May 6, 2025 I Geneva: A global report published by the World Health Organization (WHO) emphasizes that the underlying causes of disease diseases often come from factors beyond the health sector, such as the lack of quality housing, education and work opportunities.
The New World Report on the social determinants of health equity shows that such determinants can be responsible for a dramatic reduction of healthy life expectancy, sometimes in decades, in high -income countries equally. For example, people in the country with the lowest life expectancy, on average, will live 33 years shorter than those born in the country with the greatest life expectancy. The social determinants of health equity can influence the results of the health of people rather than genetic influences or access to health care.
«Our world is unequal. Where we are born, we grow, live, live and age significantly influences our health and well -being,» said Dr. Tedros Adhanom Ghebreyesus general. «But the change for better is possible. This world report illustrates the importance of addressing interconnected social determinants and provides evidence -based policies strategies and recommendations to help countries improve health results for all.»
The report emphasizes that health inequalities are closely related to degrees of social disadvantage and levels of discrimination. Health follows a social gradient for which the more private is the area in which people live, minors are their income and have fewer education, a poorer health, with less healthy years to live. These inequalities are exacerbated in populations that face discrimination and marginalization. One of the vivid examples is the fact that indigenous peoples have less life expectancy than non -indigenous peoples in high -income countries equally.
Driving inequalities of social injustice
The World Report on Social Determinants of Health Equity is the first of its kind published since 2008 when the WHO WHO health determinants commission published its final report to establish objectives by 2040 to reduce the gaps between and within the countries of life expectancy, childhood and maternal mortality. The 2025 world report shows that these objectives are likely to be lost.
Although the data is scarce, there is sufficient evidence to show that health inequalities within countries are often expanding. WHO cites that children born in poorest countries are more likely to die before 5 years than in the richest countries. Modeling shows that the lives of 1.8 million children could annually be saved by closing the gap and improving equity between the poorest and rich population sectors within low and middle income countries.
The report shows that, although there was a 40% decrease in maternal mortality worldwide between 2000 and 2023, low and low income countries in the middle of the media still represent 94% of maternal deaths.
Women of disadvantaged groups are more likely to die from pregnancy related causes. In many high -income countries, racial and ethnic inequalities in maternal mortality rates persist, for example, in some areas, indigenous women had up to three times more likely to die during childbirth. There are also strong associations between the highest levels of gender inequality, including child marriage and higher maternal mortality rates.
Situation in the Americas
The report shows that Latin America and the Caribbean remain the region with the highest levels of inequality in the world. Pandemia deepened this situation: in 2020 the regional economy hired by 7 percent, the most pronounced decrease in 120 years, with millions of people losing income and social protection.
These economic shocks are directly translated into higher levels of prevents mortality and morbidity, due to the deterioration of employment conditions (for example, more than 60% of workers in Latin America and the Caribbean work in the informal sector), housing and migratory processes, among others. The report also emphasizes that these effects are aggravated by structural racism and the lasting legacy of colonialism, which continue to exercise a significant negative impact on health and life expectancy, particularly for indigenous and Afro -descendant populations.
The report reveals that those Latin American cities that have used a participatory approach to the budget allocation for housing, green spaces and transport, have also seen positive effects both on health and social cohesion, when it comes to addressing some of these social determinants.
Breaking the cycle
Those who emphasize that measures to address income inequality, structural discrimination, conflict and climatic interruptions are key to overcoming deep health inequalities. It is estimated that climate change, for example, pushes 68-135 million additional people to extreme poverty in the next 5 years.
Currently, 3.8 billion people worldwide are deprived of adequate social protection coverage, such as child/paid disease license benefits, with a direct and lasting impact on their health results. The high debt loads have been paralyzing the ability of governments to invest in these services, with the total value of interest payments carried out by the 75 poorest countries in the world that increase four times in the last decade.
WHO asks for collective action of national and local governments and leaders within health, academia, research, civil society, together with the private sector to:
- address economic inequality and invest in social infrastructure and universal public services;
- overcome structural discrimination and determinants and impacts of conflicts, emergencies and forced migration;
- Manage the challenges and opportunities of climate action and digital transformation to promote the co-benefits of health equity; and
- Promote governance arrangements that prioritize action on social determinants of health equity, including the maintenance of platforms and intergovernmental policies strategies, assigning money, power and resources at the most local level where it can have a greater impact and train community participation and civil society.
Situation in the Americas
Editor’s note
In Resolution Wha74.16 (2021), the seventy -four World Health Assemblies asked the WHO general director to prepare an updated report on the social determinants of health, its impact on health and health equity, the progress made so far in addressing them and recommendations for new actions. This World Report on Social Determinants of Health Equity provides an update of the WHO commission conclusion on social determinants of health in 2008 that declared that «social injustice kills on a large scale.»
