Similarly, the addition of an 'outcomes' class was identified as important at almost every consultation, reflecting a view that outcomes (i.e. outcome indicators and their reporting 46 ) are necessary to 'close the loop' and complete the program logic for 46 For example, public health system performance measures and public health expenditure reporting. public health. This reflects a tendency to see the top-level classes listed in Figure 5 as a program logic or cycle (rather than a hierarchy of important factors) that requires information on outcomes to complete the cycle. An alternative view on the treatment of outcomes in a public health classification is that they are already captured in the classes of 'health issues' and 'determinants of health'. Section 3.2.3 also addresses these issues. Health issues Health, and well-being issues that affect health ('issues' includes: concerns, topics, problems). Health is defined (by the WHO) as 'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity'.