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The causes of any one health problem are multi-factorial and interrelated.

For example: a teenager with asthma may have:
- A genetic predisposition to asthma
- Parents who smoke in the home-environmental issue
- Refusal to use an inhaler-personal behavior, compliance issue
- Inadequate treatment-health services deficiency

Solutions to these problems using the processes of health promotion would target both the individual related to using an inhaler and the family related to second hand smoking consequence. In addition, it would target people who set policy at schools and those who can help to improve health services for this family. Health promotion is considered “multi-tiered” because it involves various levels of society to help address a health problem.