Addressing health equity and its major challenges

Three major challenges confront public health: inequality, the climate crisis, and political instability. Four domains of recommendations, formulated to respond to the inequality-pandemic cycle, form the basis of what is needed to improve health and health equity. First, address the gross inequalities in the global, and national, economic architecture. Second, take action on the social determinants of health-the eight Marmot Principles provide an evidence-based guide to action. Third, ensure an equitable distribution of health-enhancing technology. Finally, enable community development. Marmot Places, which have been developed in England, Scotland, Wales, and the Republic of Ireland, are a way to combine domains two and four: taking action on social determinants of health at the local level. However, national action is required too, particularly on unfair economic arrangements.