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In 1974 a report
entitled A
new perspective on the health of Canadians was probably
the first acknowledgement by a major industrialised country
that biomedical interventions (ie physician services, hospital
services, pharmaceuticals, etc.) were not primarily responsible
for individual wellbeing and population level improvements
in health status.
Following the
thoughts of McKeown in trying to move beyond 'medical issues'
, what later came to be known as the 'LaLonde report' identified
four health fields that were interdependently responsible
for individual health.
The health field
concept
- Environment
All matters related to health external to the human body
and over which the individual has little or no control.
Includes the physical and social environment.
- Human Biology
All aspects of health, physical and mental, developed within
the human body as a result of organic make-up.
- Lifestyle
The aggregation of personal decisions, over which the individual
has control. Self-imposed risks created by unhealthy lifestyle
choices can be said to contribute to, or cause, illness
or death.
- Health Care Organisation
The quantity, quality, arrangement, nature and relationships
of people and resources in the provision of health care.
The LaLonde report
seemed to prompt further initiatives, principally by the World
Health Organization (WHO), beginning with the Alma Ata declaration.
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