title: Defining health by addressing individual, social, and environmental determinants: new opportunities for health care and public health.
abstract: The Millennium Development Goals (MDGs) mobilized global commitments to promote health, socioeconomic, and sustainable development. Trends indicate that the health MDGs may not be achieved by 2015, in part because of insufficient coordination across related health, socioeconomic, and environmental initiatives. Explicitly acknowledging the need for such collaboration, the Meikirch Model of Health posits that: Health is a state of wellbeing emergent from conducive interactions between individuals' potentials, life's demands, and social and environmental determinants. Health results throughout the life course when individuals' potentials--and social and environmental determinants--suffice to respond satisfactorily to the demands of life. Life's demands can be physiological, psychosocial, or environmental, and vary across contexts, but in every case unsatisfactory responses lead to disease. This conceptualization of the integrative nature of health could contribute to ongoing efforts to strengthen cooperation across actors and sectors to improve individual and population health--leading up to 2015 and beyond.
authors.affiliation: Department of Hepatology, University of Bern, Reuelweg 20, BE, Meikirch, CH-3045, Switzerland.
authors.forename: Johannes
authors.initials: J
authors.lastname: Bircher
authors.affiliation: The Partnership for Maternal, Newborn & Child Health, hosted by the World Health Organization, 20 Avenue Appia, Geneva, 1202, Switzerland.
authors.forename: Shyama
authors.initials: S
authors.lastname: Kuruvilla
mesh_terms: D003695:Delivery of Health Care; D014943:Global Health; D006291:Health Policy; D006801:Humans; D008962:Models, Theoretical; D011634:Public Health; D064890:Social Determinants of Health; D014944:World Health Organization