We have a constricted view of health care practitioners. It’s part of our general conditioning to think of “medical care” (and conventional medical care in particular) as synonymous with “health care.” As I’ve said—very likely ad nauseum—health care conceived that way isn’t about health. It’s about getting diagnosed and treated.

An article in the Canadian Medical Journal last week reminded me of this. The article reviews the evidence on how the built environment affects children’s health in two ways.

First, environments that are designed to minimize risks to children actually prevent injuries very effectively. The author, Dr. Andrew Howard, cites the disparities among industrial nation. For children aged 1 through 14, in Sweden children die from injuries at a rate of 5 per 100,000. In the United States, the rate is 14 deaths per 100,000 children. The difference in the rates is largely attributable to a built environment that protects children, for example, from being hit by cars.

Second, environments that are designed so that children can be active has a positive effect on health. Several surveys have found that parents won’t let their kids walk or bicycle to school because they fear for them. The children share that fear. As a consequence, perfectly rational behavior encourages children to remain inside where it’s safe. With a built environment design for child safety, children would be more active and physically fit.

I think this demonstrates quite clearly that the men and women who design and build the places in which we live, work, and place have a profound effect on children’s health. What they do can decrease injuries, the leading cause of death among children and young adults. Of course, the net can be thrown even wider.

For example, in an obvious example, the people who design and manufacture the products we use have an equally profound effect on children’s health. Food, of course, is the most obvious example. “Health” products are also examples. But there are others less obvious, such as toys—the controversies over bisphenol A and phthalates are only the latest in a long line of practices that affect children’s health.

So far, we have health care practitioners including urban planners and related professions, people engaged in the construction trades, product designers, and product manufacturers. They can all play a role in creating environments for children that reduce risks of injury and illness and, as a result of a safer environment or as a direct effect of the design itself, enables the use of the capacities we associate with health.

Chief among these capacities is the capacity to learn. So our most important health care practitioners are those people who teach children to learn. I do not mean by this only or even principally the people who have the professional title “Teacher.” Who I mean is those who encourage and inspire critical thinking. That can be any of us. It should be all of us because the built environment and our product environment and the natural environment that so profoundly affects children’s health is almost never explicitly about health—at least not health as the absence of disease.

But if health is the capacity to have a full, rich life, then these environments, and the social environments that give them meaning, are the stage on which our capacities play.

These ideas are explored more fully in our book Too Much Medicine, Not Enough Health.