A decision regarding work assignment in challenging environments often is made on an individual basis. The physician must consider (1) objective medical information (eg, CVD risk profile, results of exercise stress testing; see Fig. 6); (2) psychologic assessment, including potential career impacts of the expatriate assignment; and (3) availability of specialty medical facilities and expertise in the host country. Although these individual decisions are important, health professionals should not lose sight of the opportunity to approach chronic diseases on a broader basis by adopting a public health approach for the work site and the surrounding community.