 An alternative approach to the relationship between health and disability involves a broad or positive conception of health as more than, or distinct from, the absence of disease or disability. This approach has more and less instrumental versions. The former is represented by Nordenfelt’s account of health as the ability of an individual to reach her “vital goals”—those whose achievement is independently necessary and jointly sufficient for minimal happiness (Nordenfeldt 1995). On such an instrumental account, the relationship of disability to health depends on the goals that are considered vital or central and on the role of typical functions in achieving them. Some impairments will hinder the pursuit of some goals (goal-based accounts of health vary in whether or how they specify the relevant environment(s) affecting their pursuit), other impairments will have no effect, and some will enhance the pursuit of some goals. Any generalizations about the impact of impairments on health will depend on the assessment of their net effect on the pursuit of the specified goals.