From Fighting Disease to Building Health: Salutogenesis Reshapes Public Health Thinking

A growing body of research is challenging one of the deepest assumptions in modern medicine: that health is best understood through disease. An editorial published in Frontiers in Public Health, in the section on public mental health, argues that public health interventions remain dominated by pathogenic models, which focus on identifying and reducing risk factors, and that the field would benefit from a complementary orientation known as salutogenesis. Rather than centering illness, salutogenesis treats health-generating assets as things that can be deliberately identified, cultivated and scaled.

The editorial, authored by Suvarna Sanjay Sane of the ICMR-National Institute of Translational Virology & AIDS Research in Pune, Lori Rubenstein Fazzio of Bellarmine College of Liberal Arts, Ananda Balayogi Bhavanani of the Institute of Salutogenesis and Complementary Medicine in Puducherry, and Vijay V Yeldandi of the University of Illinois College of Medicine, introduces a research topic that gathers original studies, a systematic review and theoretical papers spanning schools, hospitals, psychiatric wards and sport. The intellectual foundation of the collection lies in the work of the medical sociologist Aaron Antonovsky, whose pioneering framework the editors urge newcomers to read first. The editorial also references the related concept of GRR-Resistance Deficits, which describes the absence or depletion of such resources, as a complementary lens for understanding how vulnerability arises.

Several of the studies highlighted in the research topic test whether specific practices can function as implementable GRRs in everyday institutional settings. In the academic environment, Oswal and colleagues evaluated the effect of anapana meditation, a practice centered on observation of natural breath, on secondary school students. Their findings suggest that the meditation practice helped increase students’ attention span and mental well-being compared with the previous year, leading the editorial’s authors to describe the intervention as having the potential to serve as an implementable classroom GRR.

The framing matters: rather than treating meditation as a treatment for a diagnosed disorder, the study positions a simple, low-cost practice as a health-generating asset that can be embedded in the daily routine of a school classroom and made available to entire cohorts of students regardless of their current health status. A second study in the university setting, by Ke Xu and colleagues, examined the structural relationships between physical activity, self-esteem, grit and Sense of Coherence among university students. The research suggests that physical activity and positive psychological traits strengthen a student’s SOC, and the authors use this to argue for the promotion of both physical and psychological assets within universities.

The editorial notes that the authors are explicit about the limitations of their work and underline the need for probability sampling, repeated measures through longitudinal study designs, and data collection through wearable devices in future research. Healthcare access as a universal right, protecting human life from its earliest stages, forms the backdrop for a third study that applies a salutogenic lens to a frequently overlooked population. Anlin Jenisha and colleagues addressed menstrual and premenstrual problems in adolescent girls with intellectual disability, a cross-sectional study that the editorial describes as calling for inclusive, resource-based public health interventions that empower vulnerable adolescent girls.

The authors connect the healthcare of adolescent girls with intellectual disability to the comprehensibility and manageability components of the Sense of Coherence, arguing that menstrual health in this group depends on whether girls can understand what is happening to their bodies and manage it with adequate support. They provide a feasible framework for addressing menstrual health needs within special-school settings, and they recommend that such integrated strategies be evaluated for longitudinal effectiveness, an acknowledgment that the current evidence base is cross-sectional and that longer-term follow-up is required. The collection also reaches into clinical and therapeutic settings through work on yoga, a practice with thousands of years of history in ancient India that the editorial notes was reappraised through scientific research for establishment as yogic therapy.

Zaccari and colleagues introduce the COMPASS framework in a hypothesis-and-theory paper that expands on the therapeutic mechanisms of yoga. The framework describes how yoga practices can cognitively and physiologically guide individuals from states of threat toward states of safety, and the authors present it as a robust salutogenic alternative to pain-management approaches. Complementing that theoretical work, Tolbanos-Roche and colleagues evaluated an integrated, comprehensive care model and demonstrated that a yoga-based intervention was strongly associated with enhanced patient well-being and high levels of patient satisfaction in intensive psychiatric care.

An association between a yoga-based model and well-being and satisfaction in such a setting does not by itself establish efficacy, and the editorial’s language is careful on this point, but it does suggest that salutogenic practices can be integrated into high-acuity clinical environments and accepted by patients experiencing severe mental illness. Workplace health emerges as another domain in the collection, through an original research article conducted in a hospital-based setting among emergency nurses. Sun and colleagues investigated the protective effects of perceived social support and moral resilience among emergency department nurses, a workforce repeatedly exposed to ethical strain and moral injury.

Their study reveals that these social and moral resources act as crucial buffers, mitigating the impact of moral injury and reducing health-related productivity loss. The editorial draws a specific conceptual conclusion from this finding: supportive work environments should be understood as organizational GRRs. This reframing shifts responsibility in an important way, placing the cultivation of health-generating resources within the structure of institutions themselves rather than solely within the choices of individual workers.

The research topic also extends into sport and end-of-life care, demonstrating the framework’s breadth. In a systematic review of mindfulness-based interventions, Cao and colleagues indicate that short mindfulness practices can improve sport-related performance and coping mechanisms, with the review demonstrating the capacity of such interventions to enhance manageability and performance under pressure. A separate perspective paper examines how practicing savasana, the corpse pose familiar to yoga practitioners, can serve as an accessible practice inviting people to reflect on their mortality, navigate death anxiety and find meaning in life.

The authors suggest that increasing mortality salience may help individuals reflect on mortality, navigate death anxiety and find meaning during the end-of-life period, connecting the salutogenic emphasis on meaningfulness to one of the most existential dimensions of human experience. The editorial closes by arguing that the diverse research compiled in the topic shows salutogenesis is a highly versatile and practical framework for modern public health, with evidence demonstrated through somatic practices in psychiatric wards, mindfulness in sport, supportive social networks in emergency departments and community-led health promotion models. Other contributors call for re-storying traditional health promotion models, advocating a shift of the locus of control back to communities to foster population sovereignty, so that sustainable health outcomes are achieved when communities are recognized as active, sovereign agents of their own health generation rather than passive recipients of top-down, pathogenic interventions.

The editors’ overall conclusion is direct: identifying and cultivating health-generating assets builds a stronger, more resilient Sense of Coherence in populations, and public health research worldwide must move beyond conventional disease control and health promotion to embrace salutogenic frameworks that systematically cultivate the factors creating true wellness. As with any emerging research program, the studies gathered here include cross-sectional designs and theoretical models, and the authors themselves repeatedly identify longitudinal, probability-sampled and device-based measurement as the next steps needed to consolidate the field’s claims.

Subject of Research: Salutogenesis and Sense of Coherence as frameworks for public health research and health promotion

Article Title: Editorial: Salutogenesis and public health

Article References: Sane, S. S., Fazzio, L. R., Bhavanani, A. B., & Yeldandi, V. V. (2026). Editorial: Salutogenesis and Public Health. Frontiers in Public Health, 14, 2006482. https://doi.org/10.3389/fpubh.2026.2006482

Image Credits: AI Generated

DOI: 10.3389/fpubh.2026.2006482

Keywords: salutogenesis, Sense of Coherence, public health, health promotion, Generalized Resistance Resources, Aaron Antonovsky, yoga, mindfulness, mental well-being, moral resilience, Indian Knowledge Systems, health continuum