Title

From Where does our Health Come? : The Sociologyof Antonovsky’s Salutogenesis

Author(s)Ikeda, Mitsuho; Suh, Sookja

Citation

Communication-Design. 2016, 14, p. 83-93

Version Type VoR
URL

https://hdl.handle.net/11094/55635

rights
Note

Osaka University Knowledge Archive : OUKA
https://ir.library.osaka-u.ac.jp/
Osaka University私たちの健康はどこからやってくる？

【研究ノート Research Note】

From Where does Our Health Come?:
The Sociology of Antonovsky s Salutogenesis
Mitsuho Ikeda and Sookja Suh*（Center for the Study of Communication-Design: CSCD, Osaka University; *Visiting Scholarof CSCD, Niigata Collage of Nursing）

Abstract
In this paper, the authors examine critically the salutogenic theory/hypothesis
addressed by Aaron Antonovsky (1923-1994). To remark our conclusion, the potentialof salutogenic theory, which we value, should be highlighted in terms that it pointed
out that health of human-beings is a dynamic and multi-dimensional status, andit has relative and more pragmatic aspects. We rather deem that the success inthe measurement of Sense Of Coherence (SOC) using psychometric scales is lessimportant, despite the fact that Antonovsky himself had high opinion on it as well as
his peer scientists and the followers do. The authors discuss how we can develop thelegacy of the research done by Antonovsky, focusing on the potential of qualitative
research method.
Key words
Salutogenic theory, Aaron Antonovsky,
and anthropology

1.
In, positive health, medical sociology

The Naturalist Fallacy of Health Theory(1903), George Edward Moore questioned the ethical judgment that natureor the things under the rule of nature is “goodness.” One might ﬁrstly remind “health” as something
good and this statement seems acceptable as health apparently derives from nature. However,death as well is a natural phenomenon under the rule of nature and so is illness. Therefore, it falls
in a logical collapse to say that health is good because it comes from nature. For us, being good andbeing natural are not relevant with each other. Accordingly, Moore suggests that we should not toassociate health with goodness because both health and illness embrace the concept of good andevil -

value judgment - in their property. In order to replace this invalid relevance of

health and good, we can apply “normal and abnormal” to “health and illness” so that the scientiﬁcjudgment can be released from the value judgment of good and evil. It is a suggestion of taking apremise that normal submits to nature and not does abnormal.
It is worth remarking that Moore pointed out that being good not synonym of nature. To explain further, let us say, it is no more a logical persuasion to justify the judgment that organ transplantation or euthanasia can be “evil” because it doesn t follow the rule of nature. On the other
hand, saying, “I myself don t mean to object to the idea that health is good,” Moore warns us: the83

From Where does Our Health Come?:

proposition that health is good should be considered as an unsolved problem and must not betreated as self-evident. Because we will end up with “naturalist fallacy” noted above if we determine it is self-evident (§10). It seems that we simply call healthfact torefer the particular state that can be identiﬁed as “good.” Then, looking back for this century since
Moore s warning, how far has our thought reached? Health scientists - those engaged in quantitative studies to establish scientiﬁc evidence in the area of medicine, health, nursing and so on - arehoping to contribute to the enhancement of human health, but they mostly end up with self-satisfaction believing that their research are walking in the light of the verity of nature. Despite theirglorious achievement in biomedical sciences, yet, we ﬁnd in our own daily observations that common people never stop seeking health and pose consistent demands on health specialists. The demands by common people are eclectic and they are undoubtedly in a state of “starvation” deprived
from well-being and/or health. This means that the science outcome has never caught up the“health demands” by common people. This situation can basically be attribute to the bio-medicalization1 of health and industrial commercialization. However, there are some other reasons, which
are accordingly making this dismal situation much worse. The majority of health scientists should
be indulged in their own rats races and paper chases, and have been missing thinking deeply oversome important questions; in what way health can be deﬁned, and what is the phase relation between health and something judged as good.
In this standpoint, the authors will examine critically the salutogenic theory/hypothesis addressed by Aaron Antonovsky (1979, 1988). To remark our conclusion beforehand, the potential of
salutogenic theory, which we value, should be highlighted in terms that it pointed out that healthof human-beings is a dynamic and multi-dimensional status, and it has relative and more pragmatic aspects. We rather deem that the success in the measurement of Sense Of Coherence (SOC)
using psychometric scales is less important, despite the fact that Antonovsky himself had highopinion on it as well as his peer scientists and the followers do. The establishment of the method
to measure SOC contributed to disseminating the easy tools of propagate. However, the development of quantitative research in SOC did not contribute to the further elaboration of salutogenic
theory - a counter-concept of pathogenic theory/hypothesis that modern medicine embody - inregard with qualitative research method.
Hereafter, the authors will discuss how we can develop the legacy of the research done byAntonovsky, focusing on the potential of qualitative research method.

