… A preventive innovation is an idea that an idnividual adopts at one point in time in order to lower the probablity that some future unwanted event may occur. The unwanted future event might not have happened anyway, even without adoption of the preventive innovation, so the relative advantage is not very clear cut to the individual at the time they are urged to adopt by public health programs. Also the prevented events do not occur, and thuse they cannot be observed or counted…For these reasons, preventive innovations…have a relatively slow rate of adoption.”
Everett Rogers, PhD – p. 69 “Diffusion of Inovations” 5th Ed.
What do you think? Do you agree this provides a good foundation for why the focus should be on more good, not JUST less bad? Please share your thoughts on the best ways to move forward. I look forward to hearing from you. Thank you.
Most times we hear about pathogenic or disease-causing bacteria. There are however many wonderful Salutogenic or health-causing bacteria. It is another example of our amazing body. I learned about his amazing process when reading the advice column, “Ask the Doctors”, by Eve Glazier, M.D., and Elizabeth Ko, M.D. In their 8/23 column. They informed us:
..nitric oxide…is produced by cells throughout the body and plays a crucial role in promoting blood flow….nitric oxide helps keep blood vessels relaxed and pliable. This lowers the pressure that circulating blood exerts on the walls of the veins, arteries and capillaries.
Their response was to a reader that heard brushing your tongue can be harmful. The doctors explained the research (some of which you can see here). They found that brushing your tongue and using antiseptic mouthwash can damage the tongue’s microbiome and inhibit its ability to regulate blood pressure. Yes, the tongue also has a microbiome. It’s amazing, they now even know the mechanisms of how plant strong nutrition, specifically green leafy vegetables, helps us:
…The nutrient that the tongue bacteria convert is called dietary nitrate. It’s found primarily in green leafy vegetables such as spinach, lettuce and bok choy, and in root vegetables such as carrots and beets.
Of course, these helpful benefits course through our body, and plant strong nutrition helps them work better. You may remember, (see Stress can Improve Your Health) Kelly McGonigal explains in her upside of stress book and TED talk (below), stress hormones actually help heal the heart.
Evidence supports that we can generate comprehensive benefits by creating net-positive, pervasive, reciprocal, selfish, selfless interactions by eating plant strong. From these interactions everyone and everything benefits as we help our bodies be health causing machines (see also Healthier’s By-Product is Comprehensive Improvements. Please share how you help your body be a health causing machine so everyone and everything benefits. Make it a Great Week.
Abstract: Survey research is important for understanding health and improving practice among health professions. However, survey research can have drawbacks, such as overuse and excessively lengthy questionnaires that burden respondents. These issues lead to poor response rates and incomplete questionnaires. Low and incomplete response rates result in missing data and reduced sample size, damaging the value, usability and generalizability of the information collected. To address issues related to response rates and improve health research, shorter surveys are recommended because they impose less of a burden on respondents and are useful with larger populations. Health- related surveys also often focus on the factors leading to ill health without dedicating equal attention to factors supporting positive health. This study developed and tested a short form (SF) of the validated Salutogenic Wellness Promotion Scale (SWPS), which measures causes of health (rather than causes of disease), using responses from 2052 college students. The participants answered questions about their demographics and completed the SWPS and a perceived health assessment. Statistical tests demonstrated the SWPS-SF had significant relationships with the full SWPS, health status, and Grade Point Average (GPA). Statistical tests were also used to establish cutoff scores that had a high true positive and low false negative rate. These cutoff scores demonstrated a relationship of higher performance and better health. These promising results suggest this short test can provide valid information without burdening the respondents. Authors recommend additional tests be completed to validate the SWPS-SF.
This scale provides a helpful screen tool that can accurately assess health, that is well-being not just the absence of disease. While more testing is needed, the article noted, “This study developed a short form of the SWPS, and initial evidence suggests it can provide valuable data for participants, health professionals, and health researchers. This short, complementary tool will provide data about health-causing actions, address the pathogenic bias, and improve response rates due to its short format.” The full article can be accessed on PubMed here.
The SWPS-SF provides a quick way to screen for peoples behaviors that indicate health improvement from beneficial, physical, social, emotional, spiritual, intellectual, vocational, and environmental actions. Feedback, as can be provided to professionals and individuals, has been shown to help people improve behaviors and it provides professionals with information about how to nudge them toward better actions. The data can also be used to help design a health promoting environment.
The SWPS-SF is a tool that when used should help generate comprehensive improvements by creating net-positive, pervasive, reciprocal, selfish, selfless, synergistic interactions so everyone and everything benefits. Please contact me if you have any questions. I look forward to talking with you.
To enlighten means “(to) give (someone) greater knowledge and understanding about a subject or situation”. Upon further reflection, I realized that we learn more by asking questions, often unexpected, questions that may seem to be off the topic at first.
