The author refers to the social, economic, individual, and collective dimensions of the relationship between health and disease. He considers that individuals and populations are not equally exposed to protective and risk factors. He highlights the uneven development between nations and Brazilian regions, and communities, as well as discussing the relationship between development, wealth, health, and social justice. The article analyzes development theories and makes a distinction between economic development and growth. The concepts of development trap and social refugees are coined. The author defines a healthy community, points to the need for a shift in the current development model, and delineates the health sector's role and limitations in dealing with social inequality.