2.

The Origin of Antonovskyʼs theory and its preliminary speculation

Until the late 1970s, Antonovsky had already started his life-history studies of Jewish female
born in Central Europe between 1914 to 1923. And his book written with Nancy Datan and Benjamin Maoz published in 1981, was grounded on the research of which objects were middle-aged
women with diverse cultural background who were born between 1915 to 1924 and lived in Israel(Datan et al. 1981: 2). They were the women who had been aged sixteen to twenty ﬁve in 1939, thatis to say, when the Nazi began to send Jews and others to concentration camps. As it was expected, the ratings of a group of concentration camp survivors in the emotional health was obviously (p <.001) low compared to those of a [statistical] control group. And while 29% in the group84私たちの健康はどこからやってくる？

of concentration camp survivors, in the control group, the ratio of those keeping better emotional
health was 51%. It was presumed that having experience of the concentration camp gave negativeeﬀects to their emotional health. Nonetheless, why were a little under one third of the concentration
camp survivors able to be in reasonable emotional health?
At ﬁrst, Antonovsky could not ﬁnd any clear explanation for what he had observed. These
women had had at minimum three environmental stressors until then. They are, namely (1) theconcentration camps, (2) living in exile after World War II, and (3) three Middle-East Wars. Even
after experiencing harsh stress situation, one-third to a half of the population kept reasonable
health. Antonovsky discovered that stressors caused some responses in living organism that enhance positive function.
He describes,“Evidently a shock stressor can have salutary consequences for an organism, provided it isescapable. But when one thinks only of the pathogenic consequences, one misses the vista thatsuch a ﬁnding (=) opens up” (Antonovsky 1988: 1,).

In addition, it is assumed that he was aware of the eﬀect of stress coping derived from theenvironment as well as the responses at the organism level. Speciﬁcally, he describes, “Being highon stressors, given high social supports, is salutary” (Antonovsky 1988: 8). Having come by thisoriginal idea, Antonovsky addressed his new theory “Salutogenic model” in(1979). What is central in the salutogenic model is that it indicates the limit of pathological orientation,, which has been the fundamental paradigm in biomedicine, emphasizing theother-way-around thought based on “orientation.” Below shows the theoretical frame-

work of “salutogenic orientation.”
The model comprises the idea that healthhealth-ease and illness, dis-ease should not behealth-easesalutary

dis-ease(neutral)pathological

Sense Of Coherence, SOC
Generalized Resistance Resources, GRRs

Tension Management
stress(coping)(neutral setting)Fig.1.