An example of asking a different and somewhat off the mark questions happened when Marshall & Warren discovered that it was a bacteria, Helicobacter pylori, not stress and lifestyle that caused peptic ulcers (see this 1984 Lancet article). This amazing discovery was possible because they asked good questions. That paradigm improving work helped them to eventually win the 2005 Nobel Prize.
As I attended a fantastic 2022 Appalachian Energy Summitt presentation about how North Carolina was going to get to net-zero carbon with transportation, a question broke our rabbit hole thinking. The discussion was about electric cars and continued with a discussion about the need for a recharging infrastructure, fast charging stations and or battery exchanges, and the need for policy. As we learned, despite available technology, without supportive policy, change is unlikely. As we continued down the rabbit hole of electric cars and their benefits, then infrastructure, fast chargers, and exchange batteries, someone asked a question: What about trains? High speed rail?
It stopped us in our tracks (pun intended). As he stated, even if we have all this, we still must drive, ugh… If we had trains, we could arrive rested, socialize, read, do work if desired and travel easily. He also pointed out the possibility of trains helping NC get to net-zero emission if done right. As I reflected, I realized how different our conversation would have been if we would have thought about what the best way would be to travel, rather than how can we just convert what we currently do toward something better. This question enlightened.
A Problem focus is limiting
Questions enlighten. If we start with the understanding we want things to be better and deprivation will never work for the long term, it will help. Deprivation means doing without. Unless we have a better substitute, it will not be desired. Seeing the new way as better requires framing and promotion. Simply eliminating a problem is less bad, not more good and it limits our thinking toward the problem, not a possible paradigm improving solution as documented by Barbara Fredrickson’s Broaden & Build Theory of Positive Emotions (see Build a Net Positive Life for ALL).
This is important because we always move towards what seems better. But to get us to move in that direction, the good must be 3x better than the loss is bad (refer to Critical Positivity Line or the Losada Line). The positive must be 3x more beneficial than the loss because evolution taught us to be oversensitive to losses. We function with what experts call loss aversion. Loss aversion is part of us because it enabled us to survive. Therefore, if we want paradigm improving answers, we shouldn’t ask, what is the problem? As Einstein explained:
Asking a different question enlightens because it can enable us to use different thinking. In health we seem to only ask, what causes sickness? Why are we asking that question when we want to know, “What causes health?” Asking the right questions can help us think about how to create comprehensive improvements that are much more than just not bad.
Dr. Hoglund explained how and why using a salutogenic approach would be more effective for public health efforts at generating comprehensive improvements by focusing on creating net-positive, pervasive, reciprocal, selfish, selfless synergistic interactions through their activities to promote health. If you agree and like it, I encourage you to share this with everyone and especially all the health professionals you know.
After participating and presenting the 2021 6th International Conference on Salutogenesis: Advancing Salutogenesis for thriving societies in June, I had another realization about how salutogenesis can be differentiated from pathogenesis. My understanding is that salutogenesis methods can cause better, not just less bad, outcomes. Pathogenesis was developed for less bad outcomes. It works great and effectively treats disease and its precursors. From my understanding, that means salutogenesis must produce something different, not just another way to do the same thing, such as treat problems more effectively.
I realized that salutogenesis is primarily what you use daily – over the long term. I had this realization as I listened to many good presentations and had invigorating discussions about salutogenesis with colleagues. While salutogenesis produces immediate benefits related to feeling good for doing good, salutogenesis is about how to play the long and short game. Salutogenesis therefore is for chronic care, while pathogenesis, or traditional “health” care, must play the short game for emergency care. Pathogenesis then should primarily be used for the short-term or acute care.
To explain this I have updated my often viewed video, Pathogenesis & Salutogenesis. The previous video has almost 30,000 views as of June, 2021. Please let me know how you like the update and if it has helped you better understand how to effectively use salutogenesis to generate comprehensive improvements.
Here is the updated video which is also posted here and on my YouTube Channel.
For me salutogenesis is a way to practice paneugenesis because it can generate comprehensive improvements and create all good for health. Life is all about probabilities, not guarantees. Salutogenesis improves the probability of better outcomes.
We can increase the probability of generating comprehensive improvements if we work at creating pervasive, reciprocal, selfish, selfless, synergistic interactions so everyone and everything benefits. As W. Edwards Deming always asked, “By what method?”. Using the method of salutogenesis for health will help just as it will help to use quality management methods for business and manufacturing and Nudge techniques for policy.
I hope this inspires you to generate comprehensive improvements. Please share effective methods you have used that can generate comprehensive improvements so everyone and everything benefits.
From my perspective, research, and general common sense, salutogenesis must be the idea we use to advance society to a better place. I also believe it should be understood, while it will be less bad, creating more good is the major attribute. A better reality, not possible now must be created. Salutogenesis is the origins of health. It is the idea, concept, theory, and approach to health that from my view is about the creation of good health beyond the absence of problems. It is not a better way to treat disease or discomfort, rather it is a way to create better outcomes not possible otherwise.
