Type 2 diabetes, the challenge of prevention and the WHO Commission on Social Determinants of Health

There are huge disparities in the risk of death and disease across the world, with life expectancy at birth ranging from greater than 80 years in Japan and Sweden, to less than 50 years in many African countries. Disparities also exist within countries and, irrespective of a country’s overall wealth, overall risk of disease and death tend to be strongly related to socioeconomic position, with the worse health in the less well off. In 2005, the World Health Organization established the Commission on Social Determinants of Health, whose goal was to review the evidence from all regions of the world on what underlies the distribution of health outcomes by socioeconomic position, both between and within countries, and to recommend action to reduce health inequity (unfair and avoidable or remedial differences in health amongst social groups). The idea of such an analysis was to go beyond differences in personal behaviours or immediate circumstances that underlie differences in risk by social group, and attempt to understand what it is about the social, economic, and physical environments that underpin these differences.