The Salutogenic Paradigm
Introduction
The salutogenic paradigm is well-positioned to provide a theoretical heuristic, a framework, inform a set of interventions, and suggest interventions for the individual, community, and societal levels to address the immense challenges facing individuals and communities. The paradigm provides a theoretical framework that facilitates an orientation, approach, and strategy-oriented set of interventions that focuses on the factors that contribute to the creation and maintenance of optimal wellbeing. As a paradigm, the salutogenic model and the intervention that it informs can be a shift from the current pathogenic paradigm; we are currently at an inflection point that may be a positive outcome.
The salutogenic paradigm
Diagram: The salutogenic paradigm, based on Antonovsky, 1996 .The core concept of sense of coherence (SOC), consists of three dimensions (comprehensibility, manageability, and meaningfulness; generalized resistance/ salutogenic- (thriving) resources: specific resistance / salutogenic (thriving) resources.
Based on his initial research, Antonovsky’s answer to the question of Salutogenesis consists of the following key components:
Sense of Coherence: This is the way in which people make sense of the world, use the required resources to respond to it, and feel that their responses are meaningful and emotionally satisfying. It has three elements: comprehensibility (the cognitive element), manageability (the instrumental element), and meaningfulness (the emotional element).
Generalized Resistance (salutogenic) Resources: These are resources that can help people cope with stressors and manage tension successfully, and they can be internal or external, material or non-material.
Specific Resistance (salutogenic) Resources: These are resources that are shaped by life experiences and can help mobilize other resources to cope with stressors and manage tension.
Health in the River of Life: The river of life metaphor emphasizes that people will likely experience multiple stressors in a chaotic world, and salutogenesis focuses on providing health-promoting tools and environments throughout the life course.
In addition the Salutogenic Paradigm is informed by
Systems Approach: Because its area of interest is the individual within their environmental complexity, the salutogenic model is well-positioned to contextualize the individual health and wellbeing as a related physical-social-cultural/political-spiritual process and provide suggestions for a holistic approach to address the challenges it presents. The paradigm explores the complex dynamics of the development of individuals in the direction of health.
Transdisciplinarity model: At its fullest manifestation, the salutogenic paradigm, is an action-oriented transdisciplinarity( multidisciplinary) model and approach; it involves “blurring boundaries” between disciplines and the synthesis of a new epistemology– new conceptual and theoretical frameworks, and new methodological approaches that ultimately yield a deeper understanding of the processes and problems being studied “as a complex dynamic system”. The salutogenic formulation requires the exploration of the person across disciplines. It is conceptualized as a Biological- psychological, physical-social-cultural/political-spiritual framework that views the multidimensional person, engaged in many systems. (body, social and cultural relations, ecology also globally)
Challenge of data: Much of the current measurement of outcomes of interventions in the healthcare arena focus on removing pathology. Salutogenic outcomes focus on indications for optimizing well-being.
Life-long focus: The individual’s health and well-being transcends the current moment and can be understood along the life course. Starting with the origins of the sense of coherence, it develops, according to the salutogenic model, from infancy and the infant’s experience of its sociocultural and historic context. Antonovsky wrote extensively about the roles of culture in salutogenesis and the development of the sense of coherence
Complexity: From the perspective of complexity science, health is about development in the direction of more complexity and adaptability, therefore, it follows that a salutogenic health care system must facilitate development and adaptability.