Historically, health care was delivered in the community. Physicians made house calls; birth and death happened inside the home. As the modern hospital developed, health care migrated inside its walls. Meanwhile, the concept of health became increasingly medicalized, and separated from people’s daily lives.

A significant body of research shows that about 80 percent of health outcomes are caused by factors unrelated to the medical system. Our eating and exercise habits, socioeconomic status, and where we live have a greater impact on health outcomes than health care.

The pendulum is now swinging back to the community. Nontraditional players, including public, nonprofit, and commercial enterprises are establishing “communities” focused on prevention and well-being. These communities can be geographically based local initiatives, virtual communities with a global presence, or hybrids of the two.

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