Across the 53 Member States of the WHO European Region, tackling inequalities is the major challenge. Understanding the importance of mental health can help us to think more critically about the limits of economic growth and what wealth can achieve and to promote greater awareness of the benefits of reducing inequalities. This is not about utopian visions: the comparison between Sweden and the United Kingdom shows that relatively small differences in levels of inequality can have very significant effects on health. While there is no evidence that people can adapt psychologically to high levels of inequality, there is considerable evidence.