What is wellness? And what does it mean to expats?

Google Trends shows that there has been growing interest in ‘wellness’ and ‘wellbeing’ over the past five years, but what do these terms mean and what is the difference between them?

‘Wellness’ is broadly understood to mean a state of general health closely associated with various aspects of one’s lifestyle. The term is sometimes used interchangeably with ‘wellbeing’ though the latter is often associated more with a mental state than simple physical health.

In 2016, Global Wellness Institute Chair Susie Ellis stated that ambiguity and semantic overlap was set to change. Ellis predicted that wellness would become more firmly associated with health and prevention, whilst well-being would become more associated with happiness. 

But at the end of 2018, ask 12 different people what they mean, and you’ll get 12 different answers.

‘Wellbeing’ has been a subject of study for decades. The fact that ‘wellness’ is used more and more infers that there is a need to differentiate between it and ‘wellbeing’. There is certainly growing interest in the topic of personal physical and mental health as a whole, and that’s just in the West. We want to understand what wellness means to people who live away from their home country — and how they maintain it. This is of course the most important part of this study — learning not just what wellness means, but how expats can achieve it.

Our survey

We conducted 32 in-depth interviews amongst more than 70 respondents within in the main target group. These families are globally mobile, living outside of their country of citizenship. This includes — expat employees on assignment, business owners, self-employed and those supporting the family through home-work or childcare.

These expat families showed clear recognition of the term ‘wellness’ and, for most, it has meaningful associations — it isn’t dismissed as jargon.

Wellness is an important way to express the broadest perspective on all aspects of personal wellbeing with the crossover between physical and mental wellbeing being clearly recognised by the majority of respondents. When prompted, our participants stated that wellness is generally seen as holistic as well as being ‘worked towards’ rather than just happening.

For many it is synonymous with quality of life more than quality of health.

After recording what the concept of wellness meant to our families, we read the World Health Organization definition of health: ‘A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’.

Most of the people we surveyed agreed with the statement and as covering the broad, holistic sense of wellness as a ‘state’ rather than an ‘outcome’.

Read the full survey here. Or click on the links below to read about specific topics:

• Wellness while living away from home
• Expat mental health
• Physical health, diet and exercise
• Expat mental health
• Expat health care 
• Personal security and safety

Summary and conclusions

The individual

Wellness is a collection of factors, from the essential to the subjective: everyone agrees that exercise and mental health are key to wellness while some agree that family and religion are important. What is common to all of these is that one size does not fit all. Wellness is complex and while commonality and patterns exist, it is essential that we do not reduce it to a useless simplicity that does not work for large swathes of humanity — with the huge variety of lifestyles and situations. From talking to our 32 families from 22 different countries, this could not be clearer.

Each individual needs to find what suits them: should they stay near their family or are they comfortable being far away? And then strive to make it a reality for them. The key is, don’t sleepwalk through your life making passive decisions. Expats are often forced to address areas that others never have to think about, and this can encourage making positive, conscious decisions from diet and education, to family ties.

Happiness

Directly and indirectly, happiness was a keystone of wellness — diet, fitness and mental health were just aspects to address in achieving it. Understanding what YOU need and then being able to get there is the challenge.

Empowerment

An important but difficult factor for happiness faces those who see poverty. The direct effect of witnessing can impact mood, but worse, the powerlessness to help is a real challenge for most people.

This feeds into the factor of empowerment. Having the power to choose and making our own choices about how we live our life makes us happier. Expats have a head start on their static counterparts as most have made one of the biggest life choices by deciding to move to another country. Our report found that: “The sense that it was an active choice and not a life that had been forced on to them made people more settled in their working lives.”   

Family and friends

Both parents and children say that being far away from loved ones is the biggest negative influencer on overall wellness. Setting up contact using social media, video calls or telephone is therefore essential.

Preparation and settling in

For expats, the first few months are essential to setting up good routines and habits for the family — often hinting at pre-trip planning as a way of setting yourself up for success. For some, the novelty of living somewhere new can wear off, for others it takes a few months to make things work. Advice and support seems essential to helping families settle. People who relocate without support, can take a long time to settle and suffer from mental health issues or end up coming home.

Diet and exercise

These two factors were the most recognisable parts of wellness — that a healthy body played a role equally as important as a healthy mind. Expats in particular have an opportunity to address this, with many old habits — good and bad — being unsustainable in their new country of residence. Many make conscious, positive steps towards a healthier diet having been forced to reassess it.

Many families enjoyed access to cheaper, fresher, healthier food in their new country.  

This often goes hand-in-hand with exercise regimes but work pressures and business travel can mean expats are often time poor, “and exercise is usually the first thing to go”. This in turn can lead to a spiral of stress and poor health.

Health care

Our families recognised health care as one of the most important aspects of life overseas, but our conversations indicated that it was often inadequately researched or planned for in advance. Health care providers like Aetna International offer support from pre-trip planning to virtual health care which help families settle; giving peace of mind, offering on-going advice and support, as well as covering the cost of treatment. Why put something as important as access to the right care and support in the hands of a quick internet search?

Many people are cynical about insurers but describe wanting services such as those offered by companies like Aetna International: advice, country guides, virtual health care — both preventative care and condition management, pre-trip planning, on-going support, and mental health support. An ecosystem of health care such as this helps to keep people well, which in turn eases the burden on health and wellness resources, and keeps premiums in check. 

Climate

Many expats move abroad for a better climate and others enjoy a better climate as a happy by-product of moving for another reason. Many families said wellness was improved in better climates because it “allows people to be outdoors more”.

Culture

Exposure to cultural diversity is a fundamental benefit but it was only seen as loosely linked to wellbeing — usually through wider horizons and a more positive self-image. Parents particularly like the fact that their children would grow up in a global environment — living an “international lifestyle” and learning new languages.

Mental health

While everyone agrees mental health is directly linked to wellness, expats have particular challenges whether related to increased stress or cultural norms and stigma in their new home.

Mindfulness

Our expat interviewees not only acknowledge the role mindfulness can play, they say how moving abroad forces/helps you to think about yourself, your body and your environment. For some this was about dietary choices, for others it took the form of meditation or prayer.

This also has its challenges as it can bring on stress: as people are forced to think about – even worry about — everything!

Summary

Wellness is complex and personal but expats have the positivity, insight and proactivity to achieve it by striking a healthy balance in their lives — especially with the right support from friends, family and health care partners.

Click on the links below to read what our families said about various topics:

• Introduction and conclusions
• Wellness while living away from home
• Expat mental health
• Physical health, diet and exercise
• Expat health care 
• Personal security and safety

Download the 'What is Wellness?’ Expat Family Health & Wellness Survey 2018

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