Social justice - or lack thereof - has a greater impact on the health of the world's population than medical treatment, according to a landmark study that concludes that inequities are killing people on a "grand scale."
The report by a blue-ribbon international panel, being released Thursday in Geneva, says essentially that there is little point in trying to prevent and treat illness without tackling the underlying root causes such as poverty, poor housing, inadequate education and lack of human rights.
And the panel, chaired by Sir Michael Marmot, a professor at University College in London, calls on the World Health Organization and member countries like Canada to make the issue a global priority and close the health gap between rich and poor within a generation.
"Social injustice is killing people on a grand scale," the introduction reads.
"In countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health. It does not have to be this way and it is not right that it should be like this."
To underscore the gaps, a number of stark statistics are featured, including the fact that a girl born today in the African country of Lesotho can expect to live 42 fewer years than one born in Japan.
The 256-page report, entitled Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health, also challenges current economic dogma, stating that global trade and an aversion to public spending on social programs is not improving the lot of most people in the world, but making things worse.
"Economic growth is without question important, particularly for poor countries, as it gives the opportunity to provide resources to invest in improvement of the lives of their population. But growth by itself, without appropriate social policies to ensure reasonable fairness in the way its benefits are distributed, brings little benefit to health equity," the report says.
The 19 commissioners, who spent almost three years on the endeavour, call for a broad range of social measures to be instituted in rich and poor countries alike to "improve daily living conditions," including affordable housing, labour policies such as a decent minimum wage, social support like welfare, taxation measures that redistribute wealth, and universal access to basic health care.
Ronald Labonté, the Canada Research Chair in Globalization/Health Equity and a professor in the faculty of medicine at the University of Ottawa, said, "There is nothing terribly magical about these approaches, but the commission provides compelling evidence that they work."
He said the report should now shift the debate from what needs to be done to why countries are not acting.
"A failure to act now is a moral failure," Prof. Labonté said.
In fact, the report states that a business-as-usual approach will increase unfairness and unhealthiness because currently health disparities are actually increasing.
Monique Bégin, a professor in the school of management at the University of Ottawa, said that it would be a mistake to assume this issue is of interest to developing countries only.
Health inequities, she said, exist even in wealthy countries like Canada, where the abandonment of social programs is also affecting the health of citizens.
"Canada likes to brag that for seven years in a row the United Nations voted us 'the best country in the world in which to live.' Do all Canadians share equally in that great quality of life? No, they don't. The truth is that our country is so wealthy that it manages to mask the reality of food banks in our cities, of unacceptable housing, of young Inuit adults' very high suicide rates."
Prof. Bégin said she hopes the report will be a "wake-up call for action towards truly living up to our reputation."