Pathogenic and Salutogenic health concepts
The salutogenic concept of health was developed by a medical sociologist known as Aaron Antonovsky. The concept was to provide a new perspective to health promotion and needs assessment (Antonovysk, 1979). It majorly focuses on the aspects that maintain health and well-being. The salutogenic model explains the interaction between health stress and coping. This interaction is described by Antonovsky as a continuous variable that he specifically termed as “health-ease versus dis-ease continuum” (Antonovysk, 1979). The pathogenic concept of health on the other hand views disease as deviation from health. This concept focuses on factors that cause disease. It is based on the medical model dichotomy that basically divides disease and health.
Contrast and Similarities
These two concepts are similar in that they both recognize the factor of disease exists and that their factors are involved in disease causation. Both concepts aim at correcting the health deficiencies to normal states.
The contrast between the two is that while the pathogenic and salutogenic concept of health is that pathogenic concept defines disease as the deviation from health based on the dichotomy of health versus disease while in salutogenic concept, people are grouped or classified as more or less healthy or diseased. Antonovsky further explains that absolute well-being/health or total disease can only be approximated (Antonovsky, 1979). The pathogenic concept is based on disease-causing microorganisms such as bacteria, viruses and fungi while the salutogenic concept views disease causation as caused by multiple factors based on well-being achievements in terms of successful coping strategies and health. The factors that hinder these are seen as causes of disease. Salutogenic encompasses the relevance of what people who are ill feel together with those around them; this is not taken into consideration in the pathogenic concept that concentrates on the disease only.
Relevance of Salutogenic and Pathogenic concept of health to Public Health
Health promotion according to the World Health Organization as explained in the Ottawa Charter is defined as “the process of enabling people to increase control over, and to improve, their health” (WHO, 1986). The relevance of these two concepts to Public health will be explored by determining their relevance to health promotion. These two concepts are relevant in health promotion and play a vital role in the process of health promotion. The phases of health promotion which according to the Ottawa Charter are, the first phase is that which determines the background/determinants, the second phase which basically sets the objective (to lead an active productive life), and finally, the activity which means the enabling process. These phases of health promotion are similar to the three aspects of the salutogenic concept of health; focus on problem-solving, identification of General Resistance Resources (GRRs) that enables people to move towards positive health, and lastly, identification of overall and all-encompassing sense in the communities and or systems that operates in sense of coherence (SOC). Research studies have shown that SOC can be learned and has a strong relationship to apparent health, mental well-being and quality of life (Erksson & Lindstrom, 2005). It is worth noting that SOC has been scientifically proved to be very important and relevant to the learning process (Nilsson & Lindstrom, 1998). From these, it is evident that the amalgamation of salutogenesis and quality of life grasps the core components of the principles of health promotion where by salutogenesis is the process leading to quality of life (Lindström, 1994). The salutogenic concept can be implemented in public health practice through the application of its principles in healthy public policies, these are inclusive of the SOC health indicators system and the use of SOC instruments in treatments. The disease concept relevance is demonstrated in its definition of disease as deviations from normal where by an individual is labeled sick and therefore has to seek medical attention, this process of health-seeking behaviour creates an awareness that ‘something’ is wrong. This promotes health promotion in that by seeking health one is able to take control over and improve his/her health; these are objectives and aims of health promotion. Since health promotion forms an integral part of public health and has demonstrated that the two concepts are relevant to HP, they are therefore relevant in Public Health Practice.
References
- World Health Organization, 1986, Ottawa charter for health promotion, Journal of Health Promotion, Vol. 1, pp. 1-4.
- Eriksson, M., & Lindström, B., 2005, ‘Validity of Antonovsky’s sense of coherence scale: a systematic review’, Journal of Epidemiology and Community Health 59:460–466.
- Antonovysk, A. (1979) Health, stress and coping. Jossey Bass: San Francisco.
- Nilsson L., & Lindström B., 1998, ‘Learning as a health promoting process: the salutogenic interpretation of the Swedish curricula in state education’, International Journal of Health Promotion, Vol. 59, pp. 14.
- Lindström, B., 1994, The Essence of Existence , Nordic School of Public Health, NHV-Report, 3, Göteborg.