Salutogenese

Salutogenese is a theoretical framework in health promotion that emphasizes factors that support health and well-being rather than those that cause disease. It was developed by Aaron Antonovsky, a German-born sociologist and medical anthropologist, in the late 1970s and 1980s. The approach seeks to explain why some people stay healthy despite experiencing stress and adversity.

The central concept is the sense of coherence (SOC), a global orientation describing the extent to which one perceives life as comprehensible, manageable, and meaningful. When SOC is strong, individuals are better able to mobilize resources and cope with stress. Generalized resistance resources (GRRs) such as social support, financial resources, education, and coping skills help maintain health by reinforcing SOC and enabling effective response to stressors.

In practice, salutogenesis informs health promotion by aiming to strengthen SOC and GRRs through supportive environments, empowerment, education, and policies that improve access to resources. It complements, rather than replaces, pathogenic models by focusing on health production and resilience. Applications span community health, workplace wellness, chronic illness management, and mental health promotion.

Measurement and evidence: The sense of coherence is assessed with instruments such as SOC-13 and SOC-29. Research shows that higher SOC is associated with better self-rated health, lower perceived stress, and greater resilience, though questions about causality and cross-cultural validity remain.

History: Antonovsky introduced the concept in Health, Stress and Coping (1979) and later in Unraveling the Mystery of Health (1987). Since then, salutogenesis has influenced public health, education, and social policy as an approach to sustaining health across the lifespan.