Person-centered public health promotion: an overview and a plea

Abstract

The Definition of Health of the World Health Organisation (WHO) has traditionally focused on individual health as a human right, defined not only by the absence of symptoms, disorder and disease, but also including a state of continuous and balanced mental- and physical wellbeing [1]. Today, increasingly holistic approaches in medicine are concerned to integrate physical, mental, psychosocial and existential factors and to focus additionally on salutogenesis and resilience, even on happiness [2]. Over the last few decades, the WHO has summarized the global research evidence on mental health and mental wellbeing and has identified the following determinants of health as necessary for the maintenance of health and the avoidance of illness [3]: (i) a state of control: not to be helpless, to be in charge of and execute mastery in one’s own life; (ii) a sense of existential cohesion and meaning:  to experience an individual context of meaning and sense and to find individual and feasible ways to live according to this experience; (iii) a feeling of social connectedness: to feel socially connected and related, to experience the feeling of being needed and to be supported by others when needing help, to have someone to care for and  to be cared for by and (iv) a feeling of “caseness” - being a person and identity of one’s own:  this involves feelings of integrity, identity, dignity, being respected and the absence of alienation. It is here that person-centred public health and community approaches, focussing on regions or populations at risk, have to investigate and elucidate these four dimensions for each person or population at risk.In this article, the often complex patterns of specific vulnerabilities will be described, specific assets and strengths as well as specific etiological causalities analyzed and some different individual salutogenic or pathogenic health causalities and consequences  in different populations discussed, in order to elucidate an underlying basis for actions and interventions on a demographic level.