Health inequities and their causes

22 February 2018

There is ample evidence that social factors, including education, employment status, income level, gender and ethnicity have a marked influence on how healthy a person is. In all countries – whether low-, middle- or high-income – there are wide disparities in the health status of different social groups. The lower an individual’s socio-economic position, the higher their risk of poor health.

Health inequities are systematic differences in the health status of different population groups. These inequities have significant social and economic costs both to individuals and societies.

This fact file looks at what health inequities are, provides examples and shows their cost to society.

WHO/D. Rodriguez

Health inequities are systematic differences in health outcomes

Health inequities are differences in health status or in the distribution of health resources between different population groups, arising from the social conditions in which people are born, grow, live, work and age. Health inequities are unfair and could be reduced by the right mix of government policies.

WHO/C. Black

Every day 16 000 children die before their fifth birthday

They die of pneumonia, malaria, diarrhoea and other diseases. They are 14 times more likely to die before the age of five in sub-Saharan Africa than the rest of the world. Furthermore, children from rural and poorer households remain disproportionately affected. Children from the poorest 20% of households are nearly twice as likely to die before their fifth birthday as children in the richest 20%.

WHO/H. Everts

Maternal mortality is a key indicator of health inequity

Maternal mortality is a health indicator that shows the wide gaps between rich and poor, both between and within countries. Developing countries account for 99% of annual maternal deaths in the world. Women in Chad have a lifetime risk of maternal death of 1 in 16, while a woman in Sweden has a risk of less than 1 in 10 000.

Z. Balogh

Tuberculosis is a disease of poverty

Around 95% of TB deaths are in the developing world. These deaths affect mainly young adults in their most productive years. Contracting the disease makes it even harder for these adults to improve their personal economic condition and that of their families.

WHO/E. Martino

87% of premature deaths due to noncommunicable diseases occur in low- and middle-income countries

In low-resource settings, health-care costs for noncommunicable diseases (NCDs) can quickly drain household resources, driving families into poverty. The exorbitant costs of NCDs are forcing millions of people into poverty annually, stifling development.

WHO/D. Rodriguez

Life expectancy varies by 34 years between countries

In low-income countries, the average life expectancy is 62 years, while in high-income countries, it is 81 years. A child born in Sierra Leone can expect to live for 50 years while a child born in Japan can expect to live 84 years.

CC/S. Evens

There are alarming health inequities within countries, too

For example, in the United States of America, African Americans represent only about 13% of the population but account for almost half of all new HIV infections. There is no biological or genetic reason for these alarming differences in health.

WHO/A. Kari

Health disparities are huge in cities

In Glasgow, male life expectancy ranges from 66.2 years in Ruchill and Possilpark to 81.7 years in Cathcart and Simshill – a difference of 15.5 years. In London, when travelling east from Westminster, each tube stop represents nearly one year of life expectancy lost according to the findings of the London Health Observatory.

WHO/P. Brown

Health inequities have a significant financial cost to societies

The European Parliament has estimated that losses linked to health inequities cost around 1.4% of gross domestic product (GDP) within the European Union – a figure almost as high as the EU's defense spending (1.6% of GDP). This arises from loses in productivity and tax payments, and from higher welfare payments and health care costs.

WHO/A. Kari

Persistent inequities slow development

Close to 1 billion people in the world live in slum conditions, representing about one quarter of the world's urban population. The likelihood of meeting the Sustainable Development Goal 3 on good health and well-being is closely linked to the targets of goal 11 on sustainable cities and communities.