ABSTRACT

In this chapter, the authors propose a somewhat more complex framework, which they believe is sufficiently comprehensive and flexible to represent a wider range of relationships among the determinants of health. People care about their health, for good reasons; and they try in a number of ways to maintain it, to improve it, or to adapt to its decline. The provision of services that are generally recognized as health care should obviously take place in a context of consideration for the comfort of those served. The increasing concentration of health care on those outside the labour force, the very elderly or chronically ill, has, however, severely weakened this particular linkage. The situation of health care is different, however, for a variety of complex and interrelated reasons, which are implicit in the chain of effects from health care, to disease reduction, to improved health and function, to well-being.