Over the last decade we have begun to witness a major shift with regard to health and its role in society. We now live in a health society that is characterized by two major social processes: expansion of the territory of health and expansion of the reflexivity of health. A reorganization of how we approach health in 21st century societies is in the making, as the boundaries of what we call the ‘health system’ are becoming increasingly fluid. Our understanding of the determinants of health makes it obvious that every policy decision a government makes also impacts on health and our knowledge of risk factors implies that at the individual level every behavioral choice also has a health consequence. We must discuss how we can use these developments to move public health policy forward forcefully in the 21st century—far beyond what we envisaged in 1986 in the Ottawa Charter for Health Promotion.