The study by the World Health Organization (WHO) reveals that they can be responsible for a dramatic reduction in life expectancy in both rich and poor countries alike.

For example, people living in the country with the highest life expectancy will on average live 33 years longer than those born in the country with the lowest life expectancy.

An unequal world

“Our world is an unequal one. Where we are born, grow, live, work and age significantly influences our health and well-being,” said WHO Director-General Tedros Adhanom Ghebreyesus.

Inequities in health are closely linked to degrees of social disadvantage and levels of discrimination.

“Health follows a social gradient whereby the more deprived the area in which people live, the lower their incomes are,” WHO said.

Inequities are especially exacerbated in populations that face discrimination and marginalization, such as Indigenous Peoples, who have lower life expectancies than their non-Indigenous counterparts.

This is the case in both high and low-income countries.

Key targets at risk

The study is the first to be published since 2008 when the WHO Commission on Social Determinants of Health released its final report laying out targets for 2040 for reducing gaps between and within countries in life expectancy, childhood and maternal mortality.

It shows that these targets are likely to be missed, and despite a scarcity of data there is sufficient evidence to show that health inequities are often widening.

For example, children born in poorer countries are 13 times more likely to die before their fifth birthday than in wealthier countries.

Moreover, modelling shows that the lives of nearly two million children annually could be saved by closing the gap and enhancing equity between the poorest and wealthiest sectors of the population within low- and-middle-income countries.

Additionally, although maternal mortality declined by 40 per cent between the years 2000 and 2023, the majority of deaths, 94 per cent, still occur in low and lower-middle-income countries.

Appeal for action

WHO is calling for collective action to address economic inequality and invest in social infrastructure and universal public services.

The agency also recommends other steps, including overcoming structural discrimination and the determinants and impacts of conflicts, emergencies and forced migration.