When the World Health Organisation redefined health as “a state of complete physical, mental and social well-being”1 it not only expanded health far beyond medicine, it openly acknowledged the vast accumulated knowledge about the central role of societal determinants of population health. Despite the public's belief to the contrary, medical care is a relatively minor, albeit important, contributor to health,2 far outweighed by societal factors, of which social class has been the most extensively studied.3 4 In 1988, a seminal report by the United States Institute of Medicine defined the mission of public health as “ensuring the conditions in which people can be healthy.”4 In turn, this required those working in public health to consider the societal nature of these essential conditions in which people could achieve the highest attainable standard of physical, mental, and social wellbeing. Paradoxically, the discipline of public health has generally ignored the societal roots of health in favour of medical interventions, which operate further downstream. For example, public health efforts at preventing and …
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A 1996 study studied this question.
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