1. Department of Health Promotion and Development
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 RESOURCES3

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

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

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:

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. GRR 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
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 (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. and thus prevent tension from being transformed into stress.
A SSR is a
newly engaged
material asset
skill
talent
ability
strength
expertise
proficiency
adeptness
of an
individual
group
community
setting
that is
activated
specifically to
impart control over
avoid
reinterpret
adapt 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… SRR GRR Suicide prevention hotlines
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