Poverty and social determinants

Healthy cities confront issues directly relevant to poverty through their policy focus on equity, the social determinants of health and the empowerment of disadvantaged groups. Although 2% of the population of the WHO European Region lives in absolute poverty, a further 165 million live in relative poverty. Striving for health and health equity in all local policies is the main theme for Phase V of the WHO European Healthy Cities Network. With active community participation, cities are developing intersectoral equity-based approaches to address inequality in health caused by deprivation, vulnerability and social exclusion.

Political leaders of cities in the WHO European Network strengthened their commitment to action against inequality by signing the Mayors’ Statement on action for equity in Europe in 2000 and the Zagreb Declaration for Healthy Cities in 2008. The statements called for cities to have clear policies and actions to reduce health inequalities, including poverty.

Cities have also used health profiles and indicators to raise awareness of how poverty affects the broad determinants of health and to identify the population groups under the greatest burden.

Poverty is the single largest determinant of health, and ill health is an obstacle to social and economic development. Poorer people live shorter lives and have poorer health than affluent people. This disparity has drawn attention to the remarkable sensitivity of health to the social environment.

Social determinants of health. The solid facts

The booklet is part of a WHO/Europe campaign to present the evidence on social determinants in a clear and understandable form. WHO/Europe has published two editions of the book, and it is used worldwide by policy-makers, public health professionals and academic institutions. It selects and describes the main social determinants of health in society today, with key research sources are given for each: stress, early life, social exclusion, working conditions, unemployment, social support, addiction, healthy food and transport policy.

Subsequently, WHO published the final report of the Commission on Social Determinants of Health (2008).