It has long been known that health is determined by many conditions in the physical and social environment much more than by the specific actions of physicians or other health professionals. In 1790, Johann Peter Frank told the graduating class of the University of Pavia Medical School that "Poverty is the mother of disease." He spoke dramatically of the misery of a bare subsistence diet, of backbreaking manual labor, of grim and inhuman housing, and so on.
In 1978 at Alma-Ata, when the World Health Organization and UNICEF, with representatives of almost all nations on earth, set out to revitalize the world movement for improved health, they spoke of the same relationships. In the language of contemporary international health work, they said:
Primary health care... involves, in addition to the health sector, all related sectors and aspects of national and community development, in particular agriculture, animal husbandry, food, industry, education,