Te Poutoko Ora a Kiwa and the School of Population Health have launched the landmark World Report on Social Determinants of Health Equity, a call to action for governments, communities and sectors to turn evidence into equity.

The launch brought together leading experts via a webinar Tools for Equity: Addressing Social Determinants in Aotearoa & the Pacific on 24 November. Through discussions the group explored how the insights of the World Report can be translated into action across the Pacific region and included speakers Dr Sudhvir Singh, Kevin Hague, Professor Alistair Woodward, Professor Boyd Swinburn, Dr Corina Grey and Co-Director Te Poutoko Ora a Kiwa Professor Sir Colin Tukuitonga.

Prof Sir Collin says the report paints a blended picture of “tales of joy and tales of doom”: while there has been progress in some areas, persistent and widening inequities remain.

Life expectancy has improved for all ethnicities since 1998, but these gains have primarily resulted from advancements in healthcare rather than systemic improvements in social determinants. For Māori and Pacific communities, gaps in housing, affordability and structural determinants continue to undermine well-being.

He says key discussion points included:

• Mixed progress: Some determinants have improved, others worsened and inequities remain entrenched.
• Housing crisis: Overcrowding and affordability indicators have deteriorated for Māori and Pacific families.
• Positive shifts: Child poverty rates fell during periods of political commitment, and healthy housing initiatives measurably reduced hospitalisations and improved school attendance.
• Structural challenges: Income and wealth inequality are intensifying, fiscal space is shrinking, and discrimination remains embedded in institutions and policies.
• Commercial determinants: Harmful industry practices and policy inertia continue to obstruct progress.

The reports on Social Determinants and Determining our Future underscore the critical role of iwi and community leadership, cross-government collaboration, and bold action on structural and commercial determinants. It calls for progressive taxation, expanded social protection, and governance that places health equity at the centre of all decisions.

Prof Sir Collin Tukuitonga offered a candid metaphor:

“If Aotearoa New Zealand were a school pupil and the parents were reading the report card, it wouldn’t say ‘best in class’ or ‘most improved’. Instead, it would describe an earnest student who got into trouble during the year — one who must try harder.”

Dr Sudhvir Singh, Unit Head for Equity and Health at WHO, emphasised the urgency for action:

“Unless we address the underlying structures of economic systems, discrimination and commercial determinants, we’ll always be playing catch-up. Evidence alone doesn’t change outcomes; implementation does.”

The report concludes with a forward-looking question: “What must we do now to turn evidence into equity?”

About the report:
The World Report on Social Determinants of Health Equity reveals that significant and avoidable gaps in healthy life expectancy persist globally, largely driven by where people live, their income, education, ethnicity, gender, disability, and access to power and resources. Despite earlier commitments, progress on achieving health equity has been insufficient.

It also identifies the structural systems that reproduce inequities and presents 14 evidence-based recommendations across four action areas, supported by country examples. Developed through extensive scientific input and global consultation, the report provides a clear blueprint for governments and sectors to take coordinated action and invest in the social determinants that shape equitable health outcomes.

Read the full report: World Report on Social Determinants of Health Equity
Read the PHAC report: Determining Our Future