By Christina Peterson – University of Tennessee, Knoxville
What is wellness? It seems like everyone applies the term in different ways. Is wellness a product you ingest? a spa treatment? a gym membership at work? While all of these may become part of a wellness lifestyle, the ethic of wellness is much deeper. I was trained in food and nutrition programming with a strong emphasis on health promotion, and yet, always felt something was missing. There must be more to wellness than what I learned, but what is it? In this post, I provide an overview of 12 foundational readings – many available freely online – that shaped how I came to view wellness. While not an exhaustive list, they are key readings for developing the wellness promotion competencies among students and emerging wellness professionals.
Historical Overview of Wellness
Appreciating the wellness promotion profession as it stands today requires an understanding of its evolution over time. Miller’s 2005 article provides a great overview of the history and development of wellness as we know it. Similarly, Kirkland attempts to answer the question of ‘what is wellness now?’ through a historical overview of the concept. Finally, Don Ardell, an early leader in the field, provides his perspective in the 1985 article, ‘The History and Future of Wellness’ where he considers questions like: how is wellness different, if at all, from medical self-care, holistic health, and health promotion? Why did it develop in the late 1970s and early 1980s and not sooner? and Who (or what) have been the key individuals (or institutions, events, or circumstances) shaping the wellness idea itself? These articles help us position the following readings on defining the concept, salutogenisis, ethics, and evaluation along the timeline of wellness promotion development.
Wellness: Defining a Concept
One of the most confusing issues in the ‘what is wellness’ question is its relationship to similar, but distinct, concepts of health and well-being. Wellness is defined by the National Wellness Institute as ‘an active process through which people become aware of, and make choices toward, a more successful existence’ and conceptualized with six interdependent dimensions. This definition emphasizes the process and the personal choice involved in wellness. The concept of wellness was well-established in many philosophical and medical traditions prior to the 1950’s, but the movement to integrate this concept into Western medicine and society is often attributed to the work of Halbert Dunn. Thus, Dunn’s 1959 article, High-level Wellness for Man and Society, is a ‘must read’ on my list. Further clarification on the differentiation of health, wellness and well-being is found in Greenberg’s 1985 article on defining wellness.
Salutogenesis and the origins of wellness
What are the origins of wellness? The Salutogenic model of health outlined by Antonovsky (1996) articulates the cognitive shift from illness prevention and remediation to health creation in health promotion. Rather than focusing on the origins of disease – or pathogenesis- the salutogenic model orients us to think about the origins of health. Extending this model to wellness invites us to think about the origins of wellness, not just risk factors for disease. As stated in the article Salutogenesis 30 Years Later: Where do we go from here?” “simply decreasing a negative state does not necessarily increase positive states.” Wellness professionals develop mindsets that aim to create ‘more good’ (not just ‘less bad’) by using autonomy-supportive, strengths-based and whole-person approaches in their practice.
Ecological Models of Wellness
Understanding a person through an ecological lens is a core aspect of the ‘Whole Person and Systems Approaches’ domain of the NWI Wellness Promotion Competency Model. This person within environment perspective on wellness is illustrated in the writings of Issac Prilleltensky who looks at the signs, sources, and strategies for well-being in the personal, relational, and collective levels of human experience. The ecological mindset implores wellness practitioners to collaborate with and serve as a bridge between other, often fragmented, professionals working on family, community, and societal wellness initiatives. In viewing wellness through an ecological lens, Prilleltensky also brings our attention to the role of power and values at each level.
Ethics of wellness promotion
Wellness promotion is more than managing programs and getting people to exercise more. It requests an adept ability to work with values – our own and those of others. In this way, wellness promotion is as much a moral philosophy as it is a technical skill. Several thinkers elaborate on the ethic of wellness promotions in ways that greatly impacted my own perspective on the practice. In a third article, Prilleltensky discusses wellness as fairness. Expanding on this topic with full-length books, Buchanan’s, An Ethic for Health Promotion: Rethinking the Sources of Human Well-being and Robison’s The Spirit and Science of Holistic Health, were both engaging and inspirational.
My own interest in wellness promotion intersects with my background program evaluation. Using quantitative and qualitative data to evaluate programs and communicate key findings to stakeholders is another core competency for wellness practitioners. While certainly not foundational readings, I have begun to explore what evaluation from a wellness perspective would look like in two blog posts for NWI (1, 2) and a forthcoming research article. Wellness assessment is a growing topic of interest in the field and several quantitative tools exist for practitioners seeking to assess where clients are at in their wellness journal or demonstrate improved wellness among groups participating in a program. National Wellness offers a free downloadable wellness focus tool . The Perceived Wellness Survey, a well-researched assessment, is also available as a free download.