# Health and Strong Societies ## expand\_more The development of a society, poor or rich, can be judged by its people’s health, the equity of health across the social spectrum, and how well its weakest members are protected from the disadvantages of ill health. Traditionally, society has looked to the health sector to deal with its concerns about health and disease. But many health inequities are the result of conditions in which people are born, grow, work, and age—and the consequence of failed social policies, unfair economic arrangements, and weak governance. As the global burden of disease shifts from infectious diseases to non-communicable disease challenges, many of which are influenced by drivers beyond the health sector, addressing the social determinants of health becomes imperative. Cross-sectoral collaboration across government, finance, education, housing, employment, and transport will be as essential as efforts to strengthen national health systems. Focusing on the determinants of health outside the health sector also requires prioritizing human rights, equity, and women’s empowerment. ## Subthemes ### Health & Aging ![Health & Aging Subtheme](/sites/g/files/omnuum10866/files/styles/hwp_16_9__480x270/public/gheli/files/health-aging-260x180.jpg?itok=KGa4785k) ### Health & Inequity ![Health & Inequity Subtheme](/sites/g/files/omnuum10866/files/styles/hwp_16_9__480x270/public/gheli/files/health-inequity-260x180.jpg?itok=aDyJTaRF) ### Health Systems ![Health Systems Subtheme](/sites/g/files/omnuum10866/files/styles/hwp_16_9__480x270/public/gheli/files/health-systems-260x180.jpg?itok=ew-RTKZY) ### HEALTH & AGING expand\_more For the first time in history, most people can expect to live into their 60s and beyond. Most of the health problems of older age are the result of chronic diseases, but many can be prevented, and others can be effectively managed, provided the appropriate health services are available. Urbanization, along with advances in transportation and communication, offer both advantages and disadvantages for the well-being of older people. For some, these changes will create new opportunities, such as continued employment, but for others, they will remove social safety nets. If we are to build societies that are cohesive, inclusive and equitable, we need to ensure that the needs of an aging population are met—in fact the greatest costs to society will not be the expenditures required to meet these needs, but the benefits that will be missed if we fail to make the appropriate investments. Below are examples of resources relevant to the overarching themes. Previously highlighted resources and additional resources can be found in [our digital Repository](https://repository.gheli.harvard.edu/repository). #### **Resources:** [GBD 2023: Global Age-Specific All-Cause Mortality and Life Expectancy Estimates for 204 Countries and Territories and 660 Subnational Locations, 1950–2023](https://repository.gheli.harvard.edu/repository/14635) This article, published by The Lancet, provides estimates for life expectancy and age- and sex-specific mortality for 204 countries and territories using data from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2023. The article examines data from 1950 through 2023, finding that global life expectancy increased dramatically between 1950 and 2019, declined in 2020 and 2021 during the COVID-19 pandemic, and experienced a post-pandemic recovery in 2022 and 2023. The article also examines trends in mortality rates across age, sex, and location. [Lancet Series 2025: Alzheimer's Disease](https://repository.gheli.harvard.edu/repository/14638) This Lancet Series discusses the current and future clinical landscape for Alzheimer’s disease following new advances that inform disease diagnosis, development, and treatment. The series provides an overview of new diagnostic practices and the typical patient journey, evidence-based advice for treating the cognitive and psychological symptoms of Alzheimer’s using medication and non-medication approaches, and current controversies and future outlooks in Alzheimer's research. [Lancet Series 2025: Inequalities and Disparities in Cardiovascular Health](https://repository.gheli.harvard.edu/repository/14639) This Lancet series examines the structural and systemic factors driving disparities in cardiovascular disease burden and outcomes in Europe. The series looks specifically at disparities in cardiovascular health among four high-risk groups (women, racial and ethnic minorities, older adults, and people with mental health conditions) and provides recommendations for public health interventions, research, and clinical practices that address persistent inequalities for these targeted populations. ### INEQUITY & POVERTY expand\_more Social inequities in health refer to disparities that are judged to be unfair, unjust, and avoidable and that systematically influence the health of vulnerable populations. These may be generated early or late in life by differences in access to material resources, social circumstances, or health behaviors. For example, the conditions under which people work influence their health and the circumstances which promote health. There are strong linkages between health and poverty, particularly at the level