Inequalities in length of life are the most fundamental of inequalities, as all other inequalities are conditional on being alive. Mortality inequalities are socially patterned, observed in all societies, and growing. Despite considerable contributions by many previous studies, there are major shortcomings in our understanding of the causes of social inequalities in health and mortality. In particular:

• The causes of change in health inequalities over time and in different social and economic conditions remain unclear.
• An overly individualized approach to studying health has failed to account for the fact that health inequalities are produced and maintained in families, which vary in size, generational length, social acceptability, and complexity.
• The interplay between the social and genetic processes that underlie health inequalities is largely unknown.
• The integration of demographic methods, causal inference approaches in epidemiology, and machine learning approaches for the study of social inequalities in health remains weak.

The Max Planck – University of Helsinki Center goes beyond standard observational research by using exceptionally detailed linked family-based data, natural experimental designs, genetically-informed social epidemiological data, and advanced dynamic modelling techniques that enable us to unearth the pivotal social processes that generate health inequalities. Our findings will be ground-breaking as they respond to the four major shortcomings of existing research by elucidating from the root causes of social inequalities in health. The research will be highly innovative and will establish how social family constellations and genetic factors are intertwined with individual social characteristics and how they produce health inequalities, how they drive long-term change in these inequalities, and how they manifest themselves differentially in different macro-level social conditions.

The Center research agenda is based on four thematic pillars:

1. Family; to assess the causes of long-term changes in health inequalities and to establish the contribution of social family factors and multigenerational interdependencies in the production of social inequalities in health
2. Genetic factors; to estimate the effects of social position on health by employing genetic information and to assess how genetic associations are mediated or modified by family and social position
3. Comparisons; to evaluate variations in explanations of social inequalities in health by means of international comparative research, and to analyze macro-level contextual modifiers
4. Methods; to advance causal multistate modeling and to integrate recent advances in counterfactual analysis from neighboring disciplines to inform analyses in Themes 1-3, and demography and population health research more generally.

The need to better understand the root causes of health inequalities is more pertinent than ever. Social inequalities in health and mortality have grown and the unprecedented health and social consequences of the COVID-19 pandemic may hit the vulnerable the hardest, further exacerbating health gaps. Our results will advance scientific understanding of the drivers of health inequalities, and will help to devise policies to tackle these inequalities.