A summary of the interim statement of the Commission on the Social Determinants of Health* is published online by THE LANCET Thursday 6 September. Almost 60 years after the formation of the World Health Organisation (WHO), the report's author Professor Sir Michael Marmot (University College London [UCL], UK) concludes that now is the time for politicians and health-care professionals to unite globally to counter the social and political factors that contribute to widespread health inequity across the world.
To illustrate the wide gaps in health equity, the life expectancies of three children are highlighted: one African, one South Asian, and one European. At birth each, representing the average for their country, has life expectancy of less than 50 years. The African and South Asian figures come from 1970, the European figure from 1901. Over the past century, life expectancy for Europeans increased by about 30 years, and is still rising. Between 1970 and 2000, the life expectancy of South Asia's rose by 13 years; for the child in sub-Saharan Africa, life expectancy has risen by four months.
Central to the Commission's report is the social gradient in health. Regardless of the difference in social structure and health differences between countries and within countries (both rich and poor), the evidence shows that the lower an individual's socioeconomic position the worse their health. The report comments that the gradient in health should not deflect attention from the plight of people at the bottom of the gradient, the poorest of the poor.
Professor Marmot comments: "The time for action is now. Not just because better health makes economic sense. But because it is right and just. The outcry against inequity has been intensifying for many years from country to country around the world. These cries are forming a global movement. The Commission on Social Determinants of Health places action to ensure fair health at the head and the heart of that movement."
Notes to Editors:
* the full version of the report of the Commission on the Social Determinants of Health (CSDH) will be published online at: http://www.
** Further information about the CSDH is available from http://www.
The CSDH was set up by the World Health Organisation in 2005. It is chaired by Professor Sir Michael Marmot (UCL, UK). The Commissioners are influential global and national level policy-makers, scientists, practitioners, and civil society leaders from all over the world, united by their concern about health inequity, and their conviction that societal action is needed to respond to it.
The Commission is building a global movement for change to improve global health and reduce health inequity. It is building partnerships with governments, civil society, and international organizations. It is reviewing the global evidence base on health inequity, harnessing national and local knowledge for action, and advocating change. The CSDH is concerned with action to tackle the range of health determinants - from structural conditions of society to the more immediate influences, at al levels from global to local, across government and inclusive of stakeholders from civil society and the private sector. Recommendations for action will be made in the Final Report in 2008.