Upon returning from the conference in Finland in 2009, I was concerned the idea of salutogenesis was being used pathogenically. By that I mean the salutogenic techniques discussed were more focused on treatment and helping people recover than on creating a new and better reality. Which also, by definition, must mean bad things get better or become less problematic. To voice this idea, my response was to publish the linked article, “Salutogenesis 30 Years Later: Where do we go from here?“. Nine years later, in 2019, those in Europe who chose not to participate in the article I published wrote a related linked article, “Future directions for the concept of salutogenesis: a position article“.
Fortunately, since this virtual conference started at 3am for me, it was in Girona, Spain, I was able to send videos of my scheduled presentations (below). Each 10 minute presentation was supposed to be a conversation starter to generate a discussion about how to advance salutogenesis.
If you watch these presentations and it generates ideas or thoughts, please share. Of course each of these ideas are an attempt to help generate comprehensive improvements by creating pervasive, reciprocal, selfish, selfless, synergistic interactions so everyone and everything benefits. As I have noted previously, salutogenesis is an effective way to practice paneugenesis or create all good. I look forward to hearing from you about how we can advance the ideas of salutogenesis.
I just uploaded a video to my YouTube page (below) that reviews how I see the evolution of positive health. Within this video I describe how the concepts of wellness and salutogenesis are related. After you watch this short 11 minute video, please share your thoughts. Thank you.
2016 has been a crazy year. The unexpected happened: the Cubs won the worlds series, Donald Trump became our president, and Army beat Navy. Am I in Bizarro world?
For me Bizarro world would be where up is down, black is white, in is out, etc. I have had the Bizarro sensation lately. The Seinfeld TV series covered this topic. In this episode, George Costanza, the neurotic, self-loathing, short, stocky, slow witted, bald man, and self proclaimed “Lord of the Idiots” character decided he needed to do the opposite of everything. He decided he should do the opposite of what he would have or thought he should do because, so far in his life, what he had done was always wrong (see clip).
I work for a Department of Health Education and Promotion. To me this should mean those in our department are charged to promote, support, and encourage health. Health is the PRESENCE of physical, mental and social well being and NOT merely the absence of disease and infirmity, according to the World Health Organization. This suggests the job of health professionals should be to promote, encourage, support and enable actions that create improved levels of physical, mental and social well-being.
In general, when we determine if things are better, the same, or worse we compare expectations to a reference point. Our reference point, or what we compare our current reality to, is used to determine if things are better, the same, or worse. If it looks like things would be about the same, it would be neutral and therefore likely to maintain the status quo. Please note, people have a noted bias for status quo.
The status quo then would be not having anything worse than how it is, or it could be thought of as a state of not bad meaning no new efforts are needed. Not bad would then be equivalent to a “zero” state. Based on the idea of improvement, not bad or zero would be the opposite of the inherent goal health promotion has to improve health unless we are in Bizarro world. Health promotion should be about going beyond zero by helping people experience a better, true good, state of health or a +3 – as compared to our neutral reference, zero, or status quo. (see video)
Recent experiences have made me feel that I am in Bizarro world. Our department is in the process of hiring 3 new professors for the department of health education and promotion. For these searches we brought in 6 outstanding candidates for interviews and presentations.
Each candidate was highly intelligent, had a great grasp of science and advanced statistics, had completed compelling studies, and had done work of a high caliber. My push into Bizarro world happened because these candidates had focus areas of suicide, HIV, adolescents and alcohol, teen pregnancy, chronic obstructive pulmonary disease (COPD), and cancer. How could any of these areas of focus identify and or discover ways to be more physically, mentally and socially well – beyond the absence of those identified diseases and or conditions of infirmity? One colleague suggested suicide was not about disease. I agreed but still could not understand how suicide investigations would help discover paths to improved physical, mental or social well-being. He concurred.
Several say to me that treating disease or “fixing it” does mean more health. True, but only if you change the reference line from which you compare the current state of health. Most of us are generally healthy so our reference is not bad, neutral, managed or zero. Fixing anything below zero, is just getting us back to the status quo and not creating physical, mental and social well-being beyond our initial reference of not bad, neutral, managed, or zero. As should be obvious and is shown in research, people are less motivated to achieve an outcome of managed, not bad, neutral, or zero than to work toward developing a flourishing, achieving, or thriving outcome.
Research related to those in poverty demonstrated that those in poverty did not perceive receiving more money as a gain but a way to catch up, or get to zero, their reference point. Gains for them were not possible until they were at least out of poverty, their reference. It reminds me of Jim Gaffigan when he explained in one of his performances the arrival of their fourth child. “Yes we are having a fourth baby. To help people understand what is like to have four kids, imagine you are drowning and someone hands you a baby. Thats it.” His focus therefore was maintenance, or not getting worse. In other words, forward could only be possible if they could at least be at zero, swimming with ease, or above the poverty line in the previous example.