of the household. Out-of-pocket payments for health services can trap families in repeated cycles of catastrophic expenditure and impoverishment—the reduction in household income may then hinder a family’s ability to provide for, nourish, and educate children. To address the social determinants of health, health professionals need to promote a common understanding of the value of health across sectors and contribute to innovative mechanisms that work across conventional policy siloes. Below are examples of resources relevant to the overarching themes. Previously highlighted resources and additional resources can be found in [our digital Repository](https://repository.gheli.harvard.edu/repository). #### **Resources:** [County Health Rankings and Roadmaps](https://repository.gheli.harvard.edu/repository/14200) County Health Rankings and Roadmaps is a program from the Population Health Institute at the University of Wisconsin that focuses on the the factors that influence health differences within and across communities in the United States. The program aims to create a greater understanding of health, equity, and the policies and practices that can help improve health for all. Users can access the health data portal to explore health indicators at the county, state, and national levels. National data insights are available in the 2025 report, which focuses on how power and the way it is applied shapes health and eqeuity nationwide. [2025 Food Insecurity in Asia and the Pacific](https://repository.gheli.harvard.edu/repository/10933) This report from the Food and Agriculture Organization of the United Nations (FAO) provides a regional overview of food security and nutrition in Asia and the Pacific. This report provides the latest data on undernourishment, food insecurity, and malnutrition in the region and measures progress toward meeting the Sustainable Development Goal (SDG) 2 targets for ending hunger globally. [World Social Report 2025: A New Policy Consensus To Accelerate Social Progress](https://repository.gheli.harvard.edu/repository/12779) This report published by the United Nations Department of Economic and Social Affairs (UNDESA) and the United Nations University World Institute for Development Economics Research (UNU-WIDER) outlines trends in social development and identifies major social challenges facing the world today. This year’s report highlights how economic insecurity, inequality, and declining social trust are destabilizing societies and threatening social and sustainable development. The report offers recommendations for addressing these challenges, arguing for a new policy approach incorporating the three principles of equity, solidarity, and economic security for all. ### HEALTH SYSTEMS & DELIVERY expand\_more The majority of the world is facing a rising rate of chronic diseases (e.g., cardiovascular, diabetes, cancer, mental health disorders), risk factors (e.g., smoking, obesity), as well as intentional injuries (e.g., suicide, interpersonal violence) and accidents (e.g., road traffic injuries). Many countries that are still battling infectious diseases are now confronted with a ‘double burden’ of disease. Strong national health systems that provide equitable universal coverage, ensure access to health services, and protect against financial hardship that results from out-of-pocket health care costs have never been as important. From public health measures and population-level strategies to clinical health services spanning prevention, management, and treatment, innovation will be needed on both the ‘supply side’ (e.g., delivery of high-quality services) and the ‘demand side’ (e.g., people seeking and using the services). WHO Director General Margaret Chan asserted that universal health coverage is “the single most powerful concept that public health has to offer.” The recognition that good health is not only a consequence of economic development, but also a driver of it, calls for multi-sectoral action to make this conceptual idea a reality. Below are examples of resources relevant to the overarching themes. Previously highlighted resources and additional resources can be found in [our digital Repository](https://repository.gheli.harvard.edu/repository). #### **Resources:** [How State Policies Shape Access to Abortion Coverage: Data Interactive](http://repository.gheli.harvard.edu/repository/11264) This data interactive, developed by the Kaiser Family Foundation (KFF), shows the increase in states with laws restricting abortion coverage when using Medicaid and private insurance from 2010 to the present. The set of interactive maps provides up-to-date coverage for all 50 states. The most recent map, accurate as of January 2025, shows that 30 states and the District of Columbia have Medicaid coverage limitations, 10 states have private insurance limitations, 25 states have state marketplace coverage limitations, and 8 states have no coverage limitations. [Tracking Universal Health Care Coverage: 2025 Global Monitoring Report](https://repository.gheli.harvard.edu/repository/13095) This report, published jointly by the World Bank Group and the World Health Organization (WHO), analyzes global progress toward achieving universal health coverage (UHC). The 2025 report presents data on two