Inequality killing on a ‘grand scale’ globally, experts warn

The Independent has reported that inequality continues to kill people on a “grand scale” across the world, experts have warned, with factors like poor housing and a lack of education and jobs influencing health more than genetics or care.

It comes as a new report from the World Health Organisation (WHO) revealed targets designed to help tackle global health inequalities within a generation will not be met.

In 2008, the WHO commission on the social determinants of health highlighted how the conditions in which people are born, grow, live, work and age, as well as access to power, money and resources, have a powerful influence on health.

One key target set out in the document was to halve the gap in life expectancy between countries and between social groups within countries by 2040.

It also aimed to halve adult mortality rates in all countries and reduce child and material mortality rates by 90% and 95% respectively.

While WHO said progress has been made against all three targets, it warned that the “current rates of improvement are insufficient” to meet them in the next 15 years.

The new report highlights that improvements in education, job opportunities, water, energy, sanitation, housing and transport “have contributed greatly” to progress, but this has been “brought to a halt by a series of predictable and preventable global crises” and also “driven by conflict and pandemics”.

The biggest increase in life expectancy was in the bottom third countries – from 59 years to 66 years – although WHO warned “progress has slowed significantly”.

Available data also shows that the gap in life expectancy between the most and least advantaged groups within some countries has widened in the last two decades.

WHO said mortality among mothers and in children under five has improved, but needs to reduce further.

During the same period, the global maternal mortality rate declined by 40%, but will have to fall from 197 deaths to 16 deaths per 100,000 live births to meet targets.

According to the UCL Institute of Health Equity, since the 2008 commission, a million people in 90% of areas in England were living shorter lives than they should have been between 2011 and the start of the Covid-19 pandemic.

It also highlights how life expectancy stalled nationally between 2010-2012 and 2020-2022, with the largest decreases seen in the most deprived 10% areas of the North East.

WHO is calling for action to address the so-called “structural drivers” of inequality, which include economic and political systems that create an unequal distribution of money, power and resources.

Professor Sir Michael Marmot, director of the UCL Institute of Health Equity and chair of the 2008 commission, said “The new report reinforces that most health outcomes are driven by the social circumstances of daily life, and inequities in power, money and resources.”