Elizabeth Bachrad

Population Health Strategist

Elizabeth is a mission-driven advocate for the “Triple Win”—the intersection of health equity, environmental sustainability, and economic prosperity. As a Population Health Strategist and Head of Strategy at Business for Health, she bridges the gap between government policy and industry innovation. With an academic background in Sport Psychology and Population Health, Elizabeth advises global organizations on human capital management, ensuring that health is treated as a long-term sustainable investment rather than a cost.

Lonnie Golden, PhD

Professor of Economics and Labor-Human Resources

Dr. Golden brings a salutogenic lens to the world of labor economics. His extensive research examines the vital connection between work hours, job quality, and human happiness. By analyzing the micro and macro effects of work-life conflicts, flexible scheduling, and the 4-day workweek, Lonnie identifies the structural determinants of mental and physical health in the modern economy. His work focuses on creating objective and subjective indicators that empower workers to assess and improve their own professional well-being.

Current Project Spotlight: Dr. Golden and Ms. Bachrad are currently collaborating on the development of the Salutogenic Work Inventory, a pioneering tool designed to measure the health-generating resources available within organizational structures.

Shimon Waldfogel, MD

Psychiatrist & Salutogenic Systems Architect

Dr. Waldfogel integrates decades of clinical expertise with a forward-looking approach to systemic health. His work is centers on developing salutogenic strategies that enhance well-being within the professional sphere, with a specialized focus on the current AI-work intersection. As technology reshapes the landscape of labor, Shimon is dedicated to ensuring that “Useful General Intelligence” serves to augment human coherence and resilience rather than diminish it. His frameworks provide a roadmap for maintaining purpose and health-promoting “sense of coherence” in an increasingly automated world.

For over a century, medicine has been driven by a single question: What makes people sick? This question has led to remarkable advances—vaccines, antibiotics, surgical techniques that would seem like miracles to our ancestors. But it’s also left us with a blind spot.

What if we also asked: What makes people healthy?

This isn’t just wordplay. It’s a fundamental shift in perspective—one that opens up entirely new possibilities for how we approach wellbeing. This shift has a name: salutogenesis.

The Birth of a New Question

The term “salutogenesis” comes from the Latin salus (health) and the Greek genesis (origin). It literally means “the origins of health.” The concept was developed by medical sociologist Aaron Antonovsky in the 1970s, and it emerged from a striking observation.

Antonovsky was studying women who had survived Nazi concentration camps. As expected, many survivors showed lasting psychological trauma. But what caught his attention was something else entirely: a significant number of these women were thriving. Despite enduring unimaginable horror, they had somehow maintained their mental and physical health.

This puzzled him. How was this possible?

Rather than asking what broke down in those who struggled (the traditional medical approach), Antonovsky asked what enabled some people to stay well despite overwhelming adversity. This question led him to develop the salutogenic model—a framework for understanding what moves people toward health and flourishing.

The River of Life

Antonovsky used a powerful metaphor to illustrate the difference between the traditional approach and salutogenesis. Imagine life as a river.

The traditional medical model positions doctors as lifeguards standing downstream, ready to pull drowning people from the water. They intervene when things go wrong—treating illness, managing disease, responding to crises. This is essential work, but it’s reactive.

The salutogenic approach asks different questions: What determines how well people can swim? What makes the water calmer in some stretches? Can we teach people to navigate the currents? Can we improve conditions upstream?

The river metaphor acknowledges something important: we’re all in the water. No one stands safely on the shore. Life inevitably brings challenges, stressors, and hardships. The question isn’t whether we’ll face difficulty—it’s whether we have what we need to keep swimming.

The Sense of Coherence

At the heart of salutogenesis is a concept Antonovsky called the Sense of Coherence (SOC). This isn’t a personality trait you either have or don’t have. It’s more like an orientation toward life—a deep, enduring confidence that:

1. Life is comprehensible. The world makes sense. Even when difficult things happen, they aren’t random chaos. You can understand, at least to some degree, what’s happening and why. This doesn’t mean everything is predictable—just that events can be placed within some coherent framework.

2. Life is manageable. You have (or can access) the resources needed to meet life’s demands. These resources might be your own skills and strengths, or they might come from others—family, friends, community, institutions. The key is believing that challenges can be addressed.

3. Life is meaningful. Your existence matters. The demands of life are worth investing in. There are things you care about, purposes worth pursuing, reasons to engage rather than withdraw.

