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A contribution to the analysis of inequalities in health in France using indicators of self-assessed health

Abstract : This dissertation is devoted to two main topics: the measurement and the explanation of health within an analysis of inequalities in health status.

In chapter 1, we review health indicators which are commonly used within empirical analyses and take part in the debate on the use of self-assessed health. We show that there is a challenge to apply recent methodological refinements of the measurement of health proposed in the international literature, which at present, lacks in the French context.

Chapter 2 develops an innovative method of constructing a concrete measure of health by taking into account an individual health information being considered less subjective, namely the number of diseases and their respective severity level. Moreover, the construction considers several variables which are classically collected in health surveys.

Chapter 3 describes, within a framework applied to health, measurement tools such as stochastic dominance and inequality indices, which are commonly used for inequalities analyses.

In chapter 4, we analyse income-related inequalities in health in France in 2004 and in the period 1998-2004. The analysis shows income-related inequalities in health favouring socially advantaged groups. These inequalities have nevertheless decreased between 1998 and 2004, this reduction driven by a lower elasticity of health with income and lower inequalities in income over socioeconomic groups. The analysis being carried out with alternative measurements of health, inequalities in health appear to vary quantitatively with both the number of categories of self-assessed health and the distribution of health used to cardinalise this variable.

Chapter 5 investigates the explanation of health status in adulthood according to social and family background, as measured by the mother's and the father's socioeconomic status, as well as their respective longevity. Three methods are used. The first approach emphasises that distributions of health of individuals born to a father or a mother in higher socioeconomic statuses significantly dominate distributions of health of individuals born to a father or a mother in lower socioeconomic statuses. The parametric approach confirms the effect of social background on health in adulthood. Furthermore, it shows that health in adulthood can be explained significantly by parents' longevity. To conclude, concentration indices of inequalities describe inequalities favouring individuals whose parents had lived longer and inequalities in health favouring individuals born to socially advantaged families. Therefore, this chapter concludes that in France there is a family and social determinism in health.
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Sandy Tubeuf. A contribution to the analysis of inequalities in health in France using indicators of self-assessed health. Economics and Finance. Université de la Méditerranée - Aix-Marseille II, 2008. English. ⟨tel-00288887⟩

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