Salutogenesis is a concept many chiropractors understand and work with on a daily basis, yet for many, it’s a foreign concept. At its heart, the concept of Salutogenesis asks, “How can we build up health and wellbeing rather than merely curing disease?” It is the flip side of pathogenesis, which asks what causes disease and aims to cure it.
A recent literature review published in the Journal of Contemporary Chiropractic has taken the proverbial magnifying glass to this term and asked how it can be applied to preventative care to reorient health systems towards building up health and wellbeing. It is a welcome addition to the current conversation about something that essentially lies at the heart of the chiropractic experience.
It seems that pathogenic approaches alone aren’t enough for modern life. Chronic lifestyle-related conditions like cardiovascular disease, diabetes, obesity, anxiety, depression, and stress disorders continue to grow even as biomedical science advances. The dominant paradigm, one focused on diagnosing and treating illness, has not stemmed this tide of chronic ill-health. Research advances, as do lifestyle adjustments, but the data still shows the strain. The authors of this literature review argue that addressing symptoms and risk factors alone is no longer enough.
Can we achieve a paradigm shift in healthcare? Can we put Salutogenesis first? And what is chiropractic’s role in this? The paper begins to answer these questions.
Let’s talk about salutogenesis
Salutogenesis was first developed by Aaron Antonovsky in the 1970s and 80s. Rather than asking “What causes disease?”, salutogenesis asks “What creates health?”. In this view, health is not merely the absence of pathology but a dynamic process of managing life’s stressors using internal and external resources. The concept emphasises factors that support resiliency, coherence, and thriving in the face of challenges.
Central to this model is the Sense of Coherence (SOC), a psychological orientation comprising three dimensions:
- Comprehensibility – perceiving life events as structured and predictable
- Manageability – believing you have the resources to cope
- Meaningfulness – feeling life’s challenges are worthy of engagement
Individuals with a strong SOC are better equipped to cope with stress, adopt preventive behaviours, and sustain well-being.
Another key concept is Generalised Resistance Resources (GRRs). These are the biological, social, psychological, and material strengths that help people make sense of and manage stress – for example, social support, financial stability, education, and cultural resources. People and communities with stronger GRRs tend to have higher resilience and better health outcomes.
Some of these terms fit right in with the chiropractic paradigm, and indeed with the Australian Spinal Research Foundation’s definition of the subluxation. That is, “a diminished state of being, comprising a state of reduced coherence, altered biomechanical function, altered neurological function and altered adaptability.” When we talk about the subluxation arising as a result of trauma, toxins and stress, we also see it fit right in with the issue of GRRs as people show varying levels of resilience and ability to adapt to their environments.
With all this said, why does the salutogenic shift matter? This topic is one the study, titled “From fixing disease to building health: applying the salutogenic model to 21st-century preventative care” examined in detail. [1]
The authors of the review argue that the traditional biomedical model, though powerful for acute care and disease management, inherently narrows our view of health to risks and deficits. Preventive efforts, under this paradigm, often focus on mitigating risk factors or early disease detection rather than cultivating positive forces that generate health. This leaves psychosocial, cultural, and existential dimensions of health under-recognised.
Salutogenesis addresses this limitation by reframing health as a continuum rather than a binary state of ‘well’ versus ‘ill’. On this continuum, individuals and populations are always somewhere between ease and dis-ease, constantly interacting with stressors, resources, and meaning-making processes. Health is built through capacity rather than merely risk reduction. [1]
Evidence for Salutogenesis in Preventive Care
The review identified 64 studies spanning theoretical work, empirical research, and policy frameworks. Three major themes emerged [1]:
- Salutogenesis as a Theoretical Foundation for Health Creation
Across disciplines, salutogenesis offers a coherent and robust conceptual basis for rethinking preventive care. It challenges the pathogenic focus of medicine and places emphasis on resource building, coherence and adaptive capacity. Rather than seeing the body as a machine to fix, it sees humans as dynamic agents continuously engaging with life stressors and resources.
This perspective aligns with movements such as positive health, lifestyle medicine and indeed chiropractic care, which emphasise well-being rather than merely symptom-based care or disease avoidance. Importantly, salutogenesis considers all the elements in a persons life and environment and sees them as a whole rather than the sum of their parts.
- Sense of Coherence Predicts Preventive Outcomes
A substantial body of evidence positions SOC as not just a psychological construct but a measurable predictor of health behaviour and outcomes. People with stronger SOC tend to:
- Engage more consistently in health-promoting behaviors such as balanced diet, physical activity, adequate rest, and stress management
- Exhibit higher health literacy and motivation for preventive action
- Show reduced incidence of depression, anxiety, and stress-related disorders
- Demonstrate resilience in the face of socioeconomic adversity and life stressors
Importantly, SOC shows stability across cultures and ages, making it a versatile metric for preventive health planning. [1]
These findings suggest that strengthening SOC could be a legitimate target of preventive interventions. Imagine if the way we cared for people could help them find meaning, build coherence, and tap into their resources in a more effective way, thus laying a foundation for long-term healthy behaviours rather than traditional risk-based messaging?
Its less about what your body doesn’t like, and more about what it loves – things like movement, nervous system tone, and connection. Less about dysfunction, and more about building up optimal function. These
- Systemic Applications in Policy and Practice
Perhaps the most actionable insight is how salutogenic principles can reshape systems and policies. The review highlights initiatives where salutogenesis informs public health design, workplace wellness, education, and clinical prevention.
For example:
- Public health policies that prioritise equity, participation and education can foster coherence at the population level
- Workplaces that cultivate meaning, autonomy, and social support build collective resilience
- Schools that embed salutogenic principles strengthen students’ coping capacities and overall well-being
An interesting finding in the study was this: In countries where salutogenic thinking has been integrated into policy, prevention moves toward empowerment and capacity building. Health systems begin to prioritise health literacy, community participation, and environmental conditions conducive to well-being. [1]
It may not be rocket science for people who have been engaged with chiropractic for a long time, but it’s a topic that bears touching on every now and then so we can come back to the heart of what we do. Clinical chiropractic care, often concerned with functional health and patient empowerment, aligns naturally with salutogenic thinking. We love encouraging people to see their health as dynamic and self-directed, strengthening personal and social resources that enable resilience and helping people understand what optimal neurological function can mean for physical health, resilience and expression.
The study is not without a degree of pragmatism when it comes to the hurdles between where we are now in the healthcare world, and where they’d like to be in terms of flipping the script from pathogenic to salutogenic. The authors note that integrating salutogenic principles into mainstream health systems will require changes in education, funding, and research priorities.
It is something that chiropractic care seems uniquely poised to embrace, or even lead the way on. We know that salutogenesis is more than a theoretical curiosity. The question, for us, is how can it be operationalised into preventive programs, workplace wellness strategies, educational curricula, and public health policies that prioritise sustainable well-being over disease surveillance. [1]
Kenya A, Omondi Otieno K, Vuyiya C, Kenya H. FROM FIXING DISEASE TO BUILDING HEALTH: APPLYING THE SALUTOGENIC MODEL TO 21ST-CENTURY PREVENTIVE CARE — A LITERATURE REVIEW. JCC. 2026;9(1):20-41.