Health-ease/Dis-ease Continuum and the function of GRRs
(Designed by M.Ikeda, 2015)85

From Where does Our Health Come?:

considered dichotomic and mutually exclusive but rather seen as two ends that form a continuum(=health-ease/dis-ease continuum) upon which we can ﬁnd the health status of individual (theChart).
Amongst the factors involving salutogenic process, utmost importance was given to the concept of Sense of Coherence (SOC). The concept of SOC prepares for a hypothesis not only to interpret why some people are able to survive, but also, to stay in healthy condition under a harsh stresssituation. There is not a deduction that maintaining strong SOC brings health to individuals. Theinterview records in the Antonovsky s study imply that the individuals with weaker SOC, when
they are informed how SOC is observed in actual life situation, are likely either to accept the SOC
without questioning regardless of their original thought, or, on the contrary, to deny the idea of
SOC. In the meantime, the conditions that keep stronger SOC include optimism and ﬂexible response for successful adaptation. SOC is a state of inner consistency held by individual, and expressed as a conviction born of the subjective experience of individual in concordance with thelogical construct of SOC. Antonovsky himself deﬁned SOC as follows; “
(1)
(2)
(3)
(Antonovsky, 1998: 19). Now, with reference of the concept of SOC in the
preface of Antonovsky s work in 1988, the authors are going to re-conceptualize the characteristics
of SOC, indicating the four components below as we identify;(a) Consistent perception about the world: “persisting conviction”, “conviction that the interior
and the exterior environments are predictable,”(b) Rough and easy perception: the sense that “events are by and large predictable,”(c) Optimism: conviction that “it is very likely that things work well,”(d) Perception with which life world is ﬁlled: “dispositional orientation towards the world” (Antonovsky 1988: xvii, 182).
SOC is constructed by the component called GRRs,

Generalized Resistance Resources.

GRRs are explained as the components or, literally, the resources from which SOC emerges. For
instance, Antonovsky describes that “GRRs are deﬁned asresources [to emerge SOC;

added by the author]” (Antonovsky 1988:xvi). Additionally, the function of GRRs, interacting with
the individual actor, is to help ﬁnd the meaning of the misfortune as stressor inﬂicted on him/her
and to make easier to cope with it. Speciﬁcally, “(i) what is common to all GRRs, I proposed, wasthat they facilitated making sense out of the countless stressors with which we are constantly
bombarded. (ii) In providing one repeatedly with such experiences, they generate, over time, astrong sense of coherence. (Antonovsky 1988:xiii, numbers added by the authors).” As seen above,
Antonovsky s explanation implies that the GRRs involve the principle of daily practice by the individual. For instance, in his book published in 1988, Chapter ﬁve is allotted for the discussion on “thechild-rearing patterns and subcultural and cultural patterns of social organization that build up the
GRRs out of which a strong SOC emerges” (Antonovsky 1988:xvi).

86私たちの健康はどこからやってくる？

3.

Sensing SOC: Revival of qualitative interview method

As we indicated at the end of the section 1 in this article, we do not value very much thepsychometric measurement of SOC contrary to the appraisal it has gained in academia. That is
because, contribution of the “discovery” of the SOC, we believe, lies not in the development of themeasurement method, but in formulation of the versatile term to interpret the experienced facts ofJewish women who are in reasonable health even after the collective passion in history. In theearly age of his academic life he enjoyed in his birthplace North America, Antonovsky dedicatedhimself to research on cultural anthropology, notably, to the study of “culture and personality,” ofwhich theoretical premise inﬂuenced the formulation of the SOC. In this sense, the general principle of illustrating the SOC could by no means be unitary but rather diverse, being modiﬁed by theculture or being given various meanings through personal experience.
Antonovsky cites the series of studies done by Hans Selye (1907-1982). He also studied with
Eric John Cassel (1921-1976), an epidemiologist from Johannesburg, and he used to apply to boththeories that provide scientiﬁc evidence for his SOC eﬀectiveness. Meanwhile, Antonovsky advised
his students who conducted qualitative interview to consult about the “concept of the story telling;”
which we call “narrative” and was addressed by Eric John Cassel, then Antonovsky taught sociology of medicine at the Ben-Gurion University medical school after 1972. The main idea is that there
is a personal “story telling” of the patient that is closely related to the course of the “illness.” And
it implies the importance of getting a picture of the person s “story telling” when the treatment
providers face the patients illnesses. In this regard, the Cassel s concept of the story telling might
remind us of the lately developed “narrative analysis” which involves in better understanding of
the patients and in better medical practice, which these two actually do not have close relation witheach other. Antonovsky relates an experience Cassel himself had, concerning the importance of thestory telling in his book.
“In it he (=) tells of the elderly patient hospitalized for a serious, advanced problem of

