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Chapter 1 - Moving toward a Healthy Society

Published online by Cambridge University Press:  14 October 2025

Gregory J. Privitera
Affiliation:
St Bonaventure University, New York
James J. Gillespie
Affiliation:
Saint Mary's College, Indiana
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Summary

This chapter introduces the fundamental premise that achieving a healthy society requires moving beyond access to clinical care and addressing the broader social determinants of health. While access to quality health care is essential, factors outside clinical settings – such as economic stability, education, social equity, and the built environment – account for 80 percent of health outcomes. The chapter explores health equity and justice, distinguishing these concepts from equality and advocating for systemic changes to address underlying inequalities. Various global health care models (Beveridge, Bismarck, National Health Insurance, and Out-of-Pocket) are presented, highlighting the fragmented nature of the US system. The 6Ps framework (patients, policy makers, providers, pharmacies, pharmaceuticals, and payers) is introduced as a tool to analyze and optimize health care policy. Finally, the chapter emphasizes the interplay between diversity, health, and policy, illustrating the importance of inclusivity and justice in creating equitable and effective health systems.

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