How can community health care contribute to self-managing health?

Community health care can complement professional help. Positive effects can come from a sense of belonging. Cristina Spoiala explains how community health care can contribute to self-managing health.

21. July 2020 | by Cristina Spoiala, MA | Junior Researcher at Nivel, the Netherlands

Nowadays, patients are expected to take more and more responsibility in managing their illness/es. For patients to get to a state of self-management they require a lot of support from professionals. However, professional help is time-consuming and expensive. With the number of people with chronic illness growing, alternatives are welcomed. Community health care can be such an alternative.

The WHO  defines community health care “as environmental, social, and economic resources to sustain emotional and physical wellbeing among people in ways that advance their aspirations and satisfy their needs in their unique environment”. Successful community health care practices are exemplified through the availability of social support, health promoting services and amenities, instrumental support and role modelling. These practices allow people to retain, change and maintain their health. Further, through these practices the responsibility of looking after one’s health can become less of a burden for the patients and health system. To show the vast opportunities available, community health care can take place in neighbourhoods, sport clubs, churches or any other social group, essentially by optimizing the environment of the respective community.

Important and unique to community care, compared to professional care, are the positive effects that can come from a sense of belonging.

Community health care and its positive effects

The emotional bonds formed when belonging to a group have long been positively related to health, adjustment and well-being. In contrast, the feeling of not belonging can affect mental health negatively in comparison to when feeling connected, and can consequently negatively impact physical health and life expectancy.

In the context of self-management and chronic disease, support networks have been targeted as part of community health care. Findings show that good quality connections between neighbours can successfully aid people with chronic illnesses in improving health outcomes. Connections were strengthened when people were encouraged to share practical health information, help each other and check on each other, ultimately increasing the likelihood that healthy behaviours were adopted. Another example of strengthening a support network was achieved through training neighbours, trusted role models within a community, to be community health advisors promoting team sports. Research showed that patients were more likely to partake in sport activities led by someone they trust, who knows their local environment and who can offer extra advantages, e.g. socialising and social support. Through the aforementioned means self-manging one’s health becomes more appealing with the community’s support.

Cristina Spoiala

Cristina Spoiala

Cristina worked as a junior researcher at Nivel – institute for health services research in the Netherlands. She has a background in Social & Health Psychology, with a particular interest in community and care collectives, and alongside it Moral Psychology.

How COMPAR-EU contributes to this topic

In COMPAR-EU community interventions are being compared to interventions that take place in more traditional healthcare settings and to usual care. Example community interventions involve families, peers and close friends who were recruited to be trained/to assist in the process of supporting a patient. Researchers in other interventions also involve peers with the same chronic illnesses in order to make online communities available where patients can interact, discuss issues and offer each other social support. We may find from these studies that community health care is as effective as professional care for some health outcomes and may be administratively cheaper. From a further context analysis we will attempt to gain insights into what specific community aspects are helpful in chronic disease self-management.

While I have portrayed community care as a viable positive force for good, that is not to say that there are no disadvantages, as some small scale meta-analyses have shown by their mixed results. It is these mixed results that the current COMPAR-EU will come closer to untangling – answering the question: when and how can community care substitute or add to professional care?