The primary activities are dependent on physical environment and level of economic development in the different parts of the world
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chapters of this report focused on health systems and individual and household-level risks that might explain the U.S. health disadvantage, but it has been increasingly recognized that these health determinants cannot be fully understood (or influenced) in isolation from the environmental contexts that shape and sustain them. In contrast with traditional environmental health approaches that focus primarily on toxic substances in air, water, and soil, this more recent approach conceptualizes the environment more broadly to encompass a range of human-made physical and social features that are affected by public policy (Frumkin, 2005). These economic, social, urban or rural, transportation, and other policies that affect the environment were not traditionally thought of as relevant to health policy but are now attracting greater attention because decision makers are beginning to recognize their health implications (Cole and Fielding, 2007).