critical indicators for UHC—coverage of essential health services and financial risk protection—and reports global trends, progress, and challenges in meeting these targets. The report finds progress since 2000, with increasing service coverage and decreasing financial hardship worldwide. However, progress is not fast enough to reach the targets set out by the SDGs. [Global Antibiotic Resistance Surveillance Report 2025](https://repository.gheli.harvard.edu/repository/14652) This data publication from the World Health Organization (WHO) provides an overview of the state of bacterial antimicrobial resistance (AMR) globally. The report analyzes resistance across eight common types of pathogenic bacteria, 22 types of antibiotics, and 4 types of infection, resulting in 93 infection type-pathogen-antibiotic combinations. The report finds that from 2018 to 2023, AMR increased in 40 percent of antibiotic-pathogen combinations. The report also examines AMR burden at country and regional levels, finding that there are wide regional variations, with the frequency of AMR being highest in countries with low surveillance coverage. ### Media and Body Image: Lessons from Fiji Regional Profile In a world of global instant media, advertising imagery in one country can influence cultural ideals across borders, with occasional devastating effects on health. When Harvard anthropologist and psychiatrist, Dr. Anne Becker, suspected television as the culprit in a spike of eating disorder symptoms among girls in Fiji, she conducted [targeted research](https://doi.org/10.1192/bjp.180.6.509) to understand why this was happening and what to do about the problem. Eating disorders can lead to malnutrition, heart disease, and organ complications, and they are associated with depression and low self-esteem that can lead to suicidal tendencies. Treatment requires mental health intervention, a rare resource in poor countries. Becker found that girls were most influenced by their peers’ exposure to mass media, but education could help. Effective responses call for engaging parents to raise awareness, training teachers so they can help identify students at risk, and political activism to change policies. ### Imprisonment and Social Disparities in the U.S. Population Snapshot The rate of imprisonment in the United States more than quadrupled during the last four decades. With nearly 1 out of every 100 adults in prison or jail, the rate is 5 to 10 times higher than those in Western Europe and other democracies. With just under one-quarter of the world's prisoners held in American prisons, the U.S. prison population of 2.2 million adults is now by far the largest in the world. Perhaps most disturbing is the disproportionate representation of men under age 40 and minorities, and the prevalence of drug and alcohol addictions, mental and physical illnesses, and lack of work preparation. A landmark National Research Council [report](https://repository.gheli.harvard.edu/repository/11033/) analyzes the historically unprecedented rise in the use of incarceration in the U.S. and the consequences for the people imprisoned, their families and communities, and for U.S. society. ### Design, Health, and the Drinking Fountain Sector Perspective When London’s first public drinking fountain opened in 1859, thousands of people came out to celebrate the installation. Before then, access to clean water in London was nearly impossible for poorer classes, leading to the rampant spread of waterborne diseases like cholera. Shortly after the father of modern epidemiology, John Snow, discovered the role of water in the spread of cholera, London philanthropists spearheaded the construction of hundreds of water fountains. Their design still posed one problem: Most fountains used common cups, which also spread disease. Want to know what happens next? In this episode of the radio show [99% Invisible](https://99percentinvisible.org/episode/fountain-drinks/), host Roman Mars dives deep into the history and design of the now ubiquitous water fountain, also tracking its connections to public health, the temperance movement, and even segregation. [Learn more about water, sanitation, and hygiene](https://washdata.org/). ### Emerging Models of Education Featured This essay examines how emerging models of education in medicine, public health, and engineering are evolving to reflect the needs for an increasingly globalized world. While public health education is increasingly accommodating scholars who come from a diversity of backgrounds, engineering education is incorporating real-world challenges that not only focus on the core concepts but the applications of the concepts in complex environments. After all, resource-poor and rich countries are challenged by a similar set of problems—both need health systems that emphasize access, coverage, quality, and affordability. Arguing that we need to rethink the way in which we train health sector professionals, the authors suggest that the contemporary graduate is one who “understands systems beyond the individual organ; understands disease and cure in context; and has developed the knowledge, skills, and tools to innovate, seeing the global context as a resource for understanding and ideas rather than as developing countries in need."