People who have limited access to quality housing, education and job opportunities have a higher risk of illness and death. The social determinants of health equity outweigh genetic influences, health-care access or personal choices in influencing health outcomes.  

• Within countries, life expectancy varies by decades, depending on which area you live in and the social group to which you belong.  Where data is available, health inequities within countries are often widening.
• People in the country with the highest life expectancy will, on average, live for 33 years more than those born in the country with the lowest life expectancy. 
• Indigenous populations have lower life expectancy than non-Indigenous populations in rich and poor countries alike.  
• Children born in low-income countries are 13 times more likely to die before the age of 5 than children in high-income countries. If we eliminate wealth related inequality within low-and-middle-income countries, every year the lives of 1.8 million children could potentially be saved. 
• Between 2000 and 2023, maternal mortality improved globally from 328 to 197 deaths per 100 000 live births, representing a decline of 40%. However, global successes in reducing maternal mortality stagnated between 2016 and 2023, and maternal mortality increased in 2021, due to impacts from the COVID-19 pandemic.

They stem from how society allocates resources and opportunities, reinforced by political choices and leadership. 

• Income inequality within countries has almost doubled over the past two decades, and is now even greater than the significant inequality observed between countries, acting as a major driver of health inequity. Across 201 countries, the top 10% of individuals earn 15 times more than the bottom 50%.
• Weak taxation systems in inadequate resources for universal public services, depriving 3.8 billion people worldwide of social protection coverage, such as child and paid sick leave benefits, which improve health. 
• Structural discrimination, such as intersecting racism and gender inequality, results in 2.4 billion women of working age lacking equal economic opportunities, impacting their health and that of their families.
• The debt burden the world’s poorest countries pulls them further away from being able to fund essential investments in social determinants of health equity. The total value of interest payments made by the world’s 75 poorest countries has quadrupled over the past decade.
• Climate change has direct health impacts and damages the social determinants of health and livelihoods unequally. About 7 million early deaths occur each year due to air pollution. By 2030, an additional 68–135 million people could be pushed into extreme poverty because of climate change. 
• Rising conflicts and forced displacement by conflict, climate change, and food insecurity affect the poorest and most vulnerable. Between 2008 and 2024, the number of forcibly displaced people has tripled to 122 million, with significant health consequences. In host countries, migrants often face service inequalities, discrimination and the loss of family support systems which negatively impact physical and mental health.

Deep-seated health inequities will not be overcome unless income inequality, structural discrimination, conflict and climate disruption are addressed. Governments can tackle inequality through comprehensive policies that use progressive taxation, where the wealthier pay proportionately more, to enable investment in universal public services like education, social protection and health.

WHO calls for collective action from national and local governments and leaders within health, academia, research, civil society, alongside the private sector to:   

• address economic inequality and invest in social infrastructure and universal public services;  
• overcome structural discrimination and the determinants and impacts of conflicts;   
• manage the challenges and opportunities of climate action and the digital transformation to promote health equity co-benefits; and    
• promote governance arrangements that devolve money, power and resources to local government, empower community engagement and civil society, and prioritize action on the social determinants of health equity in cross-government policy platforms and strategies.