Of these three components, Antonovsky considered meaningfulness the most important. Without a sense that life is worth the effort, people are unlikely to seek understanding or mobilize resources when challenges arise.

People with a strong Sense of Coherence don’t necessarily have easier lives. But they tend to navigate difficulties more effectively. They perceive stressors as challenges rather than threats, identify and use available resources, and recover more readily from setbacks.

Resources for Thriving

If the Sense of Coherence is the orientation that helps us navigate life’s waters, what shapes that orientation? Antonovsky identified what he called Generalized Resistance Resources (GRRs)—the factors that help us manage stress and move toward health.

These resources are remarkably diverse:

• Material resources: Financial security, housing, access to healthcare

• Knowledge and intelligence: Education, skills, the ability to learn and adapt

• Social support: Relationships, community connections, a sense of belonging

• Cultural stability: Shared values, traditions, a sense of identity

• Coping strategies: Problem-solving skills, emotional regulation, flexibility

• Physical factors: Good nutrition, exercise, adequate rest

What matters isn’t just having these resources, but the life experiences that come from engaging with them. When we repeatedly face challenges and find that we can understand what’s happening, marshal appropriate resources, and find meaning in the struggle, our Sense of Coherence strengthens.

This begins in childhood. Children who grow up in environments where life is consistent (comprehensible), where they’re given responsibility matched to their abilities (manageable), and where they’re valued and included (meaningful) tend to develop stronger orientations toward coherence.

But this isn’t deterministic. While early experiences matter, the Sense of Coherence can be strengthened throughout life through positive experiences and supportive environments.

A Systems Perspective

The salutogenic paradigm recognizes that health isn’t just an individual matter. We exist within interconnected systems—families, communities, institutions, cultures, ecosystems. Our wellbeing is shaped by forces at every level.

This means that promoting health requires thinking beyond individual behavior change. Yes, personal choices matter. But so do neighborhood design, workplace policies, social services, economic conditions, and cultural values. A systems approach asks how we can create environments that naturally support flourishing—that help more people develop the resources and orientation to thrive.

This perspective also bridges disciplines. Understanding what creates health requires insights from medicine, psychology, sociology, economics, urban planning, education, and beyond. No single field has all the answers. Salutogenesis provides a framework for integrating these perspectives toward a common goal.

Beyond Fixing What’s Broken

Perhaps the most profound implication of salutogenesis is this: health isn’t merely the absence of disease.

The traditional model positions health as a baseline that illness diminishes. Treatment aims to return people to that baseline—to fix what’s broken. But salutogenesis suggests that health exists on a continuum. Even without disease, there are degrees of vitality, of flourishing, of optimal wellbeing.

This shifts our aspirations. We’re not just trying to avoid sickness. We’re asking what it means to truly thrive—and what conditions make that possible.

This doesn’t mean abandoning the disease-focused approach. When people are sick, they need treatment. But it does mean expanding our vision to include health promotion, not just disease prevention. It means designing systems that help people flourish, not just survive.

Why This Matters Now

We face challenges today that the traditional medical model wasn’t built to address. Chronic diseases, mental health struggles, loneliness, burnout—these aren’t problems that can simply be fixed with a prescription. They require understanding the conditions of our lives and how those conditions support or undermine our wellbeing.

At the same time, we’ve accumulated tremendous knowledge about what helps people thrive. We understand more than ever about the social determinants of health, the importance of meaning and connection, the power of community, the foundations of resilience. What we often lack is an integrating framework—a coherent way to think about all these factors together.

The salutogenic paradigm offers that framework. It provides a theoretical foundation for understanding health promotion, a practical orientation for designing interventions, and a hopeful vision for what’s possible when we focus not just on avoiding harm but on creating the conditions for human flourishing.

In future posts, we’ll explore specific applications of the salutogenic paradigm—from individual practices that strengthen the Sense of Coherence to community and policy approaches that create health-promoting environments. We’ll examine the research evidence, share practical tools, and consider what it would mean to build a truly salutogenic society.

The Institute for Salutogenesis exists to advance this paradigm—through research, education, and advocacy. We believe that asking “what creates health?” has the power to transform how we approach wellbeing at every level.

Guided by our visionary Democracy, Opportunity, and Citizenship Moonshot, we are committed to a transformative shift in how we view health and society. This approach prioritizes creating environments that nurture individual and collective flourishing, equipping people with the knowledge, skills, and resources needed to lead meaningful lives and engage fully in democratic processes.

