Health inequities are shortening lives by decades by World Health Organization, agencies 2:05pm 9th May, 2025   May 2025    A global report published by the World Health Organization (WHO) highlights that the underlying causes of ill health often stem from factors beyond the health sector, such as lack of quality housing, education and job opportunities.    The new World report on social determinants of health equity shows that such determinants can be responsible for a dramatic reduction of healthy life expectancy – sometimes by decades – in high- and low-income countries alike.    For example, people in the country with the lowest life expectancy will, on average, live 33 years shorter than those born in the country with the highest life expectancy. The social determinants of health equity can influence people’s health outcomes more than genetic influences or access to health care.    “Our world is an unequal one. Where we are born, grow, live, work and age significantly influences our health and well-being,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “But change for the better is possible. This world report illustrates the importance of addressing the interlinked social determinants and provides evidence-based strategies and policy recommendations to help countries improve health outcomes for all.”    The report underscores that inequities in health are closely linked to degrees of social disadvantage and levels of discrimination. Health follows a social gradient whereby the more deprived the area in which people live, the lower their incomes are and they have fewer years of education, poorer health, with less number of healthy years to live.    These inequities are exacerbated in populations that face discrimination and marginalization. One of the vivid examples is the fact that Indigenous Peoples have lower life expectancy than non-Indigenous Peoples in high- or low-income countries alike.    Social injustice driving inequities    The World report on social determinants of health equity is the first of its kind published since 2008 when the WHO Commission on Social Determinants of Health released its final report laying out targets for 2040 for reducing gaps between and within countries in life expectancy, childhood and maternal mortality. The 2025 world report, shows that these targets are likely to be missed.    Although data is scarce, there is sufficient evidence to show that health inequities within countries are often widening. WHO data cites that children born in poorer countries are 13 times more likely to die before the age of 5 than in wealthier countries. Modelling shows that the lives of 1.8 million children annually could be saved by closing the gap and enhancing equity between the poorest and wealthiest sectors of the population within low- and-middle-income countries.    The report shows that while there was a 40% decline in maternal mortality globally between 2000 and 2023, low- and lower-middle-income countries still account for 94% of maternal deaths.    Women from disadvantaged groups are more likely to die from pregnancy-related causes. In many high-income countries, racial and ethnic inequities in maternal death rates persist, for example, in some areas Indigenous women were up to three times more likely to die during childbirth. There are also strong associations between higher levels of gender inequality, including child marriage, and higher maternal mortality rates.    WHO emphasizes that measures to address income inequality, structural discrimination, conflict and climate disruptions are key to overcoming deep-seated health inequities. Climate change, for example, is estimated to push an additional 135 million people into extreme poverty over the next 5 years.    Currently, 3.8 billion people worldwide are deprived of adequate social protection coverage, with direct and lasting impact on their health outcomes.    High debt burdens have been crippling the capacity of governments to invest in these services, with the total value of interest payments made by the world’s 75 poorest countries increasing fourfold over the past decade.    World report on social determinants of health equity    Unacceptable gaps persist in how long people can hope to live healthy lives, depending on where they live, the community they belong to, their level of education, how much money they have, their gender, their race and ethnicity, whether they have a disability, and other characteristics.    Between countries, in 2021, the difference in life expectancy was as wide as 33 years. Inequalities of similar magnitude are seen within countries.    These inequities are not explained only by a country’s income level: of the 34 countries that over the past 20 years have halved premature death (before age 70), some are high-income, some middle- and some low-income. Similarly for those countries that have seen either minimal change or increases in premature deaths.    Inequities in life outcomes are closely linked to degrees of social disadvantage: health follows a social gradient whereby the more deprived the area in which people live, the lower their income, the fewer their years of education, the worse their health and the fewer healthy years they can expect to live.    Independent of income, marked inequalities in health are also seen among minority racial and ethnic groups, underprivileged castes, Indigenous Peoples, refugees and displaced populations, people with disabilities, and other groups experiencing marginalization and exclusion.    Health inequalities are the measurable differences in health across population subgroups, and health inequities are those differences that are avoidable and unjust. They are the result of political, cultural, social and economic systems that shape daily living conditions: the social determinants of health equity.    Although groups are defined on the basis of characteristics of individuals, it is the operation of social determinants of health, not properties of individuals, that account for most of the health inequities between groups.    In 2005, WHO convened the Commission on the Social Determinants of Health. Its goal was to support countries in tackling social determinants of health to improve health equity. It aimed to do so by catalysing policy and institutional change to address social determinants of health within countries. The Commission’s 2008 final report concluded that “social injustice is killing people on a grand scale” and “a toxic combination of poor policies and programmes, unfair economic arrangements, and bad governance” contributes to the unjust life chances of children and adults around the world.    Since the Commission, there has been some promising progress in reducing health gaps between countries. This progress is largely due to improved conditions of daily life – greater access to education and employment, improved housing and environments, and increased access to effective primary health care. However, these actions can only achieve so much within the context of inequitable political, cultural, social and economic systems that reward the most powerful, to the detriment of the least powerful.    The persistence of structural inequities has meant that action has not been at sufficient scale, nor sustained for long enough, to effect widespread and lasting improvements to health and health equity.    The social determinants of health – that is, the conditions in which people are born, grow, live, work and age, and people’s access to power, money and resources – have a powerful influence on these avoidable and unjust health gaps.    These determinants are the main ways health is shaped, more so than access to health care services, or genetic influences. Social determinants encompass both downstream “intermediary” determinants, representing the conditions of daily life, and upstream “structural” determinants, representing governance, political and economic systems, and societal norms and values that shape who has access to resources and opportunities, and who does not.    The structural determinants create unequal distributions of money, power and resources according to a person’s social status, as defined by gender, age, education, income, race or ethnicity, disability status and other characteristics, which create inequities in the conditions of daily life that shape health. Therefore, structural determinants are the “root causes” of health outcomes .    This World report on social determinants of health equity emphasizes the need to focus on equity and levelling up all people’s health, creating healthier and more equitable societies. It emphasizes the need for action on structural determinants, because action on these “causes of the causes” is essential for achieving health equity.    http://www.who.int/teams/social-determinants-of-health/equity-and-health/world-report-on-social-determinants-of-health-equity http://www.bmj.com/content/389/bmj.r886 http://www.who.int/publications/m/item/the-impact-of-suspensions-and-reductions-in-health-official-development-assistance-on-health-systems http://www.gatesfoundation.org/ideas/media-center/press-releases/2025/01/us-withdrawal-world-health-organization http://www.who.int/news/item/16-01-2025-who-launches-us-1.5-billion-health-emergency-appeal-to-tackle-unprecedented-global-health-crises http://www.thelancet.com/countdown-health-climate http://www.ohchr.org/en/documents/thematic-reports/a78185-food-nutrition-and-right-health-report-special-rapporteur-right Visit the related web page
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