What are the extra challenges to self management that come with being affected by poverty?

Chris reflects on the challenges that poverty bring to effective self management.

Self Management Week and Challenge Poverty Week falling at the same time naturally brings to mind a theme we’ve written of in the past, in the LINKS Worker Programme blog.

What are the extra challenges to self-management that come with being affected by poverty, and is there anything it may it be possible to try to address these?

It’s long been accepted that health should be understood as a complete state of social, mental and physical wellbeing, not merely the absence of disease or infirmity. When 40% of the population live with a long term condition however, does the social aspect of wellbeing, and how this interplays with the mental and physical aspects, have any greater potential bearing?

Whether we’re talking about taking the practical steps necessary to optimise the management of a diagnosed physical or mental condition, or combination thereof, or indeed the self-management of mental wellbeing more generally, it follows that challenges around poverty have the potential to keep our attention more focused towards the base of our hierarchy of needs.

If our energy is consumed with our very survival we have less time and energy to focus on that which fulfils us, and so keeps us well. If we have to run around trying to access a foodbank for example, or deal with needlessly complex and everchanging social security claims criteria, we are likely to be less focused on following medication routines, or devoting time to exercise or other nourishing pursuits. Is it fair to say that people can become less able to, or even motivated to do so?

The levels immediately above survival in Maslow’s oft quoted hierarchy of needs are broadly to do with social relationships and support and then social esteem.

Amongst a wide ranging array of prevalent issues the first overarching emergent theme identified from qualitative analysis of issues in case notes from the LINKS Worker Programme can be summarised as ‘relationships.’ As the programme has progressed alongside the austerity agenda of the Westminster government, this has been joined, or just about overtaken in relative prevalence, by another theme, if distilling this in one word; ‘financial.’

Whilst each of these broad themes are themselves infused with the complexity typical of work in the realm of social determinants – relationships encompass parenting, spouse relations, workplace relations, isolation and loneliness and financial encompasses debt, social security, housing, employment – it is perhaps telling, if not surprising, that they are often co-prevalent in the issues individuals prioritise in accessing the programme to address.

We know that relationships and social support, in many forms, offer us a vital psychological buffer to the challenges most of us face, whether in self managing, attempting to overcome poverty or more widely. And we don’t really need any new data to confirm the intuitive or experiential knowledge that financial challenges can put a strain on relationships.

Paying attention to how this particular dynamic influences our own lives as well as those around us is perhaps one important area that can enhance wellbeing. Whilst living in poverty, attempting to self manage is a challenge beyond which many have the mental and physical energy to tackle, most certainly if striving to do so alone, or feeling as such.

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