World Health Day is celebrated on 7th April each year. It marks the date when the constitution of the World Health Organization was adopted.
This year, the theme is ‘Building a fairer, healthier world’ and puts the spotlight on health inequalities.
Our world is an unequal one.
As COVID-19 has highlighted, some people are able to live healthier lives and have better access to health services than others – entirely due to the conditions in which they are born, grow, live, work and age.
Within countries, illness and death from COVID-19 have been higher among groups who face discrimination, poverty, social exclusion, and adverse daily living and working conditions – including humanitarian crises. The pandemic is estimated to have driven between 119 and 124 million more people into extreme poverty last year. And there is convincing evidence that it has widened gender gaps in employment, with women exiting the labour force in greater numbers than men over the past 12 months.
In many countries, the socio-economic impacts of COVID-19, through loss of jobs, increases in poverty, disruptions to education, and threats to nutrition, have exceeded the public health impact of the virus.
These inequities in people’s living conditions, health services, and access to power, money and resources are long-standing. The result: under-5 mortality rates among children from the poorest households are double that of children from the richest households. Life expectancy for people in low-income countries is 16 years lower than for people in high-income countries. For example, 9 out of 10 deaths globally from cervical cancer occur in low- and middle-income countries.
Access to healthy housing, in safe neighbourhoods, with adequate educational and recreational amenities, is key to achieving health for all.
Meanwhile, 80 per cent of the world’s population living in extreme poverty are in rural areas. Today, 8 out of 10 people who lack basic drinking water services live in rural areas, as do 7 out of 10 people who lack basic sanitation services.
All over the world, some groups struggle to make ends meet with little daily income, have poorer housing conditions and education, fewer employment opportunities, experience greater gender inequality, and have little or no access to safe environments, clean water and air, food security and health services. This leads to unnecessary suffering, avoidable illness, and premature death. This harms our societies and economies.
At least half of the world’s population still lacks access to essential health services; more than 800 million people spend at least 10% of their household income on health care, and out of pocket expenses drive almost 100 million people into poverty each year.
This is not only unfair: it is preventable. That’s why the WHO is calling on leaders to ensure that everyone has living and working conditions that are conducive to good health. At the same time they urge leaders to monitor health inequities, and to ensure that all people are able to access quality health services when and where they need them.
Governments should meet WHO’s recommended target of spending an additional 1% of GDP on primary health care (PHC). Evidence reveals that PHC-oriented health systems have consistently produced better health outcomes, enhanced equity, and improved efficiency. Scaling up PHC interventions across low- and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030.
Governments must also reduce the global shortfall of 18 million health workers needed to achieve universal health coverage (UHC) by 2030.
The idea of health inequalities is deeply tied with the Sustainable Development Goals (SDGs). It is widely recognised that the pursuit of sustainable development cannot be accomplished without addressing inequality. Goals 5 (gender equality) and 10 (reducing inequality within and among countries).
It has been found that routine reviews of health sector performance (such as annual health sector reviews) tend to report national averages and occasionally averages for sub-populations (e.g. urban and rural residents). This level of data disaggregation does not allow for a more critical analysis of inequality, including trends or benchmarking, that could assist with the policy/programme design or refinement. Indeed, in the absence of appropriately disaggregated data, there is a danger that national health averages could improve without any improvement in health inequality. Therefore, the WHO has developed Health Equality Assessment Toolkit (HEAT) to measure health inequalities.
HEAT considers five dimensions of inequality:
- economic status,
- place of residence,
- subnational region, and
- child’s sex (where applicable).
Link to the WHO World Health Day 2021 site:
Link to related WHO news release:
Link to the WHO Health Equity Monitoring resources page: