New Report Highlights Persistent Social Injustice and Its Impact on Global Health

A comprehensive global report published by the World Health Organization (WHO), with evidence review support from the UCL Institute of Health Equity (IHE), emphasizes that the goals set by its initial landmark Commission on the Social Determinants of Health are unlikely to be achieved. The 2008 Commission, led by Professor Sir Michael Marmot, identified the fundamental causes of poor health—factors such as the environment in which individuals are born, grow, live, work, and age—and demonstrated how disparities in these conditions lead to significant health inequalities both within and between countries.

Their final report, 'Closing the Gap in a Generation,' aimed to halve the life expectancy gap among different social groups within countries by 2040. However, the latest WHO report indicates that where data exists, these gaps are often widening instead of narrowing. The report attributes this stagnation and increase in disparities to a lack of political will to implement sustained, structural policies necessary for equitable health improvements.

Professor Sir Michael Marmot highlighted the importance of viewing health as a collective responsibility, akin to national security or economic stability. Despite the initial recommendations from 2008, many countries have not fully adopted these strategies. As a result, the global health target to close the life expectancy gap is unlikely to be met.

The report notes stark disparities: for instance, individuals born in Japan, with the highest life expectancy, live on average 33 years longer than those in Lesotho. While there’s been some progress—such as an improvement in the gap between countries—the difference remains significant. The report stresses that health outcomes are largely dictated by social factors, including inequalities in wealth and power, which have received insufficient attention over the years.

Addressing these structural issues involves tackling economic inequality, investing in public services, enhancing social protections, managing the commercial determinants of health, and fostering international collaboration. These efforts must also align with climate change mitigation.

In the UK, data from the UCL IHE reveals troubling trends: over one million people in England experienced shorter-than-expected lives prior to the COVID-19 pandemic; life expectancy has stagnated nationally; and significant regional disparities persist, notably with worsening health in deprived northern neighborhoods.

The WHO calls for unified action from government sectors, civil society, and the private sector to prioritize health equity. The IHE actively collaborates with local governments and organizations across the UK, including Scotland and Wales, to address these disparities.

This report underscores that social injustice continues to cause unnecessary suffering and premature death, emphasizing the urgent need for global and local strategies to create fairer health opportunities for all.