# The complexity of inequity: rethinking global health through lived experience, power, and structural vulnerability

## TL;DR

This paper argues that global health inequities stem from complex systems of power and vulnerability, not just lack of resources, and calls for a new approach that values lived experiences and structural change.

## Contribution

It introduces a complexity-informed framework integrating structural vulnerability, epistemic justice, and intersectionality to rethink global health inequities.

## Key findings

- Reductionist solutions fail to address the dynamic and relational nature of health inequities.
- Structural arrangements and social meanings shape health outcomes in context-specific ways.
- Achieving equity requires redistributing epistemic authority and institutional power alongside resources.

## Abstract

Global health’s persistent inequities reflect not just gaps in resources or care, but the operation of complex, multi-level systems that inscribe power, vulnerability, and embodied experience. Prevailing frameworks remain too narrow, neglecting how health emerges from intersecting histories, adaptive institutions, and the lived experience of marginalized populations. This perspective advances a complexity-informed rethinking of inequity, integrating insights from structural vulnerability, epistemic justice, intersectionality, and the capability approach to illuminate how reductionist solutions overlook system dynamics and relational harms. By bridging data and narrative, and grounding analysis in both structural critique and lived experience, this work reframes inequity as emergent and fundamentally political. Case examples from maternal health and HIV stigma illustrate how structural arrangements and social meanings contour health in context-dependent ways. The implication is clear: achieving equity requires methodological humility, ethical rigor, and governance reforms that redistribute not only resources, but also epistemic authority and institutional power. This perspective offers an integrated conceptual architecture and calls for actionable transformation reorienting global health toward solidarity, partnership, and justice.