Let me share a quick story. My husband is an agronomist, and his passion for the land is nothing short of a superpower. Show him a picture of a plot of land, and he doesn’t just see grass, dirt, and trees, he sees a story. He can tell where water runs underground, which areas will flood in a storm, how healthy the plants are, and where wildlife will thrive or steer clear. Over the years, I’ve come to love listening to his insights about the land and discovered that they reveal interesting parallels to my own work in healthcare.
While my world revolves around primary care psychology, my husband’s life is all about land conservation. He leads an ecological science division where a team of professionals from agronomy, biology, engineering, and archaeology evaluate the land to understand it, prevent possible problems, optimize its productivity, and fix any arising issues. Their work is centered on recognizing and addressing interconnected systems, a concept that resonates deeply with integrated healthcare.
The SWAPA Framework
One of the key tools my husband’s team uses is SWAPA, which stands for Soil, Water, Air, Plants, and Animals. This framework evaluates land health by examining the relationships between these five elements. Each one is important on its own, but together, they reveal the full picture of an ecosystem’s well-being. As he described SWAPA to me, I started wondering: Could a similar model help healthcare teams create more effective, systemic health strategies?
Integrated care is at its core systemic thinking in action. The field has relied on frameworks like Bronfenbrenner’s Ecological Systems Theory and Engel’s Biopsychosocial Model to understand how physical, emotional, social, and environmental factors shape health. Instruments like the contextual interview have made these connections tangible in behavioral health. Yet, despite our progress, interprofessional treatment planning frameworks are not always widely discussed. Could an adaptation of SWAPA offer a valuable perspective to this ongoing conversation?
The SWAPA framework serves as a common language. Each professional brings their own specialized knowledge, but SWAPA gives them a way to collaborate efficiently. Thinking about SWAPA this way, we can consider how its principles might offer insights into integrated care.
Soil: The Physical Foundation
In land conservation, soil is the foundation. It determines whether plants grow, water is retained, and an ecosystem thrives. Similarly, physical health forms the foundation of well-being. Chronic stress, poor nutrition, and lack of sleep can degrade this foundation, making it harder to support overall health. By viewing the body as the “soil”, we can help all members of the health team contribute to strengthening this foundation.
Water: Emotional Flow and Nourishment
Water represents the life force of an ecosystem, hydrating the soil, sustaining plants, and supporting animals. In healthcare, water can symbolize emotional flow and nourishment. Just as ecosystems need balanced water cycles, people need emotional balance. Too much emotion can flood us, while too little can leave us thirsty. In the healthcare ecosystem, all members have the potential to influence emotional resilience.
Air: The Environment and Mental Clarity
Air represents the atmosphere that affects everything, from the quality of soil to the health of plants and animals. In healthcare, air can symbolize the external environment and internal cognitive clarity. Is the person in a safe, supportive space? Is their mental environment polluted by intrusive thoughts or unhelpful beliefs? Creating “fresh air” for systemic health might mean improving access to nature, reducing environmental stressors, or engaging in practices like mindfulness to clear mental fog.
Plants: Habits and Behaviors
Plants are the visible outcomes of an ecosystem’s health. They reflect the quality of the soil, water, and air. Similarly, a person’s habits and behaviors are the tangible expressions of their health. Healthy routines, such as regular exercise or time spent with loved ones, grow when the underlying conditions are right. Conversely, unhealthy habits might signal an imbalance in the system. Viewing behaviors as “plants” invites us to focus on nurturing the conditions that support growth.
Animals: Relationships and Social Ecosystems
Animals represent the biodiversity of an ecosystem. They depend on soil, water, air, and plants to survive, but they also contribute to the system’s balance. In healthcare, animals may symbolize relationships and social connections. Strong relationships enhance resilience, provide support, and enrich our lives. Isolation on the other hand, can destabilize our health. Health providers across disciplines can strengthen this ecosystem by connecting patients to community resources, facilitating support groups, or helping families navigate care together.
Agronomy and Integrated Care
As I reflect on these conversations with my husband, I can’t help but laugh at how much I’ve started seeing everything through the lens of soil, water, and air. I might not be able to predict where a tree will thrive, but I do see how a good support system can help a person flourish. Maybe that’s the real takeaway, not that healthcare needs more agronomists, though I think they would make valuable contributions. Rather, the deeper insight is that healing, like nature, is never a solo endeavor. So, here’s to a little more curiosity, a lot more teamwork, and maybe even a few more dinner table debates about dirt.
Share a Thought, Leave a Comment!
Very interesting comparison you’ve made through this article! In my opinion support systems are a must in a person’s life. Also, achieving a balance in life. Congratulations on this work! Very proud of you!
This is great! Nydia’s article does a great job of bridging the agronomic expertise with healthcare. It’s a compelling way to highlight how conservation principles can apply to human well-being.
El arte de ver la psicología en todo lo que hacemos. Maravilloso escrito que nos invita a abordar a nuestros pacientes desde una perspectiva completa. No sólo pienso en nuestros pacientes, si no, a nivel sistémico, los lugares donde trabajamos o donde nos envolvemos, nuestras familias, etc. Leería un un artículo o un libro de este tema. Gracias Dra. Nydia Cappas, por tan valioso escrito.