I read, review and listen to innumerable “health” experts. Unfortunately, though they proclaim to discuss health, a state that is the presence of physical, mental and social well-being, they instead generally describe our problems and the absence of health. The assumption being if we only could rid ourselves of problems, a good life and health would be had. This however is not true, beside the fact that positive and negative states are independent, we all realize once one problem is alleviated, another seems to quickly fill the void. Currently recommendations generally are phrased as what not to do to avoid a problem instead of what to do to create desired outcomes. Advice on what not to do and what to avoid, not only ignites ironic processes (for more information about this see Related Post Here), it as useful as telling taxi driver not take you to the airport. McDonough and Braumgart in The Upcycle: Beyond Sustainability – Designing for Abundance used the taxi analogy to highlight their concern about the usefulness of telling people what not to do.
The current situation is frustrating for me, as someone who attempts to focus on the causes of health. For example, a recent “health” professional I listened to discussed sexual dysfunction at a large organization attributed to injury or trauma and related prescriptions. After the presentation an audience member asked if it could be online porn that was the problem. In response the speaker acknowledged, yes that could be “a” causal problem. Others had more possible relevant problematic causal factors such as drug abuse or mental disorders. All of which may be”a” source. If all of these could be the source, what could or should be done? The strategy is generally to prioritize the problem but what affects the most. While initial efforts seem to help, substitution takes place among the many possible causes and we return to the status quo.
Doing anything results in a perceived “good” effort because it attempts to rectify a causal source of a bad or something undesired. Not only does this seem morally correct, it seems necessary to alleviate hardship and appears to be what we should do. Results of these “necessary” efforts, however, are continually found to be insufficient with regard to health creation. On the bright side, such analysis, does however create job security for those who are “problem solvers”.
Two related issues to this situation are perspective, in that what we see is what we look for and outcome measures. Is our desired outcome the absence of a problem or the presence of a desired state.
These never ending circular efforts seem to occur in most areas of life. At home if it its not the spouse, kids, inlaws, or neighbors, city government could be the culprit. In health (really disease origins), if it is not genetics or lifestyle, it must be an environmental cause of the absence of a desired state or the presence of an undesired condition. Intrapersonally, if it is not willpower, predisposing beliefs, or the parents that caused problems, it must be the friends fault. Problems always have a reason. These reasons however are of our choosing. (for related ideas, see post We Choose Why Things Happen)
What if instead of looking for problems, we look in the other direction? If we hope to transform health, our lives, and society as most seek, we must not only transform the ends, we must also transform the means. Transforming the means could mean being for health and it causes, not being against disease and infirmity and risk factors. To do this, we must adopt a new framework. To me, the necessary framework for a transformation in health means we must use salutogenesis as developed by Antonovsky. For more information on salutogenesis, See Salutogenesis 30 Years Later: Where do we go from here? Salutogenesis is about the creation, development and origins of health instead of the traditionally used pathogenic model. Pathology is abut the creation, development and origins of disease. A relevant point on these perspectives is regardless of how much we know about disease and infirmity, it does not inform us about what we desire, the enabling condition of health. Health is the presence of the positive states of physical, mental and social well-being, not just the absence of bad states.
Another key point from using these perspectives and a point I find most relevant is that these frameworks dictate the point from which we must start. Choosing to use salutogenesis means we must first decide what desired condition we want to create and the required prospective work must then focus on how to create that desired condition. Choosing to use pathogenesis, however, means we must start with an undesired condition, disease or state and then search backward or retrospectively to discover its causes. If health is what is desired, shouldn’t our work be focused on how it can be create.
With a related insight, novelist and philosopher Leo Tolstoy revealed,
Interestingly, people often claim information about health keeps changing. That is inaccurate because what causes health, as far as we know, are the same things that have caused health since we came out of the trees an began walking on our two hind legs. We are healthiest and function at our highest level when we eat nutritiously, which most sources indicate would include whole food plant strong choices, are physically active, have a strong support network of friends and colleagues, and develop into a more capable person with improved capacities and potential.
In other words, what makes us healthy is the same, what makes us sick or diseased however is often unique to the person – or disease and infirmity happen “in its own way”. As Russell Ackoff the organizational theorist, consultant and professor explained, development and growth are not synonymous because we can grow without developing and we can certainly develop without growing. Growth is just increase in size or number while development is an increase in one’s ability and desire to satisfy one’s needs and legitimate desires** and those of others. (**Legitimate desires – ones that do not hinder others to satisfy their needs and desires) (Ackoff & Rovin, 2003)
Lets focus on how health in systematic ways creates comprehensive benefits for society. That is we must focus on creating pervasive interactions that generates the ripple through society that improves outcomes so everyone and everything benefits.