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Just societies: Health equity and dignified lives

This report is available in English and Spanish only.

This report by the Pan American Health Organization’s Commission on Equity and Health Inequalities in the Americas examines social and economic inequalities in the regions, and considers several related factors such as gender, sexuality, ethnicity, disability and daily living conditions. An expanded list of the structural drivers of inequities also play prominently into the analysis.  

Conceptual framework

The conceptual framework presented in this report (p. 9) builds on the work of the previous World Health Organization Commission on the Social Determinants of Health, making several important additions:  

  • The list of structural drivers expands beyond the political, social, cultural and economic, emphasizing the natural environment and climate change and the ongoing impact of colonialism and structural racism.
  • Intersectionality is shown at the top of the framework as an ever-present frame, and sexuality, disability and migration are explicitly named.
  • Governance and human rights action on both structural drivers and the conditions of daily life are named as pathways to health equity

In sections three to five, the report makes 12 recommendations, presenting each with a table of specific objectives and concrete actions.

  1. Achieving equity in political, social, cultural, and economic structures
  2. Protecting the natural environment, mitigating climate change, and respecting relationships to land
  3. Recognize and reverse health equity impacts of ongoing colonialism and structural racism
  4. Equity from the start––early life and education
  5. Decent work
  6. Dignified life at older ages
  7. Income and social protection
  8. Reducing violence for health equity
  9. Improving environment and housing conditions
  10. Equitable health systems
  11. Governance arrangements for health equity
  12. Fulfilling and protecting human rights.

Case stories

The report is made more readable by the inclusion of case stories and highlights from initiatives across the Americas. Readers will also find the connections drawn between the information in the report and other agreements useful (e.g., United Nations Sdustainable Development Goals and relevant PAHO resolutions).

Use this resource to:

  • reflect on an updated conceptualization of the structures that drive inequities in the Americas;
  • consider the 12 recommendations and their related actions as you engage in health equity–related policy and program development; and
  • design related continuing professional development opportunities for your team.


Pan American Health Organization. (2018). Just Societies: Health Equity and Dignified Lives. Executive Summary of the Report of the Commission of the Pan American Health Organization on Equity and Health Inequalities in the Americas. Washington, D.C.: PAHO.

Related resources

Tags: Assess and report, Critical works in health equity, Key concepts, Racism/racialization, Public Health Organization, Link

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