WHAT IS SALUTOGENESIS?

Sense of coherence: sense of wellbeing
Collectively, resources promote the development and maintenance of a strong 'sense of
coherence', which is synonymous with health. The stronger the sense of coherence a person
has, the better ability they have to employ cognitive, affective and instrumental strategies
which are likely to improve coping 2 and thus wellbeing. There is not one coping strategy but
many, and a person who copes well, who has a strong sense of coherence, is able to select the
best way of dealing with the particular stressor. Each person's sense of coherence, or sense of
wellbeing, requires certain inherent prerequisites for coping successfully, as follows:
1) Meaningfulness: the deep feeling that life makes sense emotionally; that life's
demands are worthy of commitment. It is essentially seeing coping as desirable.
2) Manageability: the extent to which people feel they have the resources to meet the
demands, or feeling that they know where to go to get help.
3) Comprehensibility: the extent to which a person finds or structures their world to be
understandable, meaningful, orderly and consistent instead of chaotic, random and
unpredictable. 3
The extent to which a person develops these prerequisites - the extent to which a person has
pervasive, enduring and dynamic feelings of confidence that things will work out as well as
can be reasonably expected - is determined by that person's sense of coherence. 4 This is
firmly grounded in the person's own context and culture and Antonovsky emphasises that a
person's socialisation is fundamental to how a person sees the world and how strong their
sense of coherence will be. For this reason salutogenesis considers social and health capital as
determining factors in the creation of a sense of coherence.
Social capital can be described as levels of reciprocity in the community, trust, co-operation
and social cohesion. Health capital are those factors which influence health and could include
socio-economic background, childhood history and coping skills.
From theory to practice
The possible conclusions from Antonovsky's work are that one can expose a child to life
experiences which will contribute to a strong sense of coherence and therefore increase that
child's overall wellbeing. Although he feels it is less likely to be able to successfully
intervene in adult perceptions of health and coping strategies, others would say it is possible
to maximise their resources and accessibility to a strong sense of coherence and thus
wellbeing.
Antonovsky's theory postulates that health visitors should be given the resources to
experiment with salutogenesis in a public health promotion facet. This will contribute greatly
to a NHS which is conversing only in disease and clinical rhetoric.
Salutogenesis is a research tool which can be used as a starting point by all those concerned
with promoting health. By being able to understand how people manage their health, what
resources they use (they could be negative, for example a neighbour may suggest adding
alcohol to milk to pacify a baby) and then working to increase that person's positive
resources. This may then extend to working with people in the community, from housing
planners, social workers to community groups. This is the essence of salutogenesis; that
experts should be open "to what is going on in seemingly unrelated fields in an attempt to
2