This paper focuses on the sources that are thought to lead to the genesis of health and social inequity in a small island community. It is largely a descriptive exposition, the main aim of which is to introduce the topic in Malta. Small size is the key geographical factor. This fact is dwelt upon to stress that although there are differences, say, between the two inhabitable islands, such differences are very small. Social homogeneity and an almost indiscernible urban-rural difference are strong factors that reduce any tendency for regional inequities. Socio-cultural factors in Malta are largely determined by family life and its relation with the established church. The traditional Catholic way of life is depicted as gradually giving way to a more secular lifestyle. Politics is represented as the prime factor for causing division within the this society. This is not without reason since this factor has taken over the other cause of division, namely parochialism. Political factors determine the distribution of resources including health resources. The important economic factors are that there are no great differences between the high income and the low income groups. However, due importance must always be given to the subterranean economy. The health profile is that of a developed country with low infant mortality and a long life expectancy. Infectious diseases have been on the decline and their persistence is usually linked to areas that have remained underdeveloped. The disadvantaged groups identified are the chronically unemployed, single mothers, possibly a section of the migrant population and the elderly.