Although our scope was intended to be broad, the diversity of the phenomena, its determinants and its consequences are too complex to be properly explored in a single study.
While 'environment' in our model can be defined according to a number of different variables, here we parameterize it using elevation because it is a major topographic variable leading to the formation of prominent ecotones and defined ecoregions [ 13], which in turn are broad-scale determinants of species' distributions [ 14].
The program is built on a broad determinants of population health model [ 4].
Two broad determinants of interest are a) social capital/cohesion, and b) religion, faith, and spirituality.
Employment and cultural identification are recognised as being among the broader determinants of health associated with social and emotional well-being [ 30, 31].
11 34 Thus a holistic preventive approach, addressing broad determinants of risk behaviours, from individual through to societal influences is needed.
HPSR + A has been defined as interdisciplinary research and analysis that aims to "understand how societies organise themselves to achieve collective health goals how health systems respond and adapt to health policies, and how health policies can shape – and be shaped by – broader determinants of health" ([ 5], p. 2).
The Global Forum for Health Research notes that most research conducted globally is not relevant to the health of poor people and very little is conducted on the broader determinants of health [ 4, 5].
The fact that patients with apparently similar tumours at the time of presentation differ significantly in the time of relapse and overall survival implies that the determinants of survival could be broader than initially assumed in the purely medical framework.
In addition, the selection of questions was guided by a broader determinants of health framework and resulted in the development and use of a comprehensive questionnaire which contained reliable and valid instruments to collect detailed information about a broad range of potential predictors.