the knee. Symptom identiﬁcation, diagnostic hypothesis, conﬁrmation, and institution of appropriate therapy followed in short order, leading to discharge and ensuring re-hospitalization in
short order. For what was learned only by accident by a medical student was that this elderly
gentleman had been widowed a year before, had moved to this strange city where he had nofriends or relatives, had only a small income, and lived in a fourth-ﬂoor walk-up. The knee wasvery real and very serious. This was what had led to hospitalization this time; the next time,
it could have been malnutrition, pneumonia, or depression and suicide attempt” (Antonovsky,
1998: 5,).

As this brief description implies, a “story telling” is not what was told superﬁcially, but ashared experience between the patient and the listener in which the latter could reach the deeply
hidden aspect of life of the former. To reach a “real story,” something more than transcribing theinterview sessions is required. It requires deep compassion or rapport for the “lived experience” inphenomenological sense, of researcher him/herself.

87

From Where does Our Health Come?:

Then, here is another episode to remark.
《Episode》“In November 1982 I was teaching interviewing to beginning medical students in Israel. The
setting was a well-baby clinic, the reluctant interviewee a twenty-six-year-old mother who hadbrought her three-week-old infant, while her fourteen-month-old little girl trailed behind Her
reluctance, the nurse told us, was understandable: her four older children waited at home.
After a few words about the uneventful delivery, she remained quiet in response to the student s next question, which referred to the presence of her husband at the delivery. Fortunately, she had learned how to wait patiently and use nonverbal expressions of concern. The
woman then told him, in almost in-audible words, that her husband had been killed in theﬁghting in Lebanon some four months earlier: The rapport had been created, and she began
to speak, going on for nearly an hour. At ﬁrst, the picture that emerged was the one we had
expected. The terrible blow could not be recalled But the Rehabilitation Division of the Ministry of Defense had already arranged her move to a more spacious apartment, an adequate
pension, ﬁnancial assurance of her children s education, and the like. The diagnosis had been
made, the therapy designed. / But the student, who had learned Cassel s concept of the story,
had been taught to get a picture of the person s life, and patiently elicited what no one else had
been successful in learning. As a child, her father had raped Mrs. R. Pregnant at sixteen, she
had had no alternative but to marry the man whose death had made her a war heroine. She
was often beaten, related to as a baby-making machine, and no more than occasionally provided for ﬁnancially. The death had been the most fortunate thing that had ever happened toher. For the ﬁrst time in her life, she now had the possibility - no more than that - of a decent
human existence. Clearly, her strength was in adequate to transform this into a reality. Solution of ﬁnancial problems, the assigned therapy, was necessary but far from suﬃcient. It wasa magic bullet, not an adequate basis for active adaptation” (Antonovsky, 1998: 9-10).
To close this discussion about the SOC, we would like to choose three examples of “narratives”
from the Antonovsky s work in 1988 in which the respondent interviewees mentioned religious
belief. In the 1988 book, Antonovsky did not explicitly deal with the inﬂuence of Judaism upon his
concept of SOC. Still, the theme of faith was fairly common in the speech of those people withstronger SOC and they were more likely to be positive about it, while in the interviews with thosewith weak SOC religion was hardly brought up for the topic, or, if spoken, they doubted of it.
According to the evaluation done by Antonovsky himself, the following Narrative One and
Two were spoken by the respondents with strong SOC. And the last one, Narrative Three, wasspoken by the respondent with weak SOC.
《Narrative on faith: One》
“How we overcame all the diﬃculties in our lives? You need patience. You have to believe in
the Promise, a word I learned in Bulgaria. ... It doesn t have to be God. It can be another force,but you have to have faith. Otherwise you can t suﬀer so much and go on. ... How can yourhealth be when you re so old? But I have no complaints. ... I don t see so well, I can t read, that s
what bothers me. I work in the center for the blind about three hours a day, together with mywife... I ve always worked, and always looked for work.”88

