CanMEDS Health Advocate
What determines Health? 

What determines Health? 


We have been thinking about advocacy and now let us consider health and where health comes from - what shapes and determines health?


Definition of Health:

The World Health Organization definition of health has been used, unchanged, since 1948:

copyright: WHO/P. Virot

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. [1]




Understanding the determinants of health will help you, as a clinician, to become a more effective caregiver.  People do not have health problems in isolation form the rest of their lives. Treatment plans need to be negotiated with patients to ensure that the real issues are being address and that the management strategies are appropriate, for example: trying to correct a person’;;s anemia by recommending iron-rich foods and supplements and not realizing that they can afford afford neither meat nor vitamins. 


Our medical system often undervalues determinants of health, however, there is ample evidence that incorporating determinants of health into a patient's health care plan will improve health outcomes.

Health Canada has created a document called  "Achieving Health for All: A Framework for Health Promotion" which challenges us not to just treat illness but also to promote health "health promotion is an approach which can develop alongside and be integrated into our sophisticated system of health care".[8]


The podcast, Sick People or Sick Societies, from CBC Ideas, brilliantly examines the issues that affect a person's health, the social determinants of health, and implications for Canadian society. Though the podcast is long (~1 hour), it is well worth spending the time to listen to it.




1. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19 June - 22 July 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948. The definition has not been amended since 1948. accessed November 30, 2005

8. Achieving Health for All: A Framework for Health Promotion. Health Canada. accessed March 8, 2011

All references for this section