To clarify the idea of gains or positive outcomes, lets examine employee’s. When workers are hired they are expected to complete a specific amount of work. These work expectations then create a work level and work completed sets a reference point. If, or when a disease and or infirmity occurs, work falls below that established reference and this creates a deficit.
If health professionals then focused on bringing that workers effort back to that reference, deficit reduction, it is just a return to the status quo, not improvement to higher work levels, growth or gain. This measure, or return to previous work effort level does not even consider lost work time. Health promotion should add physical, mental and social well-being so higher levels of health enable productivity at a better, not yet attained level of performance, rather than merely a return to the status quo.
Health creation has been the focus of my career. To maintain my focus on health creation, I have used salutogenesis as my model or framework. Salutogenesis focuses on the origins of health. (salu = health; genesis = origins) I however am in the minority, most in the health field are guided by pathogenesis. Pathogenesis is a model or framework focused on the origins of disease. Isn’t that the opposite? Are we in Bizarro world? How can more be learned about better health, beyond he absence of problems, if the focus is on the origins or causes of problems in the form of disease and infirmity? Several noted scholars have questioned using pathogenesis as a guiding framework for health promotion. (see video for comparison of Pathogenesis and Salutogenesis)
Pathogenesis leaves one to wonder how an investigation using this framework can inspire strategies that create physical, mental and social well-being beyond the development of strategies for less disease. While less disease is important and morally appropriate, it is important to understand that less disease does not necessarily create more health beyond the absence of problems. Remember, health is not merely the absence of disease and infirmity – it is more than.
In addition, positive and negative states are independent. Decreasing and or increasing positive or negative states of health does not necessarily have equating reciprocal effects on the other state. Increasing physical, mental and social well-being or positive health, however, does increase capacity and potential and this improvement enables a greater ability to overcome problems that would not be possible otherwise. (see more about how high levels of health enable better health in:Serendipity? Don’t “Have” a Nice Day – Make it So! and in the story frommy recovery from a near fatal car accident) For this reason, it is recommended salutogenesis and pathogenesis be complementary. Complementary use of these frameworks is described in the linked article Salutogenesis 30 Years Later, Where do we go from here?
So what does this mean? I put on many of my students papers, <- ≠ >+, or less negative does not equal or mean more positive.(see more atLess Bad ≠ More Good – We Must Create Good) I mark this because my work and that of many other noted scholars has documented prevention does not create health, just less disease. I explain many of these issues in a previous post, Prevention Can’t Work and Problems are Irrelevant!Health has to be created. In many presentations and classes I explain how it is good to eliminate bad, but we can do more and better should be our focus. To clarify please see short video below,Better than Not Bad:
Many then ask, “But we have to do something about issues such as those of the candidates: suicide, HIV, adolescents and alcohol, teen pregnancy, chronic obstructive pulmonary disease (COPD), and cancer. Absolutely, something must be done, however to be truly effective we should do more than just eliminate the bad. We should create an idealized good that also eliminates the bad as a by-product. For this to happen, the goal must be positive, not just non-negative, and be better than the reference. We should clearly explain a goal byOperationalizing an Idealized Outcome, rather than just a not bad outcome which simply brings everything back to the status quo or reference point. A not bad outcome would only achieve better health by accident, focusing onIdealized Outcomescreatesbetter health on purpose.
I teach the capstone class and introduce my students to the ideas of health creation. At the end of the class I ask them to write a monologue to describe the impact, if any, the class had on them. Despite the possible bias because it is an assignment, without fail most students comment, “I never knew you could think about health this way.” These same comments are heard from professionals at my presentations. This makes me wonder, do we live in Bizarro world? How is it, people who focus on health improvement think it is opposite or odd to focus on discovering actions and environments that cause or lead to better health and think using the traditional techniques of investigating way to prevent bad outcomes is correct? Isn’t discovering causes of bad health the “opposite” of discovering causes of good or better health?
So what can be done? Without question suicide, HIV, adolescents and alcohol, teen pregnancy, chronic obstructive pulmonary disease (COPD), and cancer are important areas. However if we focus beyond the problem to a desired orIdealized Outcome, we can end up better while also eliminating, preventing or managing a disease or infirmity.
For the situations related to these candidates, as illustrated in earlier posts, we should Practice Paneugenesis. The aim of paneugenesis is to generate comprehensive improvements by creating pervasive, reciprocal, selfish, selfless, synergistic interactions so everyone and everything benefits. This can be done by using this 4 step Paneugenesis Process:
1.Operationalize an Idealized Outcome– make sure all involved parties know what is to be created and be sure that it is better than what can be now. The outcome should have pervasive and reciprocal effects that carry meaning and impact to and beyond the individual.
