Federated Learning (FL) is a rising approach towards collaborative and privacy-preserving machine learning where large-scale medical datasets remain localized to each client. However, the issue of data heterogeneity among clients often compels local models to diverge, leading to suboptimal global models. To mitigate the impact of data heterogeneity on FL performance, we start with analyzing how FL training influence FL performance by decomposing the global loss into three terms: local loss, distribution shift loss and aggregation loss. Remarkably, our loss decomposition reveals that existing local training-based FL methods attempt to reduce the distribution shift loss, while the global aggregation-based FL methods propose better aggregation strategies to reduce the aggregation loss. Nevertheless, a comprehensive joint effort to minimize all three terms is currently limited in the literature, leading to subpar performance when dealing with data heterogeneity challenges. To fill this gap, we propose a novel FL method based on global loss decomposition, called FedLD, to jointly reduce these three loss terms. Our FedLD involves a margin control regularization in local training to reduce the distribution shift loss, and a principal gradient-based server aggregation strategy to reduce the aggregation loss. Notably, under different levels of data heterogeneity, our strategies achieve better and more robust performance on retinal and chest X-ray classification compared to other FL algorithms. Our code is available at \href{https://github.com/Zeng-Shuang/FedLD}{https://github.com/Zeng-Shuang/FedLD}.
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