“Health in Sri Lanka for example is considerably better than it is in Russia, despite considerably higher incomes in Russia than in Sri Lanka.” said Michael Marmot.

“Some low-income countries, Costa Rica, China, India (State of Kerala), and Sri Lanka have achieved a level of good health out of all proportion to expectation based on their level of national income. This suggests strongly that good and equitable health do not depend on a relatively high level of national wealth”, the final report drawn up by the Commission said.

Historical commitment to health as a social goal, social welfare orientation to development, community participation in decision-making processes relevant to health, universal coverage of health services for all social groups and intersectoral linkages for health have been highlighted as factors that matter

The report pointed out that gender equality is thought to be crucial. The equal access of girls to education can make a big difference in determining a community's health said the commission report.