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Synopsis This book seeks to examine the environment in its totality and its impact on health in a Himalayan eco-system. As a fragile and threatened life-support system, the problems of this region have been a matter of considerable concern in recent years. Using an environmental health approach, which sees health issues embedded within the natural, social, political and economic systems, the author explores the subjective and objective components of people’s health in Pauri Garhwal district of Uttaranchal. She brings forth evidence, which demonstrates the importance of ecological, socio-economic and political linkages in health. Environmental degradation, erosion of subsistence economy, food scarcity, subsequent malnutrition and ill-health are closely related and constitute a vicious circle that perpetuate stagnation. Economic poverty rooted in physical and environmental poverty creates the conditions in which diseases originate. The study highlights the problems of this hill region, and makes a strong case for bearing in mind its peculiarities and specificities in the development of health service models and creative strategies of problem resolution.