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01

Salutogenesis: The Authentic Wellness Model for Health

Author // Eric L. Zielinski, D.C.

A century ago, infectious diseases were the health crises of the day. Researchers broke ground with treatments and cures. Populations underwent radical improvements in lifestyle, such as sanitation, clean water and improved nutrition. Today, we no longer fear illness as previous generations did, yet we still do not consider our era to be one of health. In place of infectious diseases, we have chronic maladies. Tuberculosis and pneumonia have been edged out by diabetes, chronic respiratory illness, and cancers.


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Photos Courtesy of Westwood Family Chiropractic

While much attention and fundraising is devoted to a search for the cures for these modern killers, some have questioned whether we are looking for the right solution at all. A relatively new theory, salutogenesis, could be the public-health breakthrough of our time.


Modern Health Philosophies

Conventional medicine is centered around the allopathic model of care. Recall that the root path indicates feeling (in words like empathy) or illness (seen in pathogen, among others). Allopathy responds to symptoms and illness with a drug or treatment. Via Merriam-Webster: “A system of medical practice that aims to combat disease by use of remedies (as drugs or surgery) producing effects different from or incompatible with those produced by the disease being treated.”

The science and practice of allopathy continues to be an irreplaceable facet of medicine. The development of treatments and general prevention for infectious diseases has saved countless lives and changed the landscape of public health dramatically over the past century.

However, the rise of chronic metabolic and stress-affected disorders is not as easily treated by drugs or procedures, as evidenced by the rise of these ailments. In response, individuals are increasingly seeking out alternative options.

Naturopathy is often thought of as an alternative to allopathy, with its use of natural remedies instead of drugs. Homeopathy is seemingly in direct opposition, treating illness with hyper-diluted substances that cause similar, rather than opposing, symptoms. For example, both allopathy and naturopathy would treat inflammation with an anti-inflammatory, whether a drug or a natural remedy. Homeopathy, on the other hand, would treat it with a minute amount of an inflammation-causing substance, hoping to engage the body’s natural responses.

While the realm of alternative healthcare focuses more prominently on prevention, the common denominator of all these schools of thought is that of reactivity. Naturopathy, homeopathy and allopathy can all falter if they remain reactive rather than proactive in an environment of longterm illnesses. That’s where salutogenesis comes in.


A Shift in Thought

In response to the increased prevalence of chronic illness, prevention has come into focus from all schools of thought. In the 1970s, Dr. Aaron Antonovsky coined the term “salutogenesis” as part of his work in sociology and medicine. Rather than focusing on pathology first, the priority of salutogenesis is literally “birth of health,” helping the individual pursue wellness mentally and physically with the hope of preventative health and overall well-being. Antonovsky stated, “The concept of health promotion, revolutionary in the best sense when first introduced, is in danger of stagnation. This is the case because thinking and research have not been exploited to formulate a theory to guide the field.”

Shortly after Antonovsky introduced the concept, the School of Nursing in Salem, Massachusetts, evaluated the field of nursing for its ability to adapt to salutogenesis. The study concluded that salutogenesis “is determined to be explicit, comprehensible, logically congruent, and to have social significance, congruence and utility. We conclude that it is suitable for adaptation to the nursing milieu.” Decades later, however, salutogenesis is still not the primary standard. For example, it is unfortunately rarely used in maternity care.


The Chiropractic Lifestyle and Salutogenic Care

The core of chiropractic care is the promotion of wellness. When an individual visits a chiropractor, she is likely to receive a holistic wellness strategy instead of a singular symptomatic treatment. Even the removal of vertebral subluxations seeks to free the body to be well before illness has a chance to settle in the body. This kind of whole-person care is consistent with salutogenesis, promoting health as a preemptive strategy.

A 2014 study from the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, found that metabolic issues were markedly improved when stress, social support, lifestyle habits, and health awareness were considered in a salutogenic approach. The study concluded that salutogenesis should definitively be part of a primary-care strategy.

While the field of chiropractic came into existence more than 70 years before the inception of salutogenesis, it is clear that the principles are similar. When 197 chiropractic practitioners were evaluated for their wellness program, Life University College of Chiropractic in Marietta, Georgia, found that the salutogenic approach led to decreased risk factors for diabetes, cardiovascular issues, metabolic disorders and even cancer.

Chiropractic adjustments sometimes focus on reactive care to neck or back pain, but chiropractors attend to the whole person. Wellness checks ensuring that there are no subluxations often prevent pain, but the ultimate goal of the adjustment is to improve overall health with a properly functioning nervous system. Additionally, the consultation during the visit often serves to provide wellness counseling for the promotion of health and the so-called “chiropractic lifestyle” as a whole.

The medical community might not be immersed in salutogenesis, but more and more, individuals desire that kind of holistic, integrative wellness care. Consumers have access to more information than ever before, and they are learning how to take responsibility for their own health. Consequently, the pursuit of complementary care is growing.

Victoria Maizes, M.D., explored this in the report “Integrative Medicine and Patient-Centered Care” in 2009:

Initially driven by consumer demand, the attention integrative medicine places on understanding whole persons and assisting with lifestyle change is now being recognized as a strategy to address the epidemic of chronic diseases bankrupting our economy…. A primary health partner who knows the patient well, is able to address mind, body, and spiritual needs, and coordinates care with the help of a team of practitioners is at the centerpiece.

Chiropractors are leading the way in becoming one of the patient’s primary health partners, and we hope to see the rest of the medical field follow suit. It is time for healthcare providers to join hands with patients to walk together toward a new beginning of healthcare, and well-care, for us all.


Pathways Issue 46 CoverThis article appeared in Pathways to Family Wellness magazine, Issue #46.

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