Health is a complex concept that has multiple dimensions. It can be influenced by individual choices, such as engaging in healthful behaviors and avoiding unhealthful ones; or by structural factors that shape the availability of health services. Health is also a dynamic process that is continually adapting to changing circumstances, including the presence of disabilities and chronic conditions.

In the United States, for example, a growing number of individuals, researchers, and policymakers view health as a largely biomedical construct that is determined by access to healthcare. This perspective is reflected in well-baby clinics, a national focus on medical research, and investments in health care facilities and infrastructure. It also is influenced by the social contexts that surround health care, such as poverty and geography.

Whether or not we accept a specific definition of health, we can agree that it is important for us to think about how we create healthy communities. A community’s health depends on many factors, such as its working environment, the quality of education, the safety of neighborhoods, and the ability of citizens to achieve societal goals. These factors, which are referred to as the “determinants of health,” influence a citizen’s personal satisfaction with life and his or her sense of meaning. Traditionally, these factors have been targeted for intervention by the healthcare system. However, this approach has limitations and risks.