Resources revisited: salutogenesis from a lay perspective

Health visitors are being pressured to move away from their traditional rol e in health promotion and public health to focus more closely on people wit h established clinical disorders. This is partly because of a paucity of th eoretical explanations against which to assess interventions directed expli citly at promoting health rather than only preventing disease. However, the re are growing public health concerns about increasing inequalities and ris ing numbers of disadvantaged groups in the UK as well. This paper revisits a grounded theory study that revealed how, in the absence of a need for cli nical intervention, health visitors appear to assess needs by treating heal th as a process fuelled by the accumulation and use of 'resources for healt h'. Wider theories about salutogenesis ('health creation') and research sho wing the importance of health and social capital demonstrate the potential of this idea, and were combined with the health visiting study to create a theoretical framework for analytical purposes, Semi-structured interviews w ith the main carer in 50 families with resident children were analysed usin g this framework, to provide a lay perspective on how people consider they maintain their health, The analysis demonstrated the usefulness of treating health as a process and of focusing on the development of health-related r esources rather than only on presenting problems. The processes of developi ng capacity were shown to be more important than the presence or absence of specific resources. Links with personal empowerment were apparent; cultura l patterns that evolved across generations and neighbourhoods revealed poss ible pathways to social cohesion. Practice approaches that enhance or inhib it the development of these health-creating resources were identified, and considered in the light of emerging public health needs.