Until recently, efforts to improve the health of Americans have focused on expanding access to quality medical care. Yet there is a growing recognition that medical care alone cannot address what actually makes us sick. Increasing health care costs and worsening life expectancy are the results of a frayed social safety net, economic and housing instability, racism and other forms of discrimination, educational disparities, inadequate nutrition, and risks within the physical environment. These factors affect our health long before the health care system ever gets involved.