A new report from the World Health Organization (WHO) highlights the critical impact of social determinants of health (SDoH) on dramatically diminishing healthy life expectancy.
Factors such as housing insecurity, education level, and job opportunities are taking years—at times decades—off people’s lives across both high-income and low-income countries, having a greater impact on an individual’s health outcomes than genetics, according to the report.
In comparison between countries with varying life expectancies, WHO found that people in the country with the lowest life expectancy will, on average, live 33 years shorter than those born in the country with the highest life expectancy.
The World report on social determinants of health equity aims to improve health equity around the world by providing evidence-based strategies and policy recommendations to guide government, civil society, and international organizations to establish “just and equitable” health care systems.
The recommendations could be helpful to providers in the United States. Although President Donald Trump issued an executive order in January shortly after taking office to withdraw from the organization, Reuters reports that Trump may be open to rejoining WHO under certain conditions, including putting an American in charge. Public health activists and U.S. lawmakers have also urged Trump to reconsider the withdrawal.
The report is the first of its kind since 2008, when the WHO Commission on Social Determinants of Health released its final report setting targets for 2040 to reduce gaps between and within countries in life expectancy, childhood, and maternal mortality. Unfortunately, the 2025 report highlights that these targets are likely out of reach.
The report includes extensive findings across countries, including:
- Those living in extreme poverty experience some of the worst health outcomes globally. Based on current trends, 6.9 percent of the global population will still be living in extreme poverty by 2030.
- People with higher educational attainment have better health and life spans compared to less educated peers at a population level.
- Climate change is estimated to push an additional 68–135 million people into extreme poverty over the next five years
- A total of 3.8 billion people worldwide are deprived of adequate social protection coverage, such as child/paid sick leave benefits.
- Women from disadvantaged or marginalized groups—determined by income, race, education, or location—are significantly more likely to die from pregnancy-related causes than their more advantaged peers, regardless of the country’s income level. In the United States, in 2020, the maternal mortality rate for Black women was nearly three times higher than that of white women.
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For the report, WHO established a policy expert group and science expert group comprised of global experts in health equity, SDoH, and public policy to provide their guidance. The groups convened regularly throughout 2021–2024.
The report also includes feedback from a diverse group of stakeholders, including virtual consultations and written feedback from member States, WHO regional offices, civil society and subject matter experts, as well as the inclusion of opinions from low- and middle-income countries and populations experiencing marginalization.
The report outlines four areas for action:
- Tackle economic inequality and support public services that everyone can use
- Address and eliminate structural discrimination
- Manage the challenges and opportunities of climate change and digital advancements in a way that promotes fair health for everyone
- Create government systems that ensure actions are aligned and effective
The organization also outlined approaches for key roles across institutions and sectors, including national and local governments, civil society, the private sector, research institutions, the UN system, and global financial institutions, and WHO.
“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 Dr. Tedros Adhanom Ghebreyesus in a statement. “But change for the better is possible. This world report illustrates the importance of addressing the interlinked social determinants and provides evidence-based strategies and policy recommendations to help countries improve health outcomes for all.”
Click here to download the complete report.