“Globally, the pervasive disparities in the health and wellbeing of children are detrimental not only to the poorest and most vulnerable children and their families and communities, but also to the whole of society,” a Lancet editorial states, and writes, “To eliminate such disparities, three major questions need to be answered. How wide is the health gap? What are the underlying and driving factors? What can be done?” The editorial highlights a report (.pdf), “The Killer Gap: A Global Index of Health Inequality for Children,” released by World Vision last week, which “tries to provide the answers,” noting “176 countries around the world are ranked according to the size of the gap between those who have greatest access to health education, awareness, prevention, and treatment, and those who have the most barriers to good health, using the four indicators of life expectancy, personal cost of using health services, adolescent fertility rate, and coverage of health services.”

“The index shows that the greatest gaps persist in the poorest and most fragile contexts and countries, but that a country’s wealth alone does not necessarily guarantee a small health gap, given that the USA, for example, sits only at 46 on the index,” the editorial continues. “There are many other factors beyond poverty — above all, that health systems fail to reach those who suffer most from health inequalities, including children unregistered at birth, children living with disabilities, orphaned children, indigenous children and ethnic minorities, refugees and displaced children, and child laborers and trafficked children,” the editorial states, adding, “The report rightly calls for greater attention to health inequalities at the highest political level, prioritization of child and maternal health in the post-2015 development agenda, and improvement of data collection.” The editorial concludes, “Ahead of the U.N. General Assembly, where the post-2015 development agenda will be discussed, it is timely to remind advocates of child health, together with health professionals (particularly pediatricians), of these remaining inequalities, and to urge collective efforts to close the gap” (9/14).