There is a quantifiable link between how much someone takes care of themselves, and their overall wellbeing; on the one hand, self-care does lead to better wellbeing, and on the other hand, people who have overall better levels of wellbeing also have more motivation to practise self-care.

The problem, however, is that many people cannot even enter that feedback loop in the first place. People Matters asked experts from health and wellness company Cigna about some of the data substantiating this issue and the way forward, and the answers weren't as optimistic as we'd hoped.

People aren't prioritising their physical health in the first place

Findings from Cigna's 2023 Vitality Study - a fresh piece of research looking at respondents' 'vitality', or overall state of health across eight different dimensions covering social, occupational, financial, intellectual, physical, spiritual, emotional, and environmental wellbeing - show that only 20% of people worldwide have a high level of vitality. The number drops to 14% in the APAC region. And in Singapore - home to one of the most notoriously stressed workforces in the world, possibly second only to Hong Kong - it's only 10%.

In this low-vitality workforce, 38% of respondents said they choose to prioritise their physical health, but that  still leaves 62% who do not. Another 63% apparently do not value learning new things and gaining understanding. 68% do not look forward to each new day. And 70% do not think they have all the skills and tools necessary to live a healthy life.

"Part of vitality is to have a level of forward-looking, forward-thinking optimism about the future," says Larisa Beckhouse Okeke, global head of insights at Cigna. "But in Singapore, people are saying they can't control the cost of living. They can't control their personal finances. And that plays into their mental health."

This effect is seen more intensively in business hub locations, Beckhouse Okeke notes, and the one deciding factor that ameliorates it is stress management. Essentially, people who take better care of themselves have higher vitality. It's the feedback loop that psychiatrists tending to stressed populations struggle with constantly: self-care will help deal with stress, but how do you practise self-care if you're too stressed to look after your health?

Can employers do anything?

Or, more importantly: what responsibility do employers have towards their stressed workforce? And how do they discharge that responsibility without becoming too intrusive?

A simple early step, especially in situations where the stress comes from financial conditions, is to push for individual insurance that is portable between jobs or even between locations. In countries with high medical costs, and particularly in Singapore, which has not only high costs but a large number of expatriate employees who cannot benefit from local subsidies, offering such plans is a good start. And ensuring that such insurance also covers mental health is doubly helpful.

In fact, Cigna's data shows that the top three elements workers want from their employer's health and wellbeing programmes are flexible work arrangements (66%), private health insurance (63%), and mental health support (34%). Preventive care, such as wellness programmes, ran fourth at 31%.

On employers' end, these programmes do bring significant cost benefits for the time and resources invested. "A healthier workforce is a more productive workforce, with people who take fewer sick days or mental health days, and who bring more energy to work," says Beckhouse Okeke. "It's a matter of how you present it - to both the employees and the employers."

The power of peer pressure

Holistic wellbeing, and in fact the acknowledgement of wellbeing itself, has taken a long time to gain traction. The pandemic did accelerate a cultural shift towards placing greater attention on employee wellbeing, but employees themselves may not share that drive; sometimes employers have to take a hard stance, suggests Christine Wee, head of client management at Cigna Singapore.

"Leadership has to set the tone, and incentives have to be in place to create competition and peer pressure among employees who may not otherwise take up wellbeing initiatives," she says.

Leadership and peer pressure plays a similar role even at the company level. Many companies, especially smaller ones, still do not make a point of wellbeing as they have other, competing priorities. In such cases, HR has a role to play in selling wellbeing more intensively to decision makers, as Beckhouse Okeke said: finding convincing ways to present the cost benefit analysis, balancing investments with cost containment measures, and overall aligning wellbeing programmes with business needs and constraints.

But HR is only an internal voice. External pressure, such as regulatory requirements, can potentially have a much greater impact. And external leadership and peer pressure in particular, from other companies that are competing for the same talent pool, can be especially effective. In Singapore's context, for example, multinationals with strongly established global policies around wellbeing and the resources to support those policies locally, set a bar for small and medium-sized enterprises that may otherwise lag behind.

Ultimately, even though wellbeing - in all its dimensions adding up to the overall measure of vitality developed by the Cigna experts - is something that must be supported on an individual level, that support in turn must be built on a similarly holistic ecosystem. Wellbeing is an issue faced by employers and society alike, and in advancing it, no one individual or organisation can succeed as a lone voice or an island: everyone needs to find a way to pursue self-care together.

This article was originally published in November 2023.