Traditional medicine is based on a pathogenic perspective that questions how diseases are created, and therefore, focuses on risk factors for diseases. Knowledge has been accumulated on ways to alleviate or eliminate these factors. In contrast, the salutogenic model theorized by Antonovsky looks at how health is restored, maintained, and promoted. It attempts to elucidate salutary factors, and to support and strengthen them
]. However, it is important that pathogenic and salutogenic models develop complementarily
]. The salutogenic model is highly valued as a basic theory for health promotion
]. It consists of a coping ability termed “sense of coherence (SOC)” and coping resources or “generalized resistance resources,” and is based on the three following assumptions. First, in the face of stressors and the resultant strain, SOC tries to cope by mobilizing generalized resistance resources. Second, the success or failure of this coping affects health, with successful coping producing positive effects on health. Third, the success or failure of coping depends on the richness of coping resources and the strength of SOC.
A person with strong SOC is better able to cope with stressors, which has a positive effect on health. Thus, SOC is also considered stress coping ability. Because SOC can strongly predict health outcomes, a number of studies have been conducted on its buffering effect on stress
] and its predictive ability related to health status
] and well-being
In the salutogenic model, the richness of coping resources as well as the strength of SOC are considered important to the success or failure of stress coping. In general, coping resources used in the stress coping process are divided into psychological and social. Psychological resources include personality tendencies such as optimism and sense of humor as well as self-concept, which includes factors such as self-esteem and self-efficacy. Social resources include social support and social networks. A number of previous studies have examined the association of self-esteem with SOC
]. This author and her colleagues found that sense of humor orientation was associated with SOC only in a rural area compared with an urban area
]. Previous studies have reported that social support and participation in regional activities are associated with SOC
]. However, few studies have examined the association between social capital and SOC.
A number of studies have also been conducted on the relationship of coping resources with well-being and health outcomes, indicating the importance of such resources
]. Other studies have pointed out that a lack of coping resources can be a risk factor in the stress coping process
]. Thus, there is a growing interest in exploring the effects of coping resources.
Previous studies have often treated SOC as one type of psychological coping resource, such as self-efficacy or self-esteem
]. However, SOC in the salutogenic model is defined as the ability to mobilize coping resources in stress coping, and therefore should be distinguished from coping resources. Because SOC is the ability to mediate between coping resources and health, it is also considered a ‘health promoting resource’
] and has drawn attention from health promotion and empowerment research. Furthermore, SOC has been found relevant in resource theories
], with regard to the ability to use coping resources as well as the usefulness of such resources.
The salutogenic model posits that coping resources are defined within sociocultural and historical contexts and that various social and historical factors influence the availability of these resources. For example, an international comparison of personality characteristics, which are considered to be psychological resources, points to the individualistic tendency of Western people and the collectivistic tendency of Japanese individuals
]. Coping resources are different depending on the country as well as regions within the country, such as urban and rural areas. Various sociocultural differences exist in these areas, including geographical conditions and industrial structures
Previous studies have suggested that an interregional comparative investigation is needed. However, few studies have actually investigated both psychological and social resources in different regions. A study by this author and her colleagues demonstrated that SOC-related factors were different between urban and rural areas. For example, economic status was correlated with SOC in urban but not rural residents, and ties with relatives and humor were correlated with SOC only in rural residents
]. Therefore, for the purpose of providing support for residents’ health, it is important to compare regions with different sociocultural backgrounds. However, it is not only important to make such a comparison, but also to identify the meaning for the generation of SOC.
The purposes of this study are to 1) distinguish social and psychological coping resources, 2) examine the availability of both types of resources, and 3) examine associations among these coping resources, SOC, and health status. By comparing urban and rural residents, the current research also attempts to examine whether regional differences influence social and psychological resources associated with health, and their relationships with SOC.