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A health policy blueprint for self-care

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‘Self-care describes the role of individuals in preventing disease, managing their health, and actively participating in their healthcare. 
 
‘It is a cost-effective and logical approach that can reduce disease burden, improve health outcomes for all and ease the pressure on national health systems from preventable health conditions.’
 
That is Flinders University Associate Professor John Litt, member of the RACGP Green Book editorial committee and Australian Self-Care Alliance (ASCA) Director, talking with newsGP ahead of International Self-Care Day.
 
Held on 24 July each year, Self-Care Day aims to raise the profile of healthy lifestyle self-care programs and improving national policies.
 
To mark the day, ASCA has released a position paper outlining the vital role of self-care in effective preventive health, calling for a ‘re-orientation’ of Australia’s healthcare system to support a more patient-centred model of care.
 
The paper argues that despite Australians’ growing ‘capacity and enthusiasm’ to engage in more preventive health lifestyle choices, barriers are present within the current healthcare structure.
 
It is calling for further engagement and support to empower people to participate in the proactive management of their health through greater self-care, to be reflected in all aspects of Australia’s healthcare system.
 
Professor Rosemary Calder, Head of Health Policy at Mitchell Institute and a member of the Expert Steering Committee for the National Preventive Health Strategy, said that self-care could be one of the ‘strongest influences in preventive health awareness, engagement, and action by individuals’ if it was properly supported.
 
‘The Australian Government has an opportunity, through the National Preventive Health Strategy, to implement the necessary structural and cultural changes needed to foster and capitalise on this capacity and enthusiasm for greater self-care, and address the barriers limiting participation,’ she said.
 
‘It’s time for a systematic approach to build self-care capability and enhance self-care activity in all aspects of health and healthcare.’
 
The position paper is part of a re-work of ASCA’s 2020 submission to the National Preventive Health Strategy through its landmark report, Self-care for health: A national policy blueprint.
 
The policy blueprint was referred by Health Minister Greg Hunt as key to the development of the National Preventive Health Strategy as part of Australia’s Long Term National Health Plan. 
 
ASCA’s strategic priorities for self-care are to:
 

• address structural health system issues to better enable self-care
• embed self-care support for individuals across health services
• promote and support informed self-care and health behaviours for all individuals, including improved health literacy.

 
Associate Professor Litt says there are many benefits of self-care, including chronic disease prevention and management.
 
‘Up to 80% of heart disease, stroke, type 2 diabetes, and over a third of cancers could be prevented through evidence-based self-care by eliminating or reducing exposure to risks such as tobacco use, unhealthy diet, physical inactivity, and excessive alcohol consumption,’ he said. 
 
‘In Australia, this means that by 2025, an estimated 29,300 lives could be saved through the effective prevention of chronic disease.
 
‘Research suggests that enabling and promoting self-care across the population can [also] improve health outcomes and physical functioning for people living with long-term chronic diseases, leading to improved clinical indicators, better symptom management and fewer hospital admissions.’
 
The ACSA paper points to the COVID-19 pandemic to highlight the role of self-care in infectious diseases, through protecting public health and minimising pressure on frontline healthcare services.
 
‘Lessons learned from the pandemic indicate the need to build resilient health systems,’ Associate Professor Litt said.
 
‘It requires informed self-care by individuals in concert with government-led population health and protection strategies, public health expert leadership and effective collaboration among researchers … [as well as] involving individuals and communities, institutions and structures in protecting health and optimising health outcomes.’
 
Self-care can also aid healthcare cost containment, given Australia’s per-person healthcare expenditure is projected to continue to rise.
 
‘People who lack the skills to undertake self-care effectively incur higher healthcare costs,’ Associate Professor Litt said.
 
‘Economic modelling that examined the cost-saving potential of self-care in Australia found that maximising self-care would save between $1300 and $7515 per hospital patient per year, and significantly lower hospital re-admission rates. 
 
‘Self-care also received specific mention in the most recent Federal Budget as a key area of policy focus.’ 
 
With self-care increasingly moving into the spotlight, particularly around doctors’ self-care amid frontline navigation of the pandemic, as well as junior doctor burnout, there is growing evidence regarding the importance of self-care in managing mental health conditions and improving emotional wellbeing.
 
The World Health Organization recently issued new guidelines on self-care interventions. 
 
In addition, Canada launched the International Self-Care Foundation, and the UK’s Self-Care Forum and university self-care research units have emerged.
 
Associate Professor Litt says these examples show global recognition of self-care as an important component of healthcare policy − and GPs can practise what they preach to their patients.
 
‘While it has taken some time to gain momentum, the push for self-care has been increasing,’ he said.
 
‘Australia is unique among self-care organisations around the world in that we focus not only on the actions individuals can take to maintain their health and prevent disease, but we also focus on the need to train healthcare practitioners to support individuals on their self-care journey. 
 
‘We can also promote system change that will allow GPs to provide more self-care support by encouraging new models of care.’
 
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chronic disease management health policy preventive health self-care

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