WHO - Closing the gap in a generation: Health equity through action on the social determinants of health (2008)

'Closing the gap in a generation' is the final report of the Commission on Social Determinants of Health, which was set up by the World Health Organization (WHO) in 2005 to organize the evidence on what can be done to promote health equity, and to foster a global movement to achieve it.

The resulting report of the Commission presents one key message. While maldistribution of health care is one of the social determinants of health, the incidence of illness and loss of life arises in large part because of the conditions in which people are born, grow, live, work, and age. Poverty and unequal living conditions are a result of poor social policies and programmes, unfair economic arrangements, and bad politics. By tackling the social determinants of health, there could be a significant reduction in the health gap in a generation.

In particular, the chapter on gender equity highlights barriers like lack of access to resources, lack of decision-making power and violence against women in reaching health equity. A number of case studies illustrate promising practices across the world.

The Commission’s overarching recommendations involve:

1. Improving daily living conditions.

2. Tackling the unequal distribution of power, money and resources – globally, nationally and locally.

3. Measuring and understanding the problem and assessing the impact of action.