Self-managing versus self-management: reinvigorating the socio-political dimensions of self-management

TLDR

In Australia, self‑management is largely defined as practitioner‑led education programmes that aim to equip chronic‑disease patients with information and skills to manage their health, yet this view overlooks the organic, consumer‑driven self‑managing that arises from lived bodily experiences and daily health choices. The authors contend that to address health inequalities, health professionals and policymakers must scrutinize the harmful assumptions embedded in contemporary self‑management discourse. Their research shows that consumers’ self‑management consists of navigating diverse information sources and experiences rooted in their own lived bodily knowledge.

Abstract

In Australia, self-management predominantly refers to education programmes that, theoretically, equip people with chronic disease with the necessary information and skills to manage their own healthcare, maintain optimal health, and minimize the consequences of their condition. These programmes are designed, and often delivered, by practitioners. Our research has demonstrated that for consumers, self-management involves navigating and responding to a myriad of information sources and experiences, many of which originate in their own lived bodily experiences and personal knowledge. In contrast to this organic and dynamic version of self-managing that is naturally practised by consumers, common practitioner and policy representations of self-management tend to discount consumer agency and overlook the daily ways in which people manage their own body, experiences and health choices. We argue that if the self-management movement is to tackle health inequalities (rather than creating new ones), health professionals and policy-makers must examine the potentially damaging assumptions that are inherent in contemporary self-management discourse.