WHO warns inequality still dictates who faces disease and receives care

Income, education, gender and geography continue to influence exposure to risk factors and access to screening, diagnosis and treatment, according to a new WHO report.

The World Health Organization has warned that inequality continues to shape who develops non-communicable diseases and who receives care, in a new report that examines cancer, cardiovascular disease, chronic respiratory disease and diabetes alongside major risk factors such as tobacco use, alcohol, obesity, unhealthy diets, inactivity and air pollution. According to the WHO, the findings point to a global health burden that is shared widely but not evenly, with prevention and treatment still strongly influenced by social and economic circumstances.

In its report, “The State of Inequality: Noncommunicable Diseases and Their Risk Factors”, the UN health agency said income, education, sex, age and where people live can all affect exposure to risk and access to diagnosis and treatment. The WHO said these gaps can appear at every stage, from reducing exposure to risk factors through to managing long-term illness. It also noted that evidence from low- and middle-income countries shows people with less education are more likely to have hypertension and diabetes.

The report highlights clear differences in screening and treatment access. The WHO said poorer and less educated women are less likely to undergo cervical cancer screening, while tobacco use is higher among less educated men than among more educated men. Geography also matters, the agency said, with rural populations in many low- and middle-income countries facing weaker access to hypertension diagnosis and treatment, as well as cervical cancer screening, than people in cities.

The WHO also pointed to environmental inequality. It said rural households are more likely to be exposed to indoor air pollution, while urban residents are more exposed to outdoor pollution. The report argues that governments need policies and programmes designed around equity, not just average national progress, if they are to narrow the gaps in prevention and care for diseases that remain among the world’s leading killers.