A Global Agenda for 2025–2028: Promoting, Delivering, and Protecting Health «Part Three»

Determinants of Health and Root Causes of Disease

This strategic objective responds to the clear reality that the conditions in which people are born, grow, work, live, and age—the determinants of health—have a greater impact on health and well-being than access to healthcare services alone.

The objective emphasizes that investing in cost-effective interventions for disease prevention and health promotion generates significant savings and benefits: people will live longer, healthier, and happier lives; economies will become stronger and more resilient; and pressure on health and social care systems can be substantially reduced.

Health determinants influence the distribution and exposure to environmental and behavioral risk factors (e.g., tobacco and nicotine use, harmful alcohol consumption, physical inactivity, unhealthy diets and food insecurity, air pollution, exposure to hazardous chemicals, risks related to water, sanitation, and wastewater, foodborne diseases, radiation, and social isolation and loneliness), which account for over 40% of diseases and premature deaths globally.

Addressing the underlying and root causes of disease—including systemic and structural barriers such as those related to gender—is an essential part of fulfilling the right to health for all. This objective will be pursued through actions that place health and well-being at the center of government policies, particularly in non-health sectors that directly or indirectly influence health, especially schools and workplaces, using the “One Health” approach.

This strategic objective also seeks to understand the behavioral drivers and barriers among individuals, communities, and diverse population groups; to engage and empower them in decisions affecting their health and well-being; and to ensure effective implementation of evidence-based preventive interventions.

Shared Outcome 2.1: Reduced health inequalities through action on social, economic, environmental, and other determinants of health

Emphasis will be placed on actions within the health sector and across sectors that promote well-being and health equity as shared benefits, placing health outcomes at the center of relevant policies and processes.

Priority will be given to strengthening decision-making and resource allocation to ensure universal access to key public goods for health (e.g., clean air, safe food, healthy diets, housing, safe and active transport, clean energy, education, and safe and healthy workplaces).

The role and capacity of the health sector will be strengthened through improved evidence, policy options, analyses (such as Health Impact Assessments and Health Equity Impact Assessments), advocacy, and multisectoral action to apply policy interventions in other key sectors (e.g., transport, food and agriculture systems, social policy, schools and healthy workplaces, housing, water, sanitation) that enhance health across the life course by improving living and working conditions, benefiting from the One Health approach.

Efforts will be made to expand fiscal space for social protection, early childhood services, safe and decent employment, gender equality, food and income security, and to address the impacts of demographic change.

Health sector capacities will be strengthened to assess the health impact of social inequalities and the differential effects of sectoral policies, and to address systemic and structural health barriers such as those related to gender and age.

The work will also examine the increasing influence of trade practices and agreements on health (e.g., related to tobacco and nicotine products, harmful alcohol use, and unhealthy foods) to reduce harm and promote policy coherence and health-protective measures, including safeguarding children and adolescents from exploitative marketing.

Cities and local governments will be supported to implement actions on health determinants across the life course.

Governance for health and well-being will be promoted at all levels and across tiers of government.

Special attention will be given to ensuring that programs reach people in vulnerable situations or facing marginalization and discrimination, including persons with disabilities, migrants, displaced populations, and older adults.

Shared Outcome 2.2: Priority risk factors for noncommunicable and communicable diseases, violence and injury, and poor nutrition are reduced through multisectoral approaches

Multisectoral approaches will be jointly designed and implemented across the life course, including through cost-effective policies based on the right to health, legislation, and regulatory actions, to reduce major risk factors for noncommunicable and communicable diseases, violence, injuries, mental health conditions, and poor nutrition, while considering the need for healthy reablement and rehabilitation.