Through innovative platforms, practical tools, and dynamic media initiatives, we work to enhance citizen agency and promote holistic well-being. Our programs empower individuals to develop core capabilities for meaningful participation, fostering inclusive communities where everyone has a voice and the opportunity to shape their future.

Join us in advancing the Democracy, Opportunity, and Citizenship Moonshot. Together, we can create a more equitable and health-focused society that prioritizes flourishing, resilience, and active engagement for all.

The Institute for Salutogenesis is a non-profit organization with a bold belief: every individual, regardless of their background, deserves the chance to reach their fullest potential. Our moonshot, Democracy of Opportunity, champions equitable access to the resources and conditions essential for all citizens to lead healthy, thriving lives and engage fully in our democracy.

Our Moonshot: Democracy, Opportunity and Citizenship

The Institute for Salutogenesis, is fueled by an audacious vision: the Democracy, Opportunity and Citizenship Moonshot . This isn't just a goal; it's a commitment to creating a world where every individual, regardless of their background, has the opportunity to thrive. Our moonshot is about maximizing human potential, fostering engaged communities, and creating a society where every citizen can flourish.

The Democracy, Opportunity and Citizenship Moonshot is the principle that all individuals, irrespective of their background or circumstances, deserve access to resources, opportunities, and societal support to thrive and achieve their full potential. It's about leveling the playing field and ensuring that everyone has the chance to lead a fulfilling life.

Questions That Engage Us:

• What are the factors that contribute to individual flourishing?

• What is the role of the ecosystem (communities and culture) in the creation of flourishing life?

• How to provide for a society that creates and supports structures and processes that facilitate and promote individual flourishing from the first 1000 days of life?

Our Approach: Salutogenesis

At the heart of our work is salutogenesis, a revolutionary approach to health that shifts the focus from merely treating illness to actively creating and sustaining well-being. We look beyond the absence of disease to promote the factors that help individuals and communities flourish. Through innovative programs, cutting-edge research, and impactful advocacy, we're changing the conversation around health and well-being.

Our Theory of Change

We recognize that individual health is deeply intertwined with the systems we live and work within. To create lasting change, we focus on transforming these systems – our communities, workplaces, and healthcare – into environments that actively support health and well-being. The challenges facing individuals and society today are complex and interconnected. From health disparities to social inequities, these issues require innovative solutions that address root causes rather than just symptoms. The Institute for Salutogenesis is dedicated to driving meaningful change through a bold theory of change that leverages paradigm shifts and systems thinking.

Our Guiding Paradigms: Citizenism and Salutogenesis

Central to our strategy is the concept of paradigm shifts. These fundamental changes in underlying assumptions encourage us to rethink traditional frameworks and promote resilience, empowerment, and active engagement. By integrating diverse disciplines like biology, psychology, and political science, we aim to initiate meaningful systemic change while respecting the complexity of human experience.

The Salutogenic Paradigm

We prioritize promoting health and resilience over simply combating disease, recognizing well-being as a multi-faceted state. Inspired by the World Health Organization's definition of health, we embrace a holistic approach that encompasses physical, mental, and social well-being:

“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

The Citizenism Paradigm

Grounded in the principles of the Declaration of Independence, this paradigm asserts the fundamental equality of all humans and their inalienable rights to life, liberty, and the pursuit of happiness. It emphasizes the power and responsibility of citizens to actively participate in shaping their communities and government:

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the pursuit of Happiness.”

Driving Systemic Change Through Paradigm Shifts

Fundamental shifts in underlying assumptions—paradigm shifts—are the key to transformative change. By promoting the Citizenism and Salutogenic paradigms, we aim to:

• Reshape Thinking: Challenge traditional approaches to health and governance, shifting the focus towards prevention, empowerment, and holistic well-being.

• Influence Policies and Practice: Advocate for policies that prioritize health, equity, and individual agency.

• Empower Individuals and Communities: Equip citizens and communities with the knowledge and tools to make informed decisions and actively participate in shaping their lives and communities.

Our Tools for Change

• Moonshot Press: A multi-platform media initiative that empowers citizens and reshapes democratic engagement.

• Deliberation Platforms: Fostering dialogue and problem-solving through engaging formats.

• Citizen Toolbox: Equipping individuals with tools to become active participants in their communities.

• Embracing Advanced Technologies: Harnessing cutting-edge technologies to advance our mission.

• Health of the Nation: We use health-based indicators to monitor and measure meaningful progress.

