<P> Since the late 1970s, the federal Healthy People Initiative has been a visible component of the United States' approach to improving population health . In each decade, a new version of Healthy People is issued, featuring updated goals and identifying topic areas and quantifiable objectives for health improvement during the succeeding ten years, with assessment at that point of progress or lack thereof . Progress has been limited to many objectives, leading to concerns about the effectiveness of Healthy People in shaping outcomes in the context of a decentralized and uncoordinated US health system . Healthy People 2020 gives more prominence to health promotion and preventive approaches and adds a substantive focus on the importance of addressing social determinants of health . A new expanded digital interface facilitates use and dissemination rather than bulky printed books as produced in the past . The impact of these changes to Healthy People will be determined in the coming years . </P> <P> Systematic activities to prevent or cure health problems and promote good health in humans are undertaken by health care providers . Applications with regard to animal health are covered by the veterinary sciences . The term "healthy" is also widely used in the context of many types of non-living organizations and their impacts for the benefit of humans, such as in the sense of healthy communities, healthy cities or healthy environments . In addition to health care interventions and a person's surroundings, a number of other factors are known to influence the health status of individuals, including their background, lifestyle, and economic, social conditions, and spirituality; these are referred to as "determinants of health ." Studies have shown that high levels of stress can affect human health . </P> <P> Generally, the context in which an individual lives is of great importance for both his health status and quality of their life . It is increasingly recognized that health is maintained and improved not only through the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society . According to the World Health Organization, the main determinants of health include the social and economic environment, the physical environment, and the person's individual characteristics and behaviors . </P> <P> More specifically, key factors that have been found to influence whether people are healthy or unhealthy include the following: </P>

The choices that individuals make that influence health status are known as