I’m biased of course. I’ve been practicing yoga for more than 10 years. I teach yoga. I write about yoga. I am not the most balanced of writers on this topic. But this isn’t yoga propaganda. The reason why I think that everybody should practice yoga is that yoga is a tool for health engagement.
Health engagement (or patient activation) drives better outcomes
Let me explain. I’ve written about patient activation before – sometimes it’s referred to as patient health engagement or patient empowerment. It’s a concept that’s really popular in healthcare systems simply because it’s quantifiable.* In essence, patient activation measures whether someone has the knowledge, skills and confidence to be an active participant in their health. You answer 10 or 13 questions on how you relate to your health, to your condition if you have one, how you would respond if something came up, how you feel about your symptoms. And you get a score: score 4 and you’re high on activation; score 1, not so much. Simple, right? This is why healthcare systems like it.
The score is obviously not gratuitous. The researchers who put this forward showed that those people who score high achieve better outcomes – they are healthier, they live longer. That’s because:
- They attend checkups and health screenings (eg smear tests, mammograms etc)
- They are well-informed, especially if they have a pre-existing condition
- If they need to take medication, they do so as prescribed
- They have better conversations with their doctors
- They also cost the system less, which the system obviously cares about too
Among other reasons.
So ultimately the point of this is that being actively involved in your health, being engaged with your health and well-being, is good for both you and the healthcare system.
Yoga increases patient activation
In 2019, a piece of research** was carried out for the West London CCG, evaluating particular yoga interventions, the Yoga4health program, for patients with risk factors for cardiovascular disease, pre-diabetes, anxiety, depression, or social isolation. This is a 10-week program that includes some physical practice, breathing exercises, meditation, and relaxation.
What they found was that the yoga intervention led to improvements in both mental health outcomes (perceived stress, anxiety, and depression) and physical health (eg decrease in waist circumference).
But most excitingly, the yoga intervention also led to improvement in patient activation, with over 60% of participants reporting a significant improvement in the patient activation score. That means that those who participated in the intervention felt more knowledgeable, able, and confident to manage their own health. Which we know leads to better outcomes for both our health and the healthcare system.
Why would yoga increase patient activation?
There are a few possible reasons. Participants in this program note that they gained new skills (eg on how to manage mental health challenges), which they applied to their daily lives, with positive effects – ultimately increasing their confidence in their ability to manage challenges as they arise.
The main benefit has been the recognition that I can improve my health and mostly my mental health by using mindfulness, yoga, and meditation to keep me away from the GP.
In parallel, participants noted that they became more aware of their bodies, which meant that they noticed unhealthy behaviors and therefore had the opportunity to change them. This is, for me, the key to the benefits of yoga in this context – increased interoception. That’s the ability to listen and interpret signals that the body sends us and act accordingly. And we know that yoga and other mindfulness practices increase interoception.
Just the awareness that you get of your body, taking that away into your everyday life, that aspect of the practice I’m finding very useful.
So that’s why everyone should practice yoga
Perhaps I’m biased still. There are other things you can do to increase your activation – there are particular interventions designed all the time that aim to achieve that (I should know, we plan this into our patient programs all the time).
But the beauty of this is that it’s simple. And the benefits to health and wellbeing (and the system, let’s not forget about the system) could be huge.
*Now, this is a slightly constructed idea. When I spoke to health psychologists John Dinsmore and Tina Cartwright, they both commented that this wasn’t something not they had ever come across or something that got used routinely in academia. But healthcare systems like the NHS like it. A lot. And there’s a lot of research to back it up.
There is a caveat of course – the research has not been peer-reviewed, which is what you should always look for in a scientific finding. But I know it is currently being written up for publication, so hopefully, it’s solid and will sail through.
