Economics serving society

Child health and access to health care in France: Evidence on the role of family income

Bénédicte Apouey and Pierre-Yves Geoffard

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It is well known that France is a country with significant health inequalities: in the period 2000 to 2008, a male blue-collar worker at the age of 35 could expect to live an average of another 40.9 years, while a male white-collar worker could expect to live a further 47.2 years – a difference of 6.3 years. On the other hand, less well known are the determinants of such inequalities and when they first appear: are they already significant at birth and during early infancy, or do they develop during later childhood or adulthood ? In this article, Bénédicte Apouey and Pierre-Yves Geoffard investigate the emergence of health inequalities during infancy. They focus on the link between family income and children’s health (the “health gradient”), by identifying different aspects of health: subjective general health, specific health problems (e.g., respiratory and digestive problems) and anthropometric characteristics (height, weight, BMI, weight problems). They study first the existence of and changes in the health gradient in infancy, then turn their attention to the rôle of specific health problems in the general health gradient. They also quantify the effect of income on children’s anthropometric indicators. For all these calculations, the data used come from the Enquiry into Health and Social Security, between 1996 and 2010, which contain up to 24,000 observations of children.
The results show that household income is highly correlated to the general health of children in France: the better off a family is, the better the general state of its children. While this correlations appears weaker in France than in other developed countries, it could be that in fact it increases during the course of childhood, as in the United States and Canada; more research is necessary to verify this. Nevertheless, there is a correlation and the relationship between family income and general health is underscored by a stronger prevalence of specific health problems among children in the least well-off families (in particular, digestive problems). Income also has an impact on height, BMI and (over)weight problems among these children. Thus, the health–income gradient seen in French adults begins in the earliest years. This study leads us to ponder the rôle of health in the intergenerational transmission of social status.
Original title of the article: Child health and access to health care in France: Evidence on the role of family income
Published in : Epidemiology and Public Health / Revue d’Epidémiologie et de Santé Publique - 2014
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