私たちの健康はどこからやってくる？

(Antonovsky, 1998: 68). - Individual with high SOC.
《Narrative on faith: Two》
“I don t get mad, always laugh and sing. [After describing all he learned and dreamt about
Zionism and Israel] When I ﬁnally came, things weren t strange, I understood what was goingon. ... /... I m religious, but not a rabbi.... I love Judaism, tradition. It makes me feel optimistic,
real optimism. I always say that things will be good.... I never despair.... I have nothing to complain about. It s all a matter of will. ... I m only sorry I m not yet married ... What I can do, I do;what I can t, well ... You have to take life as it comes.”

42,(Antonovsky, 1998: 70). -Individual with high SOC.
《Narrative on faith: Three》“I believe in fate. True, I don t know who runs it, because I don t believe in God anymore.”(Antonovsky, 1998: 72). -Individual with high SOC.

4.

Circular argument in Antonovskyʼs theory

Antonovsky argued that achieving or recovering health entails in individual as an subject (1)the social-physical mechanism which generates health and (2) Sense of Coherence,. The former

is Salutogenesis - the theory of generating health which emphasize the function of the sanitary
factors - the factors which give eﬀect on health both to the individuals with good health status andto the society they belong to. And the latter indicates that we can enhance own health status when
the linkage between physical and social components (in other word, the sense of coherence) is organized. In addition, Antonovsky and his colleague researchers gained positive recognition for the“establishment” in the measurement of the SOC applying the technique of Likert scale.
However, Antonovsky s argument on the relationship between GRRs and the well-being ofindividual/society postulates an indirect causal eﬀect and makes a circular logic. In this regard, heargues; the SOC and GRRs correlate with each other and GRRs produce well-being though wellbeing itself does not directly aﬀect SOC.
《Explanation on how GRRs and SOC are relevant to well-being: 01 》
Clearly, if one has a high intelligence, lots of money, or a clear ego identity or lives in a stable, integrated culture to mention some GRRs-there will be consequences not only for the emergence ofa strong SOC, and therefore health, but for other areas of well-being as well. I would, therefore, by
and large expect positive correlations between the SOC and many facets of well-being to the extent
that the GRRs which create the life experiences that give rise to a strong SOC also directly promote well-being. If one is happy with one s ﬁnancial situation, this is not because one has a strong
SOC but because one has a satisfactory income (Antonovsky, 1998: 181)
《Explanation on how GRRs and SOC are relevant to well-being: 02》
In sum, I think it reasonable to expect positive, though not directly causal, correlations between the89

From Where does Our Health Come?:

SOC and well-being, on two grounds. First, if the SOC is indeed generative of good health, andhealth has a positive inﬂuence on global estimates of one s well-being, then the two will be related,though indirectly; Second, many of the GRRs that promote a strong SOC are also directly related
to well-being. But there is, I think, a more direct causal relationship, one that requires reﬁnement
and speciﬁcation of the notion of well-being into two diﬀerent levels of abstraction. One can distinguish between, on the one hand, the more global referents such as happiness, life satisfaction, morale, and positive (as well as negative) aﬀect and, on the other hand, how one feels about one sfunctioning. The former is strongly contingent on the inherent potential in the objective situation;
the latter will be much more directly related to the SOC (Antonovsky, 1998: 181).

5.

