Health Inequality is on the decline, but impacts are still massive, health inequality causes life expectancy drops in the high 20s, killing billions.

We find that overall health inequalities have decreased globally in the period 1990–2008 (Absolute GiniH down 1.9 years, both sexes combined) (Figure 1a). At the same time overall LE has increased (from 65.9 to 70 years for females and from 61.9 to 65.7 for males). Figure 1b shows the case of Ethiopia, an example of the general trend (LE up 10.1 years and Absolute GiniH down 5.2 years in the period). Globally, females have had greater progression in terms of decreasing within-females absolute health inequality (from 27.4 to 25.2 years) compared to within-men inequality (from 26.7 to 25.1 years). The same overall trend of reduced health inequality applies to all groups of countries stratified by income level (Figure 1c). The low-income, lower middle-income, upper middle-income and highincome group have all seen reduction in disparities in age at death. The lower middle-income group has experienced the greatest improvement (from 27.0 to 23.8 years for females and from 26.0 to 23.7 years for males). Studies of health inequalities related to socioeconomic status frequently present data on quintile gaps, i.e., the gap between health outcome in the upper and lower quintile of wealth. We study overall health inequalities, unassociated with the socioeconomic gradient, and have, therefore, stratified the countries in the world into quintiles based on health outcomes. We find that the gap between the average LE in the upper and lower LE quintiles has increased with 0.7 years (from 27.1 to 27.8 years) in the period 1990–2008. This means that the worse-off group in terms of health is left behind, i.e., that the countries with lowest LE improved more slowly (LE up 3.4 years) than the quintile group of countries with highest LE (LE up 4.2 years). The parabolic shape of the LE-versus-income curve, known as the Preston curve, is mirrored in the Absolute GiniH-versus-income curve (Figure 2). However, when carefully examining this figure, it is evident that the relation between health inequalities and average income is not a perfect correlation of the relation between average health and average income. Consequently, interesting details may appear when examining inter-regional differences or temporal changes in these relations for selected regions and countries.