These outcomes are the improvement of the level and distribution of health in the population, the health system’s responsiveness to the needs and demands of Canadians and value for money to ensure health system sustainability. [...] Well-being reflects the level of physical, mental and social well-being of individuals and of populations as it relates to material conditions, quality of life and sustainability of well-being over time.1 Health system responsiveness corresponds to the capacity of the health system to respond to the needs and expectations of the population.2 It also includes the element of trust in the health syst [...] The dimension of equity spans the first two of these goals and other dimensions of the framework, as shown in Figure 1. • The first and defining goal of the health system is to improve the health status of the population,2 where “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”21 As such, this dimension is subdivided into thr [...] This is a second ultimate health system goal that the World Health Organization (WHO) calls health system responsiveness.2 Trust corresponds to the population’s confidence in the health system;3 it results from the quality of interactions between patients and providers and the congruence between the health system and societal values.23 Some authors argue that the organization and practices of the [...] This statement emphasized the importance of public health policies to improve the health status of the population.28 Recent work by Wilkinson and Marmot for the 2008 WHO report on social determinants of health5 outlines the “remarkable sensitivity of health to the social environment.” While the health care system can prolong survival and cure people of diseases, the improvement of population healt