2. Discover Precursors– what must exist now to make the idealized outcome a reality. Discover what skills, abilities, traits, environments are necessary and or must exist to realize the idealized outcome. These precursors are conditions that must be created and are not currently present.
3. Optimize the Process– what must be done to create those precursors that will enable the idealized outcome and precursors to be created and realized. Go do that now! Do what must be done to create and put in place the necessary precursors discovered.
4. Plot Progress– find measures that document and demonstrate progress is being made toward the creation of discovered precursors and or idealized outcomes. Progress measures that indicate movement of actions taken in your process are being made toward the creation of the new, desired reality. Documenting progress is necessary to give meaning and purpose to the process and to help participants maintain motivation.
To use thePaneugenesis Processfor Suicide misses the objective. We must move toward a positive and the prevention of a negative will be a secondary benefit. That thought reminds me of my work with people in the military. Originally when we met, their goal was to limit soldier suicide. After our work together, it was agreed their real goal, orIdealized Outcome, was to create great soldiers who were confident, purposeful and had meaning in their life. As discovered, great soldiers were not only more productive, they had lower suicide rates. The goal was then transformed from limiting soldier suicide to developing great soldiers. As a by-product, this approach to develop great soldiers would also limit soldier suicides.
For the candidate who had studied and sought to limit suicide in India, I would suggest adjusting the research goal toward theIdealized Outcome of finding purposeful groups in India. Groups doing good in that area are also likely to have lower suicide rates. Such an example was shown in theDecember 18th, 201660 Minutes program show about the “White Helmets” group in Syria. The “White Helmets” groups are a trained force of 3000 rescue workers that offer Syrian civilians help and hope.
For the candidate who focused on HIV and MSM, (Men who have Sex with Men) an alternative approach may prove more useful. Most of the work focused on the positive or negative feelings these individuals had about themselves, their community and or religious group, and their homosexuality. An analysis of these variables with safe sex practices and HIV was conducted. The goal was to have less bad, as measured by HIV and negative personal feelings, and not to create true good beyond the absence of HIV and negative feelings. Questionable benefits from this work were highlighted when findings from this work documented that those that felt more negative about themselves were the individuals that more regularly used condoms and therefore had safer sex practices.
An alternative aim for this work, using the “all good” orPaneugenesisapproach, would seek comprehensive improvements and Idealized Outcomes in this situation to the individual, the community/congregation and all related stakeholders. To do this, a beginning study would investigate multiple community and or religious groups to determine which groups had homosexual individuals with good personal feelings about themselves and if homosexual’s in those groups had a higher life satisfaction and safer sex practices.
Upon discovering a more health creating group, the research would then seek to Discover thePrecursors or conditions, such as a more accepting or more closely integrated community/congregation, that enabled that group to do and be better. It would also be necessary to understand theProcessesused, possibly community functions or congregation by-laws, that created thosePrecursors. Follow-up intervention research would then work to create identified successful Precursors in other communities and or congregations byOptimizing the Processesto enableIdealized Outcomes. Research would investigate processes and outcomes.
The researcher who investigated adolescents and alcohol hoped to lessen problems associated with adolescents using alcohol such as accidents and school difficulties. An alternative aim using the “all good” or Paneugenesis Process would be to measure positive outcomes such as graduation and college acceptance rates. Increases in these rates are related to purpose and direction in life and also, as a by-product, show lower or more managed alcohol use.
The same alternative “all good” orPaneugenesis Processcould be used by the researcher who focused on teen pregnancy. In my discussions with this candidate I asked, if you lower teen pregnancy, what do you get? She admitted there was no clear direction toward something positive and agreed a positive outcome such as higher graduation rates and college acceptance rates would be a good aim. She confirmed, those thinking about future generally have more meaning and purpose while also having lower pregnancy rates.
It think it can be seen how using thePaneugenesis Process toOperationalize an Idealized Outcomewill create a process that can lead to outcomes beyond less bad. For the other candidates who focused on Chronic obstructive pulmonary disease (COPD) and Cancer, the aim of improved physical, mental, and social well-being such as is possible with a whole food plant based eating style may be appropriate. Whole food plant based eating style improves well-being and provides extensive environmental benefits for all and this provides purpose and meaning to their lives from their food choices. Beyond improved health, a by-product of a whole foods plant based eating style prevents and can sometimes reverse chronic diseases.
Operationalizing the Idealized Outcome is a vital component. The outcome must be positive or thePaneugenesis, creating all good process, is not possible. EveryIdealized Outcomeshould operationalize, or make clear, that work is directed toward an outcome that creates meaning and connection. It also should be explained how this outcome will have an impact beyond the individual. As Dan Ariely explains in “Payoff: The Hidden Logic that Shapes our Motivations“, when effects move beyond ourselves, our social circle, and even our existence – this drives people to work extra hard to gain meaning. To maintain motivation and effort, it is vital to document progress is being made. People must see measures thatPlot Progress and demonstrate movement forward. The by-product benefit of having a meaningfulOperationalized Idealized Outcome is the enhancement of inherent joy and the minimization of confusion. This outcome reciprocally leads to higher passion and improved productivity.
