The report addresses health inequities because of economic status -- worldwide as well as within individual countries. It calls for closing health inequities within a generation.
"Inequities in health, avoidable health inequities, arise because of the circumstances in which people grow, live, work and age, and the systems put in place to deal with illness," the report states. "The conditions in which people live and die are, in turn, shaped by political, social and economic forces."
WHO set up the Commission on Social Determinants of Health in 2005 "to marshal the evidence on what can be done to promote health equity and to foster a global movement to achieve it." WHO is the directing and coordinating authority for health within the United Nations.
The report includes these examples of health differences around the world:
- 80% of people with diabetes live in low- or middle-income countries.
- In Afghanistan, the lifetime risk of maternal death is one in eight; in Sweden the risk is one in 17,400.
- In the U.S., 886,202 deaths would have been prevented between 1991 and 2000 if African-Americans had the same mortality rates as whites.
In its 248-page report, the commission outlines a three-pronged approach to addressing health inequities:
- Improve the conditions of daily life -- the circumstances in which people are born, grow, live, work, and age.
- Tackle the inequitable distribution of power, money, and resources -- the structural drivers of those conditions of daily life -- globally, nationally, and locally.
- Measure the problem, evaluate action, expand the knowledge base, develop a workforce that is trained in social determinants of health, and raise public awareness about the social determinants of health.
The report closes with an emotional call-to-action: "Reducing health inequities is, for the Commission on Social Determinants of Health, an ethical imperative. Social injustice is killing people on a grand scale."
By Caroline Wilbert
Reviewed by Louise Chang
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