The Salutogenic Model of Health: Ease, Dis-ease, and the River in Between

This chapter presents the paradigmatic shift in the way health and disease are viewed from pathogenesis to salutogenesis. First, the basic assumptions of the salutogenic model of health are presented in an illustrious way, showing what led Aaron Antonovsky to ask the salutogenic question of “what creates health” and coin the term “salutogenesis.” Second, the distinction between salutogenesis and pathogenesis, emphasizing that they are not two sides of the same coin, is discussed along five major dimensions: (a) Health/Sick dichotomy vs. Ease/Dis-ease continuum, (b) Focus on a disease vs. focus on the whole person, (c) Risk factors vs. salutary factors, (d) Stressors: negative vs. neutral, and (e) Focus on biology vs. considering psychosocial factors. Third, the core concept of the salutogenic model of health—the sense of coherence (SOC)—is reviewed, with reference to its three components: comprehensibility, manageability, and meaningfulness, which are illustrated by real-life examples. Space is given to the development of SOC and to the concept of generalized resistance resources. Fourth, applications of salutogenic theory and SOC measurement in various contexts and disciplines are reviewed. Fifth, current theoretical and empirical issues and debates which call for future research are presented. The chapter ends with a conclusion in which it is recapitulated that salutogenesis and pathogenesis can coexist.