Health Equity For All: Time For Action
6 September 2007
A summary of the interim statement of the Commission on the Social Determinants of Health was published online in 'The Lancet' on 6 September 2007.
Almost 60 years after the formation of the World Health Organisation (WHO), the report's author Professor Sir Michael Marmot (UCL Epidemiology & Public Health) concludes that now is the time for politicians and health-care professionals to unite globally to counter the social and political factors that contribute to widespread health inequity across the world.
To illustrate the wide gaps in health equity, the life expectancies of three children are highlighted: one African, one South Asian, and one European. At birth each, representing the average for their country, has life expectancy of less than 50 years.
The African and South Asian figures come from 1970, the European figure from 1901. Over the past century, life expectancy for Europeans increased by about 30 years, and is still rising. Between 1970 and 2000, the life expectancy of South Asian's rose by 13 years; for the child in sub-Saharan Africa, life expectancy has risen by four months.
Central to the Commission's report is the 'social gradient in health. Regardless of the difference in social structure and health differences between countries and within countries (both rich and poor), the evidence shows that the lower an individual's socioeconomic position the worse their health. The report comments that the gradient in health should not deflect attention from the plight of people at the bottom of the gradient, the poorest of the poor.