Health systems should be based on principles of equity, disease prevention, and health promotion with universal coverage, based on primary health care. That was the conclusion of a three-year investigation by the World Health Organization’s (WHO) Commission on the Social Determinants of Health. The commission presented its findings Aug. 28 in a report titled Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Among the examples the report cites is the fact that, in Sweden, the risk of a woman dying during pregnancy and childbirth is 1 in 17,400, but in Afghanistan, the odds are 1 in 8. “Biology does not explain any of this,” says the report. “Instead, the differences between--and within--countries result from the social environment.”
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,” says the report. “Social injustice is killing people on a grand scale.” Consequently, the health sector--globally and nationally--needs to focus attention on addressing the root causes of inequities in health.
The commission makes three overarching recommendations: improve daily living conditions; tackle the inequitable distribution of power, money, and resources; and measure and understand the problem and assess the impact of action. Download the executive summary.
