This backgrounder is part of a Local Democracy Research Centre paper on global health inequalities. Read Still unequal: dealing with health inequalities through the pandemic and beyond
Seven out of 10 people live in countries where inequality is growing fast, and those at the top of society are leaving the rest behind.
We have known that this is a critical issue for some time. There is no shortage of evidence about the impact of health inequity going back over the last few decades. There have been three major reports into health inequalities in the UK commissioned by the UK government – the first being the Black Report in 1980, followed by the Acheson Report in 1998. The Marmot Review ‘Fair Society Healthy Lives’ was published in 2010. Sir Michael Marmot had been commissioned to analyse the causes and extent of health inequalities in England and identify what could be done to improve health. The next section will explore this in more detail.
There have also been important global reports. The WHO’s 1978 Alma Ata declaration convincingly argued that “health for all” could be achieved only through a New International Economic Order and people’s participation in decisions affecting their community’s health. The principles were affirmed in the report of the Commission on the Social Determinants of Health and the 2008 World Health Report. The commission proposed “tackling the inequitable distribution of power, money, and resources” that drive systematic inequalities in health outcomes, and improving daily living conditions especially for those in vulnerable circumstances. (source BMJ January 2021).
In the 33 countries that provided data to Eurostat in 2018, 147 million people (24 per cent of the population) were at risk of poverty or severe material deprivation or were living in households with very low work intensity. World Bank data for the period 2012 to 2018 indicate that in a further 14 non-European Union countries in the Region, 32 million people lived below the national poverty line (11 per cent of the population)
In terms of health status, approximately nine per cent of the population aged 16 years and over (44 million people) in the 33 countries that provided data to Eurostat reported their health to be poor or very poor – this proportion rose with age to approximately 26 per cent of those aged 75 years and over (13 million people). In a further 13 non-EU countries in the Region participating in the 2017–2020 World Values Survey (WVS), 9.5 per cent (20 million people) perceived their health to be poor or very poor.