Economics serving society

Education policies and health inequalities: Evidence from changes in the distribution of Body Mass Index in France, 1981-2003

Fabrice Etilé

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We tend to forget that the democratisation of education can be beneficial for people’s health. It is explained by various factors: higher wages allow better access to care; greater understanding of preventive health campaigns; increased possibilities to imagine oneself in the future...everything points to the fact that the better-educated take better care of themselves. Some economists, including Angus Deaton, even suggest that it is more profitable for public health to invest in general information than in preventive health campaigns that target the least privileged.
In this article, Fabrice Etilé quantifies the contribution of the democratisation of information to the changes in Body Mass Index (BMI) distribution that occurred among French adults between 1981 and 2003. In this period, the prevalence of obesity (a BMI reading above 30) grew from 5.5 per cent to 11.4 per cent. At the same time, the proportion of higher education diplomas increased from 10 per cent to more than 20 per cent. Etilé uses regressions called “unconditional quantiles” to deconstruct the changes in BMI distribution in two kinds of effects: structure effects