So how can this help Make 2017 Great? Use this to clarify to yourself and others (operationalize) a personal or work Idealized Outcome to achieve in 2017. Investigate and discover Precursors that must be true to realize the desired outcome. Do you need a degree? Co-worker with other skills? What skills, abilities, connections or conditions must exist for you to realize that Idealized Outcome? After you Discover thePrecursors that must exist, design your life in 2017, Optimize Your Process, so you create those needed Precursors. To keep moving toward your goal and to maintain your motivation you will need consistent reminders of the progress you are making. To give yourself reminders or notices that you are moving toward your goal, find a way to regularly Plot Your Progress. Good luck.
I look forward to hearing how you will generate comprehensive improvements by creating pervasive, reciprocal, selfish, selfless, synergistic, interactions so everyone and everything benefits.
My work seems obvious so I am confused by traditional practice. I work with health. Most in health work from a disease elimination perspective to create health, despite the fact health is the PRESENCE of physical, mental and social well being and NOT MERELY THE ABSENCE of disease and infirmity. To accomplish this goal I use a salutogenic or health origins/causing framework while others use a pathogenic or disease origins/causing framework.
To me this is obvious, if we want to cause health, shouldn’t we study health’s precursors or causes? How is it possible to cause health through a better understanding of disease? Of course we must know how to cure and treat disease but causing better health has to lessen disease.
Am I missing something?
Other obvious things seem to happen. For instance a Mr. Obvious comment is, “And I found it in the last place I looked.” This is confusing, should someone keep looking for the item after they find it?
Another Mr. Obvious is reports of Greenhouse Gas (GhG) emissions. I hear reports of percent decreases in emissions and think great, less heat trapping emissions are being dumped into our atmosphere. This however is creative accounting, and not accurate. Generally what they mean is less emissions per square foot. For example, although less emissions are being released, the area using fossil fuels to heat, a/c and more has grown, therefore the emissions needed for that space also grew.
Despite dumping more GhG into our biosphere, a recent report documented “reductions”?
It is like when we required the catalytic converters for cars. Although less emissions were released per car, we had more cars so there was no decrease in emissions. To me this is obvious, if we want to improve we must actually reduce the emissions in total, not just per square foot. We must find a way to do good, not just less bad (see here for more about this).
In another Mr. Obvious moment, a former student I had in 2006, 10 years ago, saw me recently and was impressed by something that should be obvious. Now she is getting a graduate degree. She said she remembered me because of one thing I said in class. She explained that her group was telling me that they did their best work under a time crunch so there was no reason to get started early. My Mr. Obvious, and obviously memorable comments was:
“Of course you do your best work when you are in a time crunch, it is the only option you have left. If however you do your work early, you have an opportunity to do even better work.”
While she doesn’t remember much else from class, so she claims, she said she always remembered that and now gets to work on her projects early so she can do better work.
To me my work is a Mr. Obvious. We should be doing what causes health because it builds physical, mental and social well-being and enables higher capacities and potential. Higher health is good because when something difficult or tragic happens, which most likely will happen, the person than has the capacity and ability to not just overcome, they can be better. If we only take preventive action, we are less likely to create the potential needed to achieve and reach a higher state of well-being. Increased capacity, skills, and potential is always useful to achieve what is desired and is especially useful if something difficult happens.
To me this seems obvious, yet to others it does not. For me it proved beneficial because at 17 I was in great shape, physically, mentally and socially and also had a great family. I did what I did to have a better life, not in case something happened and would more likely recover, but simply because I wanted a better life to enjoy.
Unfortunately something did happen, on September 21, 1984 I was the passenger of a car that collided head on with another. The driver and the other 2 passengers of the car died and I suffered a severe head contusion. I lapsed into a coma for a week. When I awoke, I was paralyzed and the brain damage caused me to lose all I had known. At the time, it was not expected to be able to go to college and had a marginal chance of completing high school.
I did recover and am now able to thrive. (To see more of my story and recovery click here) My recovery was only possible because I was in good physical, mental and social well-being at the time. My parents and family were amazing and they were there for me and pushed me to be better.
Therefore, not only did being engaged in physical, social, emotional, spiritual, intellectual, vocational, and environmental health promoting activities at that time in my life make my things better then, it also helped me have a better life today. My parents consider my wonderful children, Amanda & Annika a miracle, as do I.
Engage in health promoting actions to make your life better now. Not only will it make your life better, if something does happen, as things usually do, it will help you avoid, overcome or recover faster. Make it a great day, week, year, and life!
