Many factors combine together to affect the health of individuals and communities. Whether people are healthy or not, is determined by their circumstances and environment. To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have c

The causes of poor health are many and complex, and, therefore, solutions are complex and diverse, as well. Public health conceptualizes and organizes this complexity by applying the concepts and principles of ecology, which views individuals as embedded within their environment, or context.

Viewing the individual’s behavior as the problem to be “fixed,” rather than the context in which that behavior occurs, is seen as “blaming the victim.” Under this view, the context of people’s lives structures their health behaviors to a large degree, and so blaming individuals for having poor health behaviors is ineffective and unfair.

The original PRECEDE–PROCEED model was described by Green in 1974. That version visualizes the assumed causal chain, which shows that behavioral problems produce health problems, which then, in turn, produce social problems, such as illegitimacy, unemployment, absenteeism, hostility, alienation, discrimination, riots, and crime. The effect of the e

The external environment is the sum total of influences that are not part of the host and comprises physical, climatologic, biologic, social, and economic components. •The physical environment includes weather, temperature, humidity, geologic formations, and similar physical dimensions. •The social environment is the totality of the behavioral, per

Thus, efforts to promote human health must take into account the interdependencies that exist among immediate and more distant environments (e.g., the “spill-over” of workplace and commuting stress to residential environments,

numerous studies over the past 20 years have found that people who are isolated or disengaged from others have a higher risk of premature death.

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

prevention is the preferred strategy, and to be successful, prevention must address the “conditions,” that is, environment, in the fullest sense, in which people live. The classic and defining public health strategy is to prevent poor health by “assuring conditions in which people can be healthy.”