What is salutogenesis?

Salutogenesis is the science of creating and maintaining health. Salus comes from Latin and means health, the part of the word genesis literally means emergence. Thus, salutogenesis is to be seen as the counterpart to pathogenesis, which describes the development of disease. In the 1970s, the medical sociologist Aaron Antonovsky investigated which factors influence salutogenesis. He developed a theoretical model about the qualities that one needs in order to become and stay healthy.

Antonovsky’s investigation

Antonovsky conducted a study of adaptability to  menopause in a group of women who had been imprisoned in concentration camps at a young age  . He compared their ability to manage this particular hormonal condition to that of a control group.

Despite the previous exposure to the concentration camps, there were women whom Antonovsky considered perfectly healthy, both physically and mentally. They seemed to have endogenous resources that kept them healthy despite the bad experiences (stressors). Through Antonovsky’s investigation, the focus of science on the development of disease (pathogenesis), which had been usual until then, was supplemented by the aspects of salutogenesis. 

It quickly became clear that there are major differences between approaching a disease from a salutogenetic or pathogenetic perspective. Pathogenesis tries to avoid disease. Salutogenesis, on the other hand, tries to achieve an attractive health goal. In the case of diabetes  mellitus, for example, the focus is not on avoiding high  blood sugar  through a diet  , but on successful jogging, which leads to overall well-being.

In further research, the question of how health develops and how it can be maintained became more of a focus.

The sense of coherence

A concept closely related to salutogenesis is the sense of coherence. Coined by Antonovsky, it means a sense of belonging and a deep inner contentment with oneself and others. Three components are important for the SOC:

  1. Comprehensibility: The ability to make connections between events in life.
  2. Coping ability: The ability to deal with events.
  3. Meaningfulness: The belief that everything that happens has a purpose. This conviction makes it easier to accept what is happening.

Everyone develops these three characteristics within their first 20 years of life. Depending on how severe these are, people can deal with crises differently, for example with drastic experiences such as the death of a family member, with  stressful  phases at work or with an illness. How healthy we are depends essentially on the characteristics of the three characteristics.

Resilience and Salutogenesis

The two terms resilience and salutogenesis are closely related. Resilience means something like resistance. The more resistant we are, the better our body can ward off disturbances, the healthier we remain. There are people who never get sick, even though they are exposed to many potentially pathogenic circumstances. Others, on the other hand, lie in bed with a fever  or symptoms of exhaustion even in mild stressful situations  . The former are more resilient because they can fall back on personal resources in critical situations and see a crisis as an opportunity for further development.

How do I stay healthy?

Theoretical models can be used to describe pathogenesis and salutogenesis well. But how does one achieve a sense of coherence in practice, as described by Antonovsky?

Personal resistance resources such as intelligence, flexibility, far-sightedness, material wealth, the social network and the  immune system play an important role in this . Anyone who has a high standard of living, many friends and a good education has the best prerequisites for staying healthy. Health is therefore strongly dependent on external circumstances. A positive self-assessment and working on one’s own identity are just as important. Only those who are at peace with themselves can stay healthy in the long term.

Finally, it should be noted that health is a process and not a state. There are always phases in life in which illness or health predominate. But a balanced lifestyle that promotes resistance resources and sets attractive health goals in terms of salutogenesis is the best prerequisite for staying healthy in the long term.


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