“What the heck is that?!!”
Upon hearing the word Salutogenesis, the above, is the typical response. One of the great people in my profession, Dr. Chris Kent, did a presentation that delved into it… and I found it so interesting I wanted to share it with my colleagues, patients and potential patients.
Salutogenesis is the process of enabling individuals and communities to increase control over, and to improve their health
–World Health Organization
Today more and more patients are arriving at my door with a greater understanding of “wellness” or the impact of “healthy lifestyle” on overall health. Salutogenesis is an extension of this; and is in contrast to the accepted norm of “Pathogenesis”.
Pathogenesis starts by considering disease and infirmity and then works retrospectively to determine how individuals can avoid, manage, and/or eliminate that disease or infirmity.
In contrast, salutogenesis, the study of health origins and causes, starts by considering health and looks prospectively at how to create, enhance, and improve physical, mental and social well-being.
-Becker, Glascoff & Felts. International Electronic Journal of Health Education, 2010; 13: 25-32
*PLEASE NOTE: This is not to say that one is the ‘right way’ and one is the ‘wrong way’; but rather to note the alternative view of healthcare.
Where one looks largely at how someone came to be sick (pathogenesis), the opposing works to find ways in which health can be enhanced. This is to say that in a Salutogenic model it is important to note where health can be improved upon; be it in the lifestyle behaviours, environment, or strategies and their effect on maintaining or improving health. Chiropractic slot very well into a salutogenic model. We are constantly checking patients who are by all accounts “healthy” in the pathogenic model of care, and finding aspects of the spine to adjust to improve their overall health. I am constantly reminding patients about their need to exercise regularly and will have chats about food choices where applicable. All these strategies are done in a way to help prevent future health crises.
Here is the big question I often answer from patients (and some colleagues!):
How do I determine that a ‘healthy’ person is in need of an adjustment?
Honestly… it’s a pretty involved topic. To put it mildly I have a set of objective indicators I check on each and every patient; young and old. I’ll look at things like posture and gait when I first enter the room with someone, then I will often perform an assessment specific to the spine, including assessing the leg length. At times we will look at further testing; like thermal scan and sEMG scanning, to determine the tone of the system and energy use. (Soon I plan to add Heart Rate Variability (HRV) to the office to determine another dimension of the model… but that will come at a later date).
Did you notice something though? In my determination of need for adjustment, pain plays 0 role in my determination. This is not to say that folks don’t tell me about where they are having challenges; because they do, it just doesn’t determine the NEED for an adjustment. The reason being that pain is such a small component of what is going on; and often a problem area is actually not directly linked to the “closest spot”.
In the end salutogenesis is what the wellness paradigm is hoping to achieve. And Chiropractors have been preaching a wellness approach for years now, and perhaps public understanding of our approach is becoming more known and appreciated.