Global Health Inequities Deepen as WHO Urges Cross-Sector Reforms to Address Social Roots

The World Health Organization (WHO) has issued a stark warning in its newly released World Report on Social Determinants of Health Equity (2025), highlighting that the primary causes of ill health worldwide are rooted in factors far beyond the reach of traditional health systems. The report reveals how persistent inequities driven by social injustice, discrimination, poverty, and weak public infrastructure are reducing healthy life expectancy—sometimes by several decades—both within and between countries, regardless of income level.

A World Divided by Health Outcomes

According to the report, people in countries with the lowest life expectancy live on average 33 years less than those in countries with the highest. However, these disparities are not limited to international comparisons. Even within nations, communities marginalized by income, ethnicity, or geography experience dramatically worse health outcomes.

Children born in low-income countries are 13 times more likely to die before their fifth birthday than those in wealthier countries. WHO estimates that if health equity were achieved, 1.8 million child deaths could be prevented annually in low- and middle-income countries.

Health Determined by Social Conditions

Dr. Tedros Adhanom Ghebreyesus, Director-General of WHO, emphasized the urgent need for systemic reforms:

“Our world is an unequal one. Where we are born, grow, live, work and age significantly influences our health and well-being. But change for the better is possible.”

The WHO report lays out how social determinants—such as housing, education, employment, income security, and community conditions—have a more profound impact on health than genetic factors or access to healthcare services. These determinants shape life expectancy, infant and maternal mortality rates, and disease burden.

For instance, people living in deprived areas are more likely to have lower income, fewer years of education, and worse health outcomes. Marginalized communities such as Indigenous Peoples face systemic disadvantages regardless of whether they live in high- or low-income countries, often experiencing lower life expectancy and higher rates of illness.

Persistent Gaps in Maternal Health

Progress has been uneven, particularly for women and girls. While maternal mortality dropped globally by 40% between 2000 and 2023, 94% of maternal deaths still occur in low- and lower-middle-income countries. Structural inequities are particularly pronounced when intersecting with gender, race, and ethnicity.

In some high-income nations, Indigenous women are up to three times more likely to die during childbirth compared to non-Indigenous women. Furthermore, high levels of gender inequality, including child marriage, are strongly associated with elevated maternal mortality rates.

Climate Change, Conflict, and Digital Divide as Emerging Threats

The report underscores new and emerging factors that are compounding health inequities:

• Climate Change: Projected to drive 68–135 million people into extreme poverty within the next five years, threatening nutrition, displacement, and access to health services.

• Conflict and Forced Migration: Disrupt health systems and disproportionately affect already vulnerable populations.

• Digital Transformation: While it offers potential to close health gaps, unequal access to digital technologies risks deepening existing divides.

The Economic Burden and Inadequate Social Protection

Nearly 3.8 billion people lack basic social protection, including benefits like child support and paid sick leave. These gaps leave billions vulnerable to falling into poverty due to illness or economic disruption. Meanwhile, high national debt burdens further limit governments’ ability to invest in essential services. The world’s 75 poorest countries now pay four times more in debt interest than they did a decade ago, severely restricting their fiscal space for health and social programs.

A Blueprint for Change: WHO’s Policy Recommendations

The report calls for comprehensive, coordinated action across all sectors of society—not just health ministries. WHO urges national and local governments, researchers, civil society, and the private sector to:

• Address economic inequality through progressive policies and greater investments in public services and infrastructure.

• Eliminate structural discrimination, especially against ethnic, racial, gender, and disability groups.

• Respond to conflicts, emergencies, and climate shocks with inclusive, equity-driven strategies.

• Strengthen governance systems that support cross-sectoral collaboration and community empowerment.

• Invest in local-level solutions, ensuring that funding and decision-making power reaches communities most affected by health inequities.

The WHO emphasizes that addressing social determinants is not merely a health issue but a societal imperative. Without urgent and collective action, the world will fall short of the targets established in the 2008 Commission on Social Determinants of Health to close global health gaps by 2040.

The 2025 World Report on Social Determinants of Health Equity paints a sobering picture of a world where opportunity and health remain tightly bound to geography, identity, and income. Yet, it also offers a roadmap for reversing course—if global leaders are willing to confront injustice head-on, redistribute power and resources, and reimagine health as a product of collective well-being rather than personal responsibility.