Resistance Resources in the Context of Health Promotion Practice and Research

1. Resistance Resources in the Context of Health Promotion Practice and Research Maurice B. Mittelmark Professor and Head Department of Health Promotion and Development University of Bergen

2. Investing in Communties: Principle, Panacea or Placebo? The Wilhelmina Rouwenhorstlezing Lecture 2nd National Netherlands Conference on Health Promotion and Education Arnhem, 11 January, 2001

3. SALUTOGENESIS RESOURCES

4. Resistance resources are“the most exciting things to be studied” Antonovsky A (1973) Address to Stressful Life Events Conference

6. SPECIFIC RESISTANCE RESOURCES ‘SRR’ GENERALISED RESISTANCE RESOURCES ‘GRR’

7. Antonovsky’s ideas about resources… • “Because the demands which are made on people are so variegated and in good part so unpredictable, it seems imperative to focus on developing a fuller understanding of those generalized resistance resources that can be applied to meet all demands.” (p. 541) Antonovsky A (1972) Breakdown. A needed fourth step in the conceptual armamentarium of modern medicine. Social Science and Medicine, 6:537-544.

8. Antonovsky’s ideas about resources… “This is not to deny the importance of specific resistance resources. They are many and are often useful in particular situations of tension… but these are all too often matters of chance or luck as well as being helpful only in particular situations.” (p. 99). Antonovsky A (1979) Health, Stress and Coping. Jossey-Bass Publishers, San Francisco.

9. An unsatisfactory state of affairs… • Emphasis on GRR shadows importance of SRR • Health promotion has a major role in strengthening GRR and SRR • GRR & SRR have different sources & are strengthened differently • Salutogenesis is more relevant to health promotion with SRR

10. All of us throughout life are continuously exposed to stressors Exposure to stressors is not from very low to very high “It is, rather, from fairly serious and lifelong… to the unbelievable hell on earth of so large a part of the world’s population” (p. 77) Antonovsky A (1979) Health, Stress and Coping. Jossey-Bass Publishers, San Francisco.

11. unhappy experiences of others in our social networks fear of aggression, mutilation and destruction life phase-specific psychosocial crises inherent conflicts in all social relations gaps between our aspirations and our achievements Antonovsky A (1979) Health, Stress and Coping. Jossey-Bass Publishers, San Francisco.

12. shocks

13. Money Knowledge, intelligence, ego identity Coping strategy (rationality, flexibility, farsightedness) Social network embeddedness Religious belief and ritual GRR

14. Antonovsky A (1979) Health, Stress and Coping. Jossey-Bass Publishers, San Francisco. Guttman, Louis (1959) A structural theory for intergroup beliefs and action. American Sociological Review, Vol. 24, No. 3 (Jun., 1959), pp. 318-328 (Facet theory and sentence mapping).

15. HEALTH SUCCESSFUL COPING GRR

16. HEALTH SUCCESSFUL COPING GRR SOC

17. HEALTH SUCCESSFUL COPING GRR SOC PSYCHOSOCIAL

18. HEALTH SUCCESSFUL COPING GRR SOC SRR PSYCHOSOCIAL INSTITUTIONAL

19. material asset skill talent ability strength expertise proficiency adeptness A SSR is a newly engaged of an impart control over avoid reinterpret adapt to individual group community setting that is activated specifically to a specific stressor and thus prevent tension from being transformed into stress. Mittelmark MB (2013). Resources for Health in the Salutogenic Model: Specific Resistance Resources contra Generalised Resistance Resources in the Context of Health Promotion Practice and Research. Netherlands Congres Volksgezondheid 2013, 3 April, 2013.

20. Institutional… • GRR • Public schools • HP schools • HP workplaces • Public health campaigns • Well baby checks • Public vaccination services • Water & sewage services • Social security system • Police services • Parks & recreation services • SRR • Suicide prevention hotlines • Clean needle clinics • Medical emergency clinics • Disaster relief teams • Illness recovery help groups • HP prisons • Handicap accessibility infrastructure • Refugee resettlement programmes • Home health care • Excursions for the home-bound

21. HEALTH SUCCESSFUL COPING GRR SOC SRR PSYCHOSOCIAL INSTITUTIONAL HEALTH PROMOTION AND HEALTH EDUCATION

24. SPECIFIC RESISTANCE RESOURCES GENERALISED RESISTANCE RESOURCES

26. A Salutogenic Model of Well-being with SRR Ubiquitous life course stress exposures (chronic) • Life • Situation • culture • social forces • social position • gender • ethnicity • age • orientations • predispositions • genetics • luck • choices • -work/play • -association • -risk taking • -etc. • Public • Institutions • Shocks • Generalised • resistance • resources • support • skills • hardiness • etc. • Life • experiences • degrees of • consistency • underload-overload • participation • autonomy Sense of coherence wish to cope – meaningfulness challenge understood - comprehensibility resources to cope - manageability • Well-being • Specific • resistance • resources • newly engaged • specifically activated Acute stressors Mittelmark MB (2013). Resources for Health in the Salutogenic Model: Specific Resistance Resources contra Generalised Resistance Resources in the Context of Health Promotion Practice and Research. Netherlands Congres Volksgezondheid 2013, 3 April, 2013.

27. Thank you