The signiﬁcance of Antonovskyʼs theory

The theoretical implication of the SOC determines (a) the intervention for the individual (andthe group he/she belongs to) and (b) the reconstruction of the life context or the environment as
the way of enhancing SOC. In other words, SOC involves in two interrelated aspects, namely, (1)the potential in the individual s ability, how one can practice adaptively to the context (= “localityof practice”) and (2) the potential of the locality with which an individual can utilize. These two aresimilar to the concept of the “faculties in locality of practice” that the author addresses (Ikeda,
Online).
Beyond the transition of time and culture that creates diversity in people and their lives, how
can SOC be made possible? The answer for this question is left to be discussed. What the philosophy of Antonovsky s theory tells us is that we are to live, over the course of life, “adapting” ourselves to various social restrictions or given environmental conditions and in that purpose we needto utilize our own physical and psychological potential so as to maintain stronger SOC. In order tochoose the environment which increases the SOC (one which decreases the SOC (provides the positive GRRs) and to avoid the. provides the negative GRRs), no one but oneself and the people

surrounding him/her have to act self-directed. That is because maintaining strong SOC is equal to“live better.” In that sense, SOC constructs a principle of practical ethics to promote the function of
salutogenesis. A Japanese medical sociologist, Yoshihiko Yamazaki once mentioned, “new paradigm
is necessary in the human-to-human service area all over the world to pay more attention to positive nature of human-beings and to focus on developing it” (Yamazaki, 2008: 53). It is exactly thisprinciple of practical ethics that establishes such a paradigm.
Kantian philosopher says that it is impossible to ﬁnd rational basis to explain the superiorityof practical reason, but every demand raised in moral life urges us to assure its truthfulness. Then,the individual s reason can do nothing but to submit the proposition. Unless the word “should do()” makes sense, we can do what we should do. When an individual determines one s own will

be guided by such rules, it can be said that the one has freedom () as Kantian philoso-

pher says. Therefore, freedom is the premise for the intrinsic attribute of will in all the rational
being (cf. Gilson 1999[1937: 234-235]).

90私たちの健康はどこからやってくる？

6.

Conclusion: What can we learn from Salutogenic theory?

Yamazaki (2008: 49, 53) also pointed out that the SOC is a sociological and anthropological concept. What can we learn from the SOC if it is so? We can ﬁnd it in the practical application of SOC
theory.
The concept of the SOC is an explanatory theory derived from Antonovsky s “wonder” (interest) that 30 percent of his study subjects were able to keep physical and emotional health despite
experiencing severe stress condition in their past. First, the causal relation between the strong
SOC and health status was presumed, and then, the method of measurement for quantitative description was developed in use of psychometric scale. Later, transitional change of the SOC became
a hot topic, and people sought the strategy to maintain the strong SOC at the end. As the authors
understood, the victory of the SOC theory is all about the discovery of “salutogenic creativity intrinsic to human-being,” and the setback for theof the SOC by measurement

scales. The latter, setback in our words, which brought “academic creativity” to those studying
SOC, made the tool of the propagation available for them to test and write.
The SOC theory has added a new view to human being that an adversity can be an origin of
salutogenic creativity however harsh it is. It seems like a paradox. But it will surely promise aharvest of thought on health in the twenty-ﬁrst century. In the past, Frederick Dun, Rene Dubos
and others had criticized the “deﬁnition of health”2 in, WHO (1946) as “being static, unitary, absolute and utopian.” Today the new idea on health willbe created in response to this criticism after over seventy years. The potential of human being, andthe health, is dynamic, pluralistic, relative, sometime assertive and very realistic! - Is the idealistic
concept of health down to earth?
In 1978, The

by WHO expressed that the achievement of health andthe health rights is the issue to be solved by people themselves. In 1986, thecalled for urgent action by all the government to protect and promote the healthas basic human rights. These were compelling but with positive anticipation. Nonetheless, the public “health demands” by common people are more or less the same as that in 1978 and before, whichmakes us “wondered.” We can say ironically “these people are starving for health.” This “wonder”
is a contrast to the “wonder” felt by Antonovsky when he found the group of people who were
healthy after severe condition like as atrocities or extermination camps. Is the ardent desire, “,” satisﬁed by enhancing the SOC? We have no idea about it but we believe that it isworth trying. It is now to start explore in order to make ain health research3. The

way will be open where the health scientists and the individuals with strong SOC speak to eachother.
Notes
1) Medicalization is the process in which human condition and trouble come to be deﬁned by professionals as medical problems. Under this social process the people think that their badness shouldbe treated and prevented by medical professionals. Bio-Medicalization of health is the process inwhich health concept and practice of human body issues come to deﬁned by biomedical frame of91

