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Ten years ago Aaron Antonovsky died after a short period of disease. His death meant a break in the leadership of a new innovative direction in public health research. His fundamental contribution was to raise the philosophical “salutogenic” question of what creates health and search for “the origin of health” rather than to look for the causes of disease. He was born in Brooklyn New York studied sociology and later became professor and head of the department of sociology of health at the faculty of health sciences of the Ben-Gurion University in Israel. Antonovsky had the salutogenic idea while conducting an epidemiological study on problems in the menopause of women in different ethnic groups in Israel. One of these groups shared a common experience—they had survived the concentration camps of the second world war. To his surprise he found that these women had the capability of maintaining good health and lead a good life despite all they had gone through. Antonovsky stated that disease and stress occur everywhere and all the time and it was surprising that organisms were able to survive at all with this constant mass exposure. The question that came to his mind was how we can survive despite all this. In his world health is relative on a continuum and the key research question is what causes health (salutogenesis) not what are the reasons for disease (pathogenesis). The salutogenic perspective focuses on three aspects. Firstly, the focus is on problem solving/finding solutions. Secondly, it identifies generalised resistance resources that help people to move in the direction of positive health. Thirdly, it identifies a global and pervasive sense in individuals, groups, populations, or systems that serves as the overall mechanism or capacity for this process, the sense of coherence (SOC). Today almost 25 years have passed since the question first was raised and it is about time to draw the conclusions of how far research has come. Presently there is a review of this research undertaken at the Nordic school of public health. The preliminary results prove that SOC develops through life time. SOC increases through the life span and it has strong positive correlations to perceived health, mental health, and quality of life. The Institute of Medicine in USA stated in 2003 that one of the most pertinent needs for the education of health professionals for the 21st century is the necessity of finding a coherent health concept—the salutogenic model would perhaps serve such a purpose.
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