Section A The concept of health holds different meanings for different people and groups. These meaning of health have also changed over time. This change is no more evident than in western society today, when notions of health and health promotion are being challenged and expanded in new ways. For much of recent western history, health has been viewed in the physical sense only. That is, good health has been connected to the smooth mechanical operation of the body, while ill health has been attributed to a breakdown in this machine. Health in this sense has been defined as the absence of disease or illness and is seen in medical terms. According to this view, creating health for people means providing medical care to treat or prevent disease and illness. During this period, there was an emphasis on providing clean water, improved sanitation and housing. In the late 1940s the World Health Organization challenged this physically and medically oriented view of health. They stated that "health is a complete state of physical, mental and social well-being and is not merely the absence of disease" (WHO, 1946). Health and the person were seen more holistically and not just in physical terms. The 1970s was a time of focusing on the prevention of disease and illness by emphasizing the importance of the lifestyles and behavior of the individual. Specific behaviors which were seen to increase risk of disease, such as smoking, lack of fitness and unhealthy eating habits, were targeted. Creating health meant providing not only medical health care, but health promotion programs and policies which would help people maintain healthy behaviors and lifestyles. While this individualistic healthy lifestyles approach to health worked for some (the wealthy members of society), people experiencing poverty, unemployment, underemployment or little control over the conditions of their daily lives benefited little from it. This was largely because both the healthy lifestyles approach and the medical approach to health ignored the social and environmental conditions affecting the health of people. During the 1980s and 1990s there has been a growing swing away from seeing lifestyle risks as the root cause of poor health. While lifestyles factors still remain important, health is being viewed also in terms of the social, economic and environmental contexts in which people live. This broad approach to health is called the socio-ecological view of health. It was endorsed at the first International Conference of Health Promotion held in 1986, Ottawa. People from 38 countries attended the meeting and reached an agreement about the creation of health. It is clear from their agreement that the creation of health is about much more than encouraging healthy individual behaviors and lifestyles and providing appropriate medical care. It must include addressing issues as poverty, pollution, urbanization, natural resource depletion, social alienation and poor working conditions. The social, economical and environmental contexts which contribute to the creation of health do not operate separately or independently of each other. Rather, they are interacting and interdependent, and it is the complex interrelationships between them which determine the conditions that promote them. In which year did the World Health Organization define health in terms of mental, physical and social wellbeing