Affordable health: The way forward

‘Everyone has the right to a standard of living adequate for the health and well being of himself and of his family’ (Article 25, Universal Declaration of Human Rights). In this article, we examine the past determinants of health in the United Kingdom, the rise of public health and the impact medical technology has had on health. We discuss the rationing of health care, and apply the principles of health economics to the wider context of the delivery of health, rather than health care. With a background of rising demand for health care and rationing of resources in the UK, combined with widespread variation in life expectancy and distribution of income across the world, we conclude that, in the context of improving world health, environmental regulation ‐ including sanitation and water supply, improved nutrition, control of fertility and better education ‐ must come first in the priorities for achieving a healthy population.