World Report on Social Determinants of Health Equity

Health is not distributed equally across populations and the forces that shape health inequities are not primarily medical. Where people are born, grow, live, work, and age; their level of education and income; the quality of their housing and environment; and the social and political structures that govern access to opportunity these are the social determinants of health, and they account for the majority of differences in health outcomes within and between countries. This landmark WHO report, the most significant global assessment of social determinants of health since the 2008 Marmot Commission, provides a comprehensive update on the state of health equity worldwide and a renewed call for action.

The report documents persistent and in many cases widening health inequities across income levels, geographies, and population groups, driven by structural factors including income inequality, discrimination, inadequate social protection systems, and unequal exposure to environmental hazards. It finds that the COVID-19 pandemic deepened existing inequities in health outcomes, economic security, and access to care and that the recovery has been uneven, with the most disadvantaged populations farthest from returning to pre-pandemic health status.

Building on the framework established by the Marmot Commission, the report argues that closing health inequities requires action on the structural determinants, the policies, systems, and power relations that shape the distribution of social and economic resources alongside investment in the intermediary determinants that translate structural disadvantage into health harm. It reviews evidence on what works across a range of policy domains including taxation and social protection, housing, education, employment, and environmental regulation.

The report is addressed to governments, international organizations, civil society, and the global health community challenging all actors to move beyond health system-focused interventions and engage with the broader political, economic, and social transformations required to build societies in which good health is genuinely accessible to all.