Salutogenesis: the concept of health creation
We often hear about finding the root cause of a disease (pathogenesis) and this is important. Much of modern medicine is taught, structured and practiced around pathogenesis – identifying the cause of an illness, understanding its development and the symptoms to look out for. So, research into answering these questions gets the lion’s share of attention and funding. But, what if we asked a different question?
While pathogenesis asks "what causes disease?" salutogenesis asks "what causes health?" and focuses on looking at those factors that can enhance our wellbeing.
It reminds us that health and wellbeing are not just about the avoidance and absence of disease.
The term was first coined by Aaron Antonovsky (1979). By looking at people who appeared to be thriving despite their stressful conditions, he asked the question "what are they doing that the unwell people are not?" He found they had coping mechanisms in place to make sense of, manage stressful situations and move forwards.
He describes the term ‘sense of coherence’ to explain how people understand the role of stress in their lives. This has three dimensions:
Sense of meaningfulness – “My world has meaning”
Sense of comprehensibility – “My world is understandable”
Sense of manageability – “My world is manageable”
While Antonovsky was looking at this through the lens of a sociologist and from the perspective of mental resilience and resource of poorer and immigrant populations adapting to new environments, it can be broadened to guide health promotion more generally. I like the term ‘health creation’ because it reminds us that there is a lot in our control and every day, we are creating our health through what we engage in. Otherwise, health would be something we stumble across or something that happens to us.
What does salutogenesis look like when applied to health creation?
Support network
Locus of control
Healthy environment
Movement/exercise
Play
Access to nutritious food
Getting enough sleep
Relaxation
Connection/social network
Health literacy
Adaptation
What else would you add to this list?