Closing the gap in a generation: health equity through action on the social determinants of health - Final report of the commission on social determinants of health
Executive Summary
Overview
Social justice is a matter of life and death. It affects
the way people live, their consequent chance of
illness, and their risk of premature death. We watch in
wonder as life expectancy and good health continue
to increase in parts of the world and in alarm as they
fail to improve in others. A girl born today can expect
to live for more than 80 years if she is born in some
countries – but less than 45 years if she is born in
others. Within countries there are dramatic differences
in health that are closely linked with degrees of social
disadvantage.
Differences of this magnitude, within and
between countries, simply should never happen.
These inequities in health, avoidable health inequalities,
arise because of the circumstances in which people
grow, live, work, and age, and the systems put in place
to deal with illness. The conditions in which people live
and die are, in turn, shaped by political, social, and
economic forces.
Social and economic policies have a determining
impact on whether a child can grow and develop to
its full potential and live a flourishing life, or whether
its life will be blighted. Increasingly the nature of the
health problems rich and poor countries have to solve
are converging.
The development of a society, rich or
poor, can be judged by the quality of its population’s
health, how fairly health is distributed across the social
spectrum, and the degree of protection provided from
disadvantage as a result of ill-health.
In the spirit of social justice, the Commission on Social
Determinants of Health was set up by the World Health
Organization (WHO) in 2005 to marshal the evidence
on what can be done to promote health equity, and to
foster a global movement to achieve it.
As the Commission has done its work, several
countries and agencies have become partners seeking
to frame policies and programmes, across the whole
of society, that influence the social determinants of
health and improve health equity. These countries and
partners are in the forefront of a global movement.
The Commission calls on the WHO and all
governments to lead global action on the social
determinants of health with the aim of achieving
health equity. It is essential that governments, civil
society, WHO, and other global organizations now
come together in taking action to improve the lives of
the world’s citizens. Achieving health equity within a
generation is achievable, it is the right thing to do, and
now is the right time to do it.