] [a]s communicators, pharmacists ask key questions to patients and start a dialogue on medical history in order to provide objective and evidence-based advice about self-medication[, and] [a]s coaches, pharmacists adopt methodologies to support health literacy and social prescribing.”
To illustrate this argument through a personal example, the last time I went to the doctor’s office, my doctor recommended that I exercise for so many minutes a day. However, she didn’t provide any kind of workout regimen. I didn’t know where to begin. It would have been helpful if she had additional resources to share like perhaps a workout app the health facility is affiliated with that has workout tutorials or different classes she would recommend based on my medical history.
Innovations in systems of care
There has been some movement in the right direction as innovators in health care incorporate drivers of health, or social determinants of health, into their business models. Ann Somers Hogg discusses this in her report You Are What You Treat. For example, Hogg explains how some innovators have hired dietitians, health workers, and health coaches and are focused on a “whole-person approach to health, addressing social connections, emotional wellbeing, nutrition, physical activity, mental health, and physical health, as opposed to just the physical health characteristics.”
As WHO’s International Self-Care Month approaches, I hope we can all work harder to incorporate self-care into our lives and create integrated systems of health that support self-care.