Revitalising the evidence base for public health: an assets model

Abstract

Historically, approaches to the promotion of population health have been based on a deficit model. That is, they tend to focus on identifying the problems and needs of populations that require professional resources and high levels of dependence on hospital and welfare services. These deficit models are important and necessary to identify levels of needs and priorities. But they need to be complemented by some other perspectives as they have some drawbacks. Deficit models tend to define communities and individuals in negative terms, disregarding what is positive and works well in particular populations. In contrast 'assets' models tend to accentuate positive capability to identify problems and activate solutions. They focus on promoting salutogenic resources that promote the self esteem and coping abilities of individuals and communities, eventually leading to less dependency on professional services.Much of the evidence available to policy makers to inform decisions about the most effective approaches to promoting health and to tackling health inequities is based on a deficit model and this may disproportionately lead to policies and practices which disempower the populations and communities who are supposed to benefit from them. An assets approach to health and development embraces a 'salutogenic' notion of health creation and in doing so encourages the full participation of local communities in the health development process.The asset model presented here aims to revitalise how policy makers, researchers and practitioners think and act to promote a more resourceful approach to tackling health inequities. The model outlines a systematic approach to asset based public health which can provide scientific evidence and best practice on how to maximise the stock of key assets necessary for promoting health. Redressing the balance between the assets and deficit models for evidence based public health could help us to unlock some of the existing barriers to effective action on health inequities. This re-balancing would help in better understanding the factors that influence health and what can be done about them. It would promote a positive and inclusive approach to action. (Promotion & Education, 2007, Supplement (2): pp 17-22).

Finding Sustainability: University-community collaborations focused on arts in health

“…In the public health field, interest was growing in the 'health assets model' (Morgan & Ziglio 2007). This model contends that, historically, health promotion has worked on a deficit model that focused on the problems and needs of communities to be addressed through health resources.…”

The utility of salutogenesis for guiding health promotion: the case for young people's well-being

“…Interest in the idea also re-emerged in the 21 st century in the context of public health and its efforts to reduce health inequalities (Morgan and Ziglio, 2007;Eriksson and Lindström, 2008). Most notably, the work of Lindstrom and and others (García-Moya et al, 2013b;Mittelmark and Bull, 2013) have highlighted its theoretical potential both in academic and practice circles and have gone some way to enhance the evidence base to demonstrate its worth as a health concept.…”

“…The generalizability of the findings regarding the stability of SOC and the factors that can contribute to the development of a strong SOC must be cautiously evaluated in terms of the cultural values and macrosystemic factors that surround the population under study. As stated in the asset model, it is fundamental to know which factors have a significant impact for who and under which circumstances (Morgan and Ziglio, 2007) and, consequently, cross-cultural studies have to be an important way forward.…”

“…With respect to young people, WHO and the Health Behaviour in School Aged Children (HBSC) study emphasised that a range of 'health assets' necessary for the growth and development of children and young people could lead to higher levels of positive mental health. Salutogenesis (sources of health), or more specifically, SOC has been described as a potential health asset for wellbeing (Morgan and Ziglio, 2007) and a possible intermediary factor that can help to link and explain the range of antecedents necessary for the achievement of wellbeing during childhood and beyond.…”

Place, space, and health inequalities

“…A focus on the positive aspects of health takes many different forms, some with greater relevance to, and evidence from, geographical studies than others. The umbrella of 'positive health' ideas includes notions of salutogenesis (Antonovsky 1979(Antonovsky , 1996, positive deviance (Marsh et al 2004), resilience (Bartley 2006;Werner 1996), and assets-based approaches (Morgan and Ziglio 2007), whilst acknowledging that each of these terms has its own focus, history, and definition (see also Chapter 15). This focus on how people stay well can be an inspiration for thinking about how health inequalities might be minimized and what the role of place might be.…”