Global social inequalities lead to widely diverging health patterns – UN report

28 August 2008

A Japanese woman will live 42 years longer than a woman in Lesotho, and such a staggering disparity in life expectancy is due to inequalities in where people are born, grow up and age, the United Nations World Health Organization (WHO) said in a new report issued today.

A Japanese woman will live 42 years longer than a woman in Lesotho, and such a staggering disparity in life expectancy is due to inequalities in where people are born, grow up and age, the United Nations World Health Organization (WHO) said in a new report issued today.

“Social injustice is killing people on a grand scale,” a commission comprised of academics including Nobel Prize winner Amartya Sen, former heads of state and health ministers said after a three-year investigation.

According to their study, entitled “Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health,” biology is not at fault for the odds of a woman in Afghanistan dying in childbirth being 1 in 8, compared to a mother in Sweden, where the risk is 1 in 17,400.

“The toxic combination of bad policies, economics, and politics is, in large measure, responsible for the fact that a majority of people in the world do not enjoy the good health that is biologically possible,” the report noted.

Recent years have witnessed surges in global wealth, technology and living standards, but how resources are allocated to services and institution-building in low-income countries is key.

A nation’s wealth alone does not determine the health of its population, the Commission said, citing the examples of Cuba, Costa Rica, China and Sri Lanka as countries which have achieved high levels of health despite relatively low national incomes.

The report pointed to the model of Nordic countries, where resources are put towards promoting equal benefits and services, full employment and gender equality, as well as for curbing social exclusion.

It also highlighted some glaring inequalities in health within countries. An indigenous Australian male can expect to live 17 years shorter than all other men in the same country, while maternal mortality is three to four times higher among Indonesia’s poor women compared to its rich women.

To broach inequalities both within and among nations, the 13-member Commission made three broad recommendations: to boost daily living conditions; to address distortions in the distribution of power, money and resources; and to understand the problem’s scope.

“Health inequity really is a matter of life and death,” said WHO Director-General Margaret Chan, who was presented with the report today.

She stressed that national health systems will not trend towards equity without “unprecedented leadership” to drive people on all fronts, not just in the health sector.

 

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