In this simple, essentially circular model, health care (via cure and care) is the predominant determinant of disease, and disease determines need and access to health care. Other factors also act on the system through disease.

Figure 1. A model published by Evans and Stoddart (1) showing that health care was considered by many in 1990 to be the predominant determinant of disease. Reproduced with permission from Elsevier and G.L. Stoddart, 1990.

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This complex model shows how the following elements interact with each other to create well-being: the social environment, the physical environment, genetic endowment, individual response (behavior and biology), health and function, disease, health care, and prosperity.

Figure 2. A model published by Evans and Stoddart (1) that accounted for multiple determinants of disease and health and function and defined well-being as the goal of policy. Reproduced with permission from Elsevier and G.L. Stoddart, 1990.

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