The question of disease-as -biological-abnormality model is that it also fails to recognize that, in most cases, the biological pathology that develops is a symptom or, or is caused by, behavioural factors - that is, it is what people do or don’t do, that, for the most part leads to them developing diseases. Despite the current fashion of discovering “genes-for-disease” this is for the most part misleading, if not actually incorrect. Why? Because gene variation is a natural and important feature of all mammalian populations. The phenotype, including how it develops and functions (i.e. whether it is healthy or diseased) , is a product of the interaction of, initially the genes, and later the phenotype itself, with the environment. Environments can and do change, and when that happens, genes that are apparently disadvantageous now may confer significant benefit, while those conferring benefit now, may become significantly disadvantageous. People create and determine the kinds of environments they come into contact with (and while we all have limits on the range of environments available to us, some have more limits in choice than others. Heart diseases, cancers, infectious diseases, and most other diseases, with few exceptions, are problems that derive from lifestyle and environmental factors, in terms of causes, spread, costs and consequences.

Unfortunately, the biological model of disease focuses attention, and most resources, on the cellular level of activity, rather than the community level, where, traditionally, most improvements in health, life expectancy and life quality have historically been made.