Conclusion

At the Institute for Salutogenesis, we believe that by challenging traditional paradigms and embracing innovative approaches, we can create a society where every individual has the opportunity to thrive. Through our theory of change, we are working to transform systems, empower citizens, and build a healthier, more equitable future for all.

Our initiatives represent a significant departure from traditional approaches to early development and well-being. We recognize the critical importance of addressing the social, economic, and environmental factors that shape individuals' lives from the earliest stages.

Focus Areas of the Institute for Salutogenesis

The Institute for Salutogenesis is dedicated to transforming health and well-being across every stage of life. We adopt a holistic, multidisciplinary approach to foster health and flourishing at personal, social, and political levels. Our focus areas are designed to create environments where every individual can thrive, supported by innovative paradigms and real-world applications.

Salutogenesis Along the Life Course

Our focus is a life course approach to health and well-being, beginning with the critical "First 1000 Days of Life" through to old age. We embrace the salutogenic model to strengthen individual and community health. Our strategy integrates the salutogenic model to address the social determinants of health at every life stage.

• The First 1000 Days: Emphasizing early life health, this period from preconception to a child's second birthday lays the foundation for long-term well-being.

• Childhood: Tailored interventions support health and development throughout childhood.

• Adulthood: Addressing the challenges and opportunities for adults to lead healthy, thriving lives.

• Elderhood: Focusing on factors that contribute to well-being for elders, ensuring a dignified and fulfilling later life.

Salutogenesis in Settings and Environments

Recognizing that health is shaped by our surroundings, we apply salutogenic principles across various settings where we live, work, and socialize.

• Community Well-being: Enhancing environmental, educational, and workplace wellness through community-based projects.

• Optimal Environments: Cultivating surroundings that support both individual and community health, enabling everyone to achieve their fullest potential.

The Salutogenic Healthcare System

We envision redefining American healthcare by prioritizing equity, sustainability, and accessibility. Our approach treats the whole person and proactively supports comprehensive health. We're leading the charge to redefine healthcare, prioritizing health creation, sustainability, and whole-person care. Our goal is a system that promotes health for all, not just treats illness.

• Equity and Sustainability: Creating a healthcare system that is fair and sustainable for all.

• Proactive Health: Focusing on nurturing comprehensive health and well-being, not just treating illness.

• Initiatives: This includes Self-Care, Academic Medicine and Clinical Practice, Research and Innovation, Advocacy and Public Health, and Digital Health.

Political Salutogenesis:

The Institute's Salutogenic Action Plan

Our Initiatives for 2026

• The First 1000 Days of Life: A salutogenic Approach We're investing in early childhood development to set the stage for a lifetime of health and thriving.

• Thriving in Montgomery County, PA: We're creating a model community for health and well-being, showing what's possible when we prioritize the factors that truly matter.

• Healthcare System Transformation: The Salutogenic Healthcare System We're working to create an accessible, affordable, and high-quality healthcare system that puts people first.

• The Salutogenic Workplace: Developing strategies and programs to enhance worker and workplace well being.

• The Whole Person Salutogenic Assistant: Our innovative AI-powered tool empowers individuals with personalized insights and guidance to enhance their health journey.

• Health of the Nation: We use health-based indicators to monitor and measure meaningful progress.

Take Action with the Institute for Salutogenesis

Join us in creating a future where everyone has the opportunity to thrive. You can make a difference by:

• Personal Engagement: Use our resources to prioritize your health and well-being.

• Social Contribution: Engage with your community and advocate for healthy environments.

• Political Involvement: Use your voice to shape policies that prioritize health and well-being for all.

Join the Movement

Together, we can build a world where everyone has the chance to reach their full potential. Explore our website, follow our activities, and learn how you can contribute to a brighter future.

How You Can Get Involved

Join us in this transformative endeavor! Whether you're an individual looking to improve your own well-bei ng, a community leader seeking to strengthen your neighborhood, or a policymaker interested in systemic change, we have a place for you.

Take Action Today!

Visit our website, follow our Moonshot Press, or join us at our next community event. Together, we can build a future where everyone has the opportunity to thrive and our democracy flourishes.

Diagram: The Institute for Salutogenesis

The Institute for Salutogenesis presents a comprehensive structure designed to promote health and well-being across various stages of life and societal settings. Each element of the Institute for Salutogenesis is interconnected, creating a holistic approach to health that is responsive to the needs of individuals and the community at various life stages and within different social and political contexts. The Institute's structure reflects a dedication to advancing health through a salutogenic lens, with a clear strategy and timeline for achieving its vision.