Clearly, neither the health system nor individual IHSs can be held solely accountable for the health status of the population served, or for the risk conditions and psychosocial risk factors that affect the health of Ontarians. Due to the broader determinants of health, this needs to be a collective responsibility that is shared by all sectors, public and private, and all government Ministries. The importance of socioenvironmental determinants of health needs to be better understood and supported by deliberate, collaborative actions and policies. Despite this acknowledgment, it must be recognized that the fundamental purpose of the health system is to promote the health of Ontarians. Therefore, IHSs should be held accountable for incorporating the three approaches to promoting health into their core business. IHSs and the Ministry of Health should also be held accountable for working collaboratively with other agencies and sectors on initiatives that effectively target the broader determinants of health. The outcomes of these efforts should be evaluated by the Ministry of Health.