The lay resource in health and health care.

In our preoccupation with developing professional health care services, we have lost sight of the contribution of lay people to their own health care. Indeed, health care has become synonymous with professional care. Recently, however, studies in Europe and North American suggest that the lay resource in health care constitutes at least 85% of all health care provided. As our knowledge of the world of lay health care expands, there is an emerging appreciation of multiple levels of lay self care, including behaviours relating to promotion, prevention, minor illnesses and injury treatment, chronic disease care, and rehabilitation. These activities appear to derive from an eclectic conceptual base that incorporates both allopathic and non-allopathic values, beliefs, and care-giving approaches. Furthermore, there is evidence of patterns of lay health care where care functions tend to be selectively distributed among discrete elements of the lay health care "system", comprised of individuals, the immediate family, the extended family, friends, mutual aid groups, lay voluntary organizations, and religious organizations. There remain, however, serious conceptual and methodological limitations in defining, observing, evaluating and interpreting the extent, quality and impact of the lay health resource. It is not, by and large, a regulated or officially sanctioned resource, so baseline data are not routinely available. Research methods useful in accounting for the lay system need further development and must be sensitive to often very subtle social and cultural aspects of lay health care. Many questions remain regarding demographic and social variations on the self-care theme.(ABSTRACT TRUNCATED AT 250 WORDS)