Using the good work of Masters student Ryan Moynahan, with colleagues, we published a new paper in the Journal of Sport Behavior. Using the Salutogenic Wellness Promotion Scale for young adults and TheH.E.A.L.T.H Model (see below the Holistic Ecological Assessment of Lifestyles for Total Health) for a guide, it was found that regular engagement in action sports improves health. Actions sports are non-traditional and possess risk, danger, rules and techniques atypical of traditional sports. Action sports include surfing, skateboarding, snowboarding, eco-challenge, and rock climbing and the number of participants in these sports is growing faster than any other sport activity.
While this findings seems obvious, the study was done because generally we only hear about the dangers or injuries from actions sports and not the benefits. As this study suggests, with proper precautions and training, similar health benefits as with participation in other sport activities is the result. Of course Risk Homeostasis Theory would suggest that only those who properly train would be involved in actions sports. If Dr. Wilde were initially looking at actions sports, it would seem the benefits of the risky behavior outweigh the benefits of safe behavior. Yet the assessment must go deeper. Engaging in actions sports without injury means they engaged in the cautious behavior of proper equipment, training, etc. so they could engage in action sports. This then is a case where the benefits of cautious behavior, being properly trained, drove them to take appropriate action.
As I say throughout my work, all of us desire to create pleasure so to help make this happen we need to highlight the benefits of actions that improve quality of life that encourages actions from which everyone and everything benefit. Any way you look at, this interesting paper documents that health benefits and more accrue from involvement in actions sports. If you are interested you can access the article at:
Shores, K., Becker, C. M., Moynahan, R., Williams, R., & Cooper, N. (2015). The Relationship of Youth Adults’ Health and Their Sports Participation. Journal of Sport Behavior, 38 (3), 306-320. (see JSB-Relationshp of Hlth & Sport part)
With my colleagues, our new article, Adapting and Using Quality Management Methods to Improve Health Promotion, has been published. You can access the journal article here. This is the abstract. If you have time to review it, I am interested in your thoughts. Thank you.
Although the western world is the most technologically advanced civilization to date, it is also the most addicted, obese, medicated, and in-debt adult population in history. Experts had predicted that the 21st century would be a time of better health and prosperity. Although wealth has increased, our quest to quell health problems using a pathogenic approach without understanding the intercon- nectedness of everyone and everything has damaged per- sonal and planetary health. While current efforts help identify and eliminate causes of problems, they do not facilitate the creation of health and well-being as would be done with a salutogenic approach. Sociologist Aaron Anto- novsky coined the term salutogenesis in 1979. It is derived from salus, which is Latin for health, and genesis, meaning to give birth. Salutogenesis, the study of the origins and creation of health, provides a method to identify an interconnected way to enhance well-being. Salutogenesis provides a framework for a method of practice to improve health promotion efforts. This article illustrates how quality management methods can be used to guide health promo- tion efforts focused on improving health beyond the absence of disease.
Key words: Quality, salutogenesis, health, systems
To be truly better, innovation is necessary. Better cannot be linear, it must be systematic. In other words, better can’t mean that it is only better in quality but not cost or functionality but not sustainability; it must be better on all accounts. Data is documenting that this can be done if continual improvement is ongoing. Research is also documenting that these solutions require a different approach and different work effort, however the results are more beneficial, and yes more profitable – in more than monetary ways. As Aaron Antonovsky said, “No one contends that museums pay off in cash.”
Better must take into account the whole system. As Jane Benyus clarify’s with BioMimicry, when nature evolves and creates new things, these new things also make life more livable. Its not so much that certain things are gone and no longer exist as they have evolved into a more complex functioning organism that improves the whole system – understand time factor. In other words, solutions were not fixes but ways to optimize the continually improving system that also provided fixes. By approaching better this way, nature created leaves and petals to not only increase the beauty of a plant, it provided feed for the plant when it fell to the ground, provided food for animals like us, and in some cases also protected it from predators with an emitted smell. Plants also are friends to the system by helping soil and air. Leaves help the soil by serving as feed, the plants hold the soil and the leaves perform photosynthesis to get food from carbon dioxide so it can exhale oxygen. It also performs many other functions to enhance its own life that also improve the system to make life more livable for all.
Nature’s answers that improved the whole system did not come about but focusing on how to fix problems, but rather by thinking about what can be done to improve the whole system. In doing this, not only was the system improved, the functioning of that species improved. A result was that problems dissolved. If the improvement did not lead to the dissolution of a problem, it really would not have been a true improvement. For example, humans developed their prefrontal cortex which now allows us to plan and predict for the future. While the benefits of this capability are innumerable and has led to our ability to create our world, problems such as being overcome by predictable problems has dissolved. For example we now know of possible weather change problems and difficulty in getting food at certain times of the year so we have built structures and stored food. Although some can suggest these solutions have created other problems, the example demonstrates solutions can not only create a better world for us, it also dissolves many associated problems.
With this in mind, it provides us with a map for how to become better at getting better. Aaron Antonovsky did work related to the origins of health, what he called salutogenesis and continually encouraged people to ask the salutogenic question – “What leads to movement toward the positive end.” This questions is not only relevant for health but for all fields – how can we move toward the positive end, not just away from the negative end. Realize positive and negative are not different ends of the same pole, they are on different poles. Positives and negatives have been shown to be independent in multiple fields. It seems we have gotten stuck with a focus on fixing problem or deficits incorrectly believing it will create positives. Maslow pointed out that progress must focus on growth not deficits because eliminating deficits does not create true growth. As I have shown in exceeding expectations, fixing problems is helpful but it can only return us to the status quo or where we were before the problem – not truly better.
If profit or money is a concern, we must remember money ALWAYS follows, it can’t lead. When better is created using the idea of continuous and never ending improvement, it starts a ripple and good things follow. Start as many positive ripples as you can. I look forward to all of us enjoying the positive ripples you create to help improve the whole system by creating interactions so everyone and everything benefits.
Morality predicated on external pressures is never sufficient. – Immanuel Kant
As explained in Steven Pinker and Rebecca Newberger Goldstein’s TED Presentation, “The Long Reach of Reason” (also below) moral progress has been instigated through reasoned arguments that documented inconsistency in values, actions, and common sense. After discussing some examples of how reasoned arguments led to moral progress, they wonder if our grandchildren will be as appalled by our actions as we are of our ancestors who saw things such as beheadings and slavery as normal. Won’t our ancestors or even our children wonder why we focused on eliminating disease when we were wanting to experience better health that we defined as the presence of physical, mental and social well-being and not merely the absence of disease and infirmity? After all, doing actions and engaging in thoughts that lead to or cause health to create gainsin well-being beyond just the absence of problems is a reasoned, logical course of action. Efforts focused on eliminating problems are insufficient and illogical if improved well-being is the goal.
Eliminating problems just brings us back to where we were, not better. If we want to be better, logic and reason suggests we must first determine the better outcome, Operationalize and Idealized Outcome, we want that is not available now and then determine how to create that better reality, Discover Precursors, Optimize the Process, and Plot Progress. This idea is the objective with salutogenesis and paneugenesis and the idea is explained in the Exceeding Expectations video you can access here or below. Reasoning and logic suggests focusing on and working toward creating a better is the obvious way to create a better tomorrow.
I look forward to hearing about how you will be exceeding YOUR expectations, doing so will generate comprehensive improvements as you create interactions that help everyone and everything benefit.
I was reading, well actually listening (I listen to a downloadable books biking to work) to Phil Jackson’s book, Eleven Rings: The Soul of Success. Phil Jackson was a player for the Knicks and a successful coach for both the Chicago Bulls and Los Angeles Lakers. Throughout the book he talks a lot about growth and leadership and what he believes has helped him win 11 championship rings.
In Chapter 6 he was discussing Lakota Indian Tribal customs and culture he tried to adopt for coaching. He explains, “One of the things that intrigued me about the Lakota culture was its view of the self. Lakota warriors had far more autonomy than their white counterparts, but their freedom came with a high degree of responsibility.” I also talk about responsibility in relation to health but attribute that more to the pathogenic or disease avoidance paradigm. To me health is an OPPORTUNITY and I consider this associated with health origins salutogenic approach. To me we do not have a responsibility, but an opportunity to have a better life. Being told we must do something generally causes resistance while an opportunity creates desire.
You can see here (and posted below) how I describe pathogenic with responsibility and salutogenic as an opportunity approach. To understand the universality of this application, Umair Haque, in his wonderful book, Betterness, explains the existing paradigm as pathogenic and recommends we adopt the new Betterness paradigm he proposes in his book because of the benefits to everyone and everything.
From my reading, I understand Phil Jackson discussed responsibility with autonomy because he believe autonomy was earned by those who had taken the responsibility to learn and develop the necessary skills and knowledge. Also because he explained how the outcome was about the tribe more so than the individual, it required the development of skill and knowledge to be able to contribute to the greater good of the tribe.
To me, this means if we hope to have the opportunity to be able to autonomously self direct and create the life we want, we must take the opportunity to grow by doing the work necessary to gain the skills, abilities and relationships that can help. We can’t know what is needed before so we must seek to grow as much as we can by building and developing. Of course doing this helps create the life we want more likely now and int he future. The point he was making with his team was how they were not individuals but a team and for them to win, they had to think about how they could function independently in such a way so that it contributed to the whole or the team’s outcome. This is how nature works also, each cell is autonomous and functions on its own – but in a way that contributes to the whole system. It seems if we also think about how to function so that we can contribute to improving the whole, it would benefit all because we will be creating interactions so everyone and everything benefits.