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

1. 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.
2. Human Biology
   All aspects of health, physical and mental, developed within the human body as a result of organic make-up.
3. 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.
4. 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.