long healthy lives?
Healthy People 2020 is now exploring these questions by
1. developing objectives that address the relationship between health status and biology, individual behavior, health services, social factors, and policies and
2. emphasizing an ecological approach to disease prevention and health promotion.
The authors of Healthy People now view the determinants of health to be “the range of personal, social, economic, and environmental factors that influ- ence health status.” It is the interrelationships among the factors that deter- mine the health status of a person and population, and poor health outcomes are often made worse by the interaction between individuals and their social and physical environment. It goes without saying that access to health services and the quality of health services can impact a given person’s health. There are
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several barriers to health care services, such as cost, availability of health care resources, and lack of insurance.
Health equity is defined in Healthy People 2020 as the “attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoid- able inequalities, historical and contemporary injustices, and the elimination of health and health care disparities” (Office of Disease Prevention and Health Promotion, 2011b).