Objective: To identify common resilience factors against non-communicable diseases (dental caries, diabetes type II, obesity and cardiovascular disease) among healthy individuals exposed to chronic adversity.

Materials and methods: The databases MEDLINE (via PubMed), Scopus and CINAHL were searched. Observational studies in English assessing resilience factors among populations living in chronic adversity were included. Intervention studies, systematic reviews, non-original articles and qualitative studies were excluded. There were no restrictions regarding publication year or age. No meta-analysis could be done. Quality assessments were made with the Newcastle-Ottawa scale (NOS).

Results: A final total of 41 studies were included in this systematic review. The investigated health resilience factors were divided into the following domains: environmental (community and family) and individual (behavioural and psychosocial). A narrative synthesis of the results was made according to the domains.

Conclusions: Individual psychosocial, family and environmental factors play a role as health resilience factors in populations living in chronic adversity. However, the inconclusive results suggest that these factors do not act in isolation but interplay in a complex manner and that their interaction may vary during the life course, in different contexts, and over time.

The association between dental caries experience and socioeconomic status, as reflected in income and educational level, is well known. However, some individuals maintain good health despite socioeconomic disadvantage. The aim of this qualitative study was to explore salutogenic (health-promoting) factors among healthy caries-free young adults of low socioeconomic status. Seventeen participants (11 women), 19–23 years of age, who were caries-free and of low socioeconomic status were interviewed in-depth. The interviews were transcribed verbatim and analysed using qualitative content analysis with an inductive approach. The theme revealed was ‘Building trust and shifting responsibility from parent to child throughout children's development lays the salutogenic foundation for oral health’, comprising three categories: (i) a basis for health; (ii) creating one's own path by testing wings; and (iii) developing resources for health. A feeling of trust was expressed, participants were confident in the unconditional support of their caregivers, and caregivers were trusting participants to be able to take control over their own oral health. Health-promotive factors were established not only by instilling healthy habits during childhood, but also by parental guidance through adolescence, enabling young adults to develop resources and assets to take control over their own health independently.

BACKGROUND: Dental caries is a global public health problem with persistent inequalities. Research with a salutogenic perspective, as in, a focus on health factors, can provide important knowledge to be used in health promotion. The aim was to explore salutogenic resources among dental caries-free young adults living in vulnerable communities in South Africa.

METHODS: A total of 32 participants (28 females, 4 males, mean age 26.2 years) with no previous caries experience were purposively recruited from two under-resourced townships. The qualitative data from interviews were audio-recorded, transcribed, and analyzed via qualitative content analysis.

RESULTS: The resulting theme, A salutogenic foundation for oral health: preservation of traditions and use of personal health assets as protection against challenges, comprised two categories: (1) Individual health assets and early intergenerational learning, and (2) Ability to apply learned health strategies. Having individual health assets and tools for coping, early learning experiences by positive family influence, being exposed to healthy traditions during hardships, and the ability to apply learned health strategies were important salutogenic resources. Together, these resources formed a salutogenic foundation for oral health which enabled individuals to develop healthy routines, make healthy choices for oral health, and maintain oral health when encountering challenges and hardships.

CONCLUSIONS: Salutogenic resources for oral health empowered individuals from vulnerable communities to maintain oral health. This suggests that future health promotion interventions should be considered and directed at multiple levels, targeting individual, family, community, and structural factors to promote sustainable oral health.