•Health inequalities remain persistent and durable, yet how and why they change over time is less known and examined.•This Special Issue brings together 16 studies examining trends in health inequalities across 20+ countries, including many outside the Global North.•While overall health outcomes improved over time in many studies, inequalities often persisted.•As such, concerted efforts are required to reduce health inequalities specifically, by addressing inequalities in the underlying macrosocial drivers of health.
© 2025 The Authors. Published by Elsevier Ltd.