Story at a glance:
- Salutogenesis is an approach to human health that focuses on the study of factors that support and maintain overall health and well-being rather than examining the factors that cause disease.
- While not inherent to the green building movement, salutogenic design often overlaps with green design and can help facilitate a shift toward a more holistic definition of sustainability.
As the green building movement begins to prioritize occupant wellness in addition to environmental sustainability, it’s important that architects familiarize themselves with the concept of salutogenesis.
In this article we cover the basics of salutogenesis and why it matters to green building and design.
What is Salutogenesis?
Coined in the 1970s by Israeli-American professor of medical anthropology Aaron Antonovsky, salutogenesis is, at its core, a health theory that looks to understand the origins of health and well-being. In this regard salutogenesis may be conceptualized as the direct opposite of pathogenesis, or the study of how diseases and illnesses develop, progress, and persist.
Pathogenesis has long informed the basis of Western medicine and is largely responsible for our society’s distinctly dichotomous view of health, under which individuals are classified as either “healthy” or “sick,” with little nuance in between. Salutogenesis, on the other hand, treats health as a continuum rather than a dichotomy, placing individuals on a sliding “ease/disease” scale based on various factors.
The Salutogenic Model of Health
Antonovsky’s salutogenic model is based around the so-called “sense of coherence,” a theoretical formulation that aims to provide an explanation for the role of stress in human functioning. Sense of coherence is measured along a scale and ultimately evaluates how confident people under stress are that their internal/external environments are predictable and that things will work out as well as can reasonably be expected.
There are three central components to the sense of coherence:
- Comprehensibility. Represents the cognitive dimension of coherence and can broadly be defined as the belief that things in one’s life happen in an orderly, predictable fashion, meaning one is able to understand events as they happen and predict—to a reasonable degree—what will happen next.
- Manageability. As the behavioral dimension of coherence, manageability can be understood as the belief that one has the skills, ability, support, help, and/or resources necessary to feasibly take care of and manage things within their control.
- Meaningfulness. Considered the motivational dimension of coherence, meaningfulness is defined as the belief that things in life are interesting, worthwhile, and that there is a reason to care about what happens.
All three components are necessary for shaping one’s sense of coherence and are largely determined by life experiences. Consistent experiences, for example, are required for comprehensibility; load balance, or the state in which one has the resources to meet life’s demands, is necessary for manageability; and active participation provides the basis for meaning.
Salutogenic Design
It should be noted that, while salutogenesis is still very much in its infancy as a social science, it is not impossible or fruitless to apply a salutogenic approach to the built environment; Antonovsky himself touched upon the concept of salutogenic design in Health, Stress, and Coping, describing it as “a measurable aspect of design that can help people operate at peak performance and help them to maintain physical and mental wellbeing.”
The idea that the spaces we live, work, learn, and play in have an impact on our health and well-being isn’t new, but most research on the topic takes a pathogenic approach, focusing on how the built environment negatively affects physical and mental health. On the flip side salutogenic design asks us to consider how buildings may work to actively support and maintain health.
Many of the salutogenic design principles and strategies put forth by Antonovsky—and later architect Alan Dilani—are geared toward hospitals and other health care facilities, though they can in theory be applied across a wider range of development categories. Most of these methodologies focus on how spatial relationships, sensory stimuli, and building layout/orientation can be optimized to facilitate comprehensibility and manageability throughout a space.
Why Does Salutogenesis Matter to Green Building?
Using daylight in health care spaces is not only great for patients but also staff. Studies have shown that daylight can increase alertness, focus, and mood. Here tubular daylighting device fixtures integrate into the nursing station ceiling just like traditional lighting fixtures. Photo courtesy of Solatube International
Now that we’ve established that a salutogenesis approach can be applied to architecture, let’s take a moment to talk about why salutogenic design matters to the green building movement.
The green building movement has, for most of its history, focused on designing, constructing, and operating buildings in ways that minimize their emissions and overall environmental footprint; the movement has primarily concerned itself with achieving environmental sustainability rather than improving occupant health. In recent years the green building movement has begun to adopt a more holistic idea of what it means to be, well, green, recognizing that human health and well-being are also important to long-term sustainability.
Ultimately salutogenesis matters to green building because it can help lead architects to environmentally friendly designs they might otherwise not consider during their pursuit of solutions that actively foster occupant health. A building that relies primarily on artificial lighting for daytime illumination, for example, can still be considered green if it uses energy-efficient LEDs and produces all its own electricity via onsite solar—but neither of these solutions are particularly impactful from a health standpoint.
Alternatively, an architect utilizing a combined salutogenic/green design approach may instead choose to prioritize daylight as the main source of illumination during daytime hours, to the benefit of both the environment and human health. From a sustainability standpoint, maximizing daylight admittance is ideal because it reduces a building’s dependency on artificial electrical lighting, thus resulting in fewer operational emissions.
Natural sunlight also helps improve occupant health and wellness by synchronizing the body’s circadian rhythms. “By exposing your body to daylight throughout the day, your healthy human circadian rhythm will have a significant role in regulating your sleep-wake cycle and have a positive influence on your eating habits and digestion, body temperature, hormone release, and other important bodily functions,” Neall Digert, vice president of innovation and market development at Kingspan Light + Air, previously wrote for gb&dPRO. Solatube’s—a company owned by the Kingspan Group—tubular skylight systems, for example, help bring daylight deep into buildings, making them especially ideal for large health care facilities.