From Where does Our Health Come?:reference, e.g. Receiving routine health checkup, consumption of health foods authorized by
medical doctors, and so on.
2) The Constitution says, “Health is a state of complete physical, mental and social well-being andnot merely the absence of disease or inﬁrmity,” in its preface (adopted by the International
Health Conference held in New York from 19 June to 22 July 1946, signed on 22 July 1946 by the
representatives of 61 States, and entered into force on 7 April 1948) .
3) As mentioning to “,” we never forget the importance of interpretive anthropology

by Cliﬀord Geertz (1978) and his hermeneutic approach in social sciences (King et al., 1994: 38-40).
Bibliography- Antonovsky, Aaron. (1979). San Francisco: Jossey-Bass Publishers.

- Antonovsky, Aaron. (1988). San Francisco: Jossey-Bass Publish-ers.
- Cassell, Eric J. (1978). Harmond-

sworth, Middlesex: Penguin Books.
- Datan, Nancy., Aaron Antonovsky, Benjamin Maoz. (1981). Johns Hopkins University Press- Frank, Arthur W. (1991) From sick role to health role: Deconstructing Parsons. In. Robertson, Roland and Bryan S. Turner eds., Pp.205-216, London: Sage.
- Geertz, Cliﬀord. (1978). New York: Basic Books.

- Gilson, Étienne. (1999[1937]). San Francisco: Ignatius Press.

- Ikeda, Mistuho. (Online) Genba-ryoku, empowerment faculty and sensibility in practice [in Japanese], (http://www.cscd.osaka-u.ac.jp/user/rosaldo/060518genba.html)- King, Gary, Robert O. Keohane, Sidney Verba. (1994). Priceton, N.J.: Princeton University Press.
- Moore, G. E. (1988 [1903]) Principia Ethica. Buﬀalo, NY: Prometheus Books,- Vansteenkiste, Maarteen and Kennon M. Scheldon, 2006. There s nothing more practical than
good theory: Integrating motivational interviewing and self-determination theory.
45: 63-82.
- Yamazaki, Yoshihiko (2009) The Implications and Challenges of Sense of Coherence (SOC) as
Stress Coping Ability for Health and Medical Sociology [in Japanese].
(Journal of Japanese Journal of Health and Medical Sociology) 19 (2): 43-55.

92

私たちの健康はどこからやってくる？

Japanese Abstract

私たちの健康はどこからやってくる？：
アントノフスキーの健康生成論について
池田光穂（大阪大学コミュニケーションデザイン・センター：CSCD）
徐淑子（新潟県立看護大学、大阪大学 CSCD）
要約
この論文では、アーロン・アントノフスキー（Aaron Antonovsky, 生没年 1923‑1994）の健康生成論について著者たちは批判的に論じる。具体的には、健康生成論の価値は、人間の健康の動態的で多面的な価値についての質的側面を明らかにしたことにあると考え、一般的に指摘されているように首尾一貫感覚（SOC）の精神測定的な数量尺度化にその価値があるのではないと主張する。それゆえ、著者たちはアントノフスキーの質的な方法論に焦点をあてて、彼の研究上の遺産を今後どのように継承すべきなのかについて論じる。
キーワード
健康生成論、アーロン・アントノフスキー、ヘルシズム（健康至上主義）、ポジティブ・ヘルス、
医療社会学、医療人類学

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