Perspectives on Salutogenesis of Scholars Writing in Spanish

Abstract

In the last few years, the influence of salutogenesis has been growing, both in the area of research and in the public health and health promotion strategies and policies, in Spain and in Latin America.

The scientific literature on salutogenesis that has been published in Spanish since 2000 is reviewed, out of which 58 scientific articles, five books, and eight doctoral theses have been identified. The publications focus on health-related professional groups, patient groups, population groups, public health, and studies related to health promotion and education.

The Salutogenesis Spanish Group is a network of professionals who are interested in this subject, who work to exchange experiences and to promote salutogenesis research and development within our contexts.

Introduction

In the last few years, the influence of salutogenesis has been growing, both in the area of research and in the public health and health promotion strategies and policies, in Spain and in Latin America. Since Hernán and Lineros (2000) reviewed this model in Spain, the number of publications that apply Antonovsky’s perspective, as well as the actions based on the health assets model , have increased.

In the last few years, this model has had an impact on the health promotion actions which have been carried out in the different scenarios. More precisely, in school health promotion , some actions oriented to promote the personal and social development of educators have been promoted, and both internal and external personal resources have been considered as an important way to reinforce general resistance resources. Proposals that promote emotional health, coexistence, resilience, and physical activity have been emphasized. Another important area that has been developed lately is the momentum of the Spanish Health Promotion Universities Network and the Latin America Health Promotion Universities Network (REUS and RIUPS, respectively, in Spanish) for setting up synergies among university members and for improving health promotion education and research. The asset maps methodology is being used in order to identify health resources. In 2013, the Alliance for Community Health was set up by many Spanish Public Health Administration entities, by the Medicine, Nursing and Public Health Scientific Societies and by the Public Health Universities and Education Centers, with the aim to promote community health from primary care health services.

The analysis of health social determinants and health equity has generated a large debate and has led to the development of different strategies and plans to reduce health social inequalities. The salutogenesis and health asset model is extremely useful when it is included in policies and programs whose aim is to achieve health equity.

Review of the Scientific Literature on Salutogenesis in Spanish

This literature has been searched from 2000 on in the Pubmed, Cinhal, Medline, Cochrane, Redalyc, and Scopus databases, by entering the following keywords: salutogenesis, sense of coherence, salutogenic, salutogenic approach, health assets, and SOC.

The selected papers were classified by their year of publication, publication type, and these topics:

• Sense of coherence

• Salutogenic policies

• Salutogenesis approach.

• Health assets

From the year 2000 to this writing, the salutogenesis literature in Spanish includes 58 articles, five books, and eight doctoral dissertations, produced in Spain, Portugal, and countries of Latin America. Tables 47.1, 47.2, 47.3, and 47.4 list journal articles in the ascending order of year of publication, with citation information in Spanish. The last column in each Table indicates in English the study group or groups that are in focus in each article.

Table 47.1 Sense of coherence —journal articles

Table 47.2 Salutogenic policies —journal articles

Table 47.3 Salutogenic approach—journals articles

Table 47.4 Health assets —journal articles

Besides the salutogenesis literature in journals, as listed in Table 47.5, several noteworthy books have been published. The first one was published in 2000, and the other four, were published after 10 years, one book on 2010 and three books on 2011. The last column of Table 47.5 indicates the issue covered in the book.

Table 47.5 Salutogenesis books

Finally, eight doctoral dissertations have been identified. Also, in Table 47.6, the last column indicates the subject of the doctoral dissertation, and five of the eight focus on population groups.

Table 47.6 Salutogenesis—doctoral dissertations

Spanish Salutogenesis Group

The Spanish Salutogenesis Group was set up on July 12, 2012, stimulated by a proposal of Professor Bengt Lindström when he visited the University of Girona (Spain) for the presentation of the book “The Salutogenic Hitchhiker,” which had been translated into Spanish by the Health Promotion Chair at the University of Girona. This group was set up by the authors of this chapter with the aim to create a meeting point, a resource for Spanish-speaking professionals who are working or wish to work from the salutogenic approach, as well as to promote the work that is being carried out in Spanish speaking countries and to build a bridge with the international group. The group’s objectives are to:

• Expand the network of professionals working in salutogenesis in Spanish.

• Promote and exchange experiences and knowledge on salutogenesis.

• Promote salutogenesis research and development within our contexts.

• Stimulate the implementation of the salutogenic approach in intervention, education, and research.

In order to develop a strategy that fosters the salutogenic approach, based on assets for public health, the Salutogenesis Spanish Group proposes the ten principles below:

• 1. The contributions of sociology, psychology, and human learning theories to medicine and health sciences have generated a salutogenic approach to public health. This new perspective complements and, somehow, also opposes the more traditional perspective of the biomedical sciences, which focuses on the recovery of health deficits. Salutogenesis is re-oriented towards people’s well-being.

• 2. The salutogenic approach emphasizes the assets that generate health and also examines the elements that make it possible for people to understand, manage, and find a sense to their life. These elements focus on the individual and group resources available—the so-called general resistance resources—that help people to understand their own life, the effects of the structural inequalities and therefore become stronger to overcome them. This perspective and its health paradigms are especially necessary now, in a context of global crisis and deep economic changes that can impact people and foster social inequalities which, in turn, have an impact on health.

• 3. The existing knowledge should be rebuilt and new knowledge should be gathered, in order to provide legislators, politicians, managers, promotion specialists, and professionals in the health, well-being, and education sectors with positive approaches for health, well-being, and human development. The salutogenic approach should be included in public health regulations, plans, and programs.

• 4. Promoting an approach to public health based on the vital life of people could make it easier to understand and to manage health assets in each phase of life. If health is included in all public policies, we will be able to understand people and communities in their contexts and in the different phases of life, and clarify the changes required in policies for better health and well-being.

• 5. Professionals should be involved with communities in all issues related to the health development process, enabling them to use all the capacities of people in a place and social context. By being aware of all we can do for our health and of what should be socially changed—and by taking the necessary steps required—we will illuminate the opportunities available to be healthy.

• 6. It is important to learn more about the relationship between health and the sense of coherence, which allows people to understand, manage, and find a sense to what happens along their life, and also to know how this impacts on their personal quality of life and on that of their community. An asset for health could be defined as any element or resource that reinforces the capacity of individuals, communities, and populations, so that they keep their health, well-being, and sense of coherence.

• 7. We should foster and improve the evidence that allows us to further understand the elements that make people and communities live a healthier life. This could help us to emphasize the health determinant analysis models that aim at understanding which is the origin of health and its correlation with quality of life. We should identify the key elements or resources that contribute to health and well-being in childhood and youth—which are crucial phases in life to learn in a healthy way—and also in other stages in life.

• 8. In order to develop purposes for the strategy that fosters the salutogenic approach, it is very important to apply a multidisciplinary approach and to complement experimental studies with narration, epidemiology, ethnography, sociology, and biomedical sciences.

• 9. A key element consists of identifying experiences , types of strategies, initiatives, and ways to work that more efficiently lead to the promotion of capacities and abilities in individuals and communities, so that health is maintained, promoted, and recovered.

• 10. It is absolutely necessary to work so that projects and actions include some indicators that lead to the evaluation of programs based on positive models. We should improve the ability to understand not only the things that work and their results, but also how things work in different contexts—because the social context of people helps to identify priorities and, thus, promote the elements which generate health and reduce the stress created by unfair inequalities, as well as all the elements that could help to design policies that allow people to evolve towards health objectives in the medium and long term.

The website of the Spanish Salutogenesis Group disseminates information about the Group, news related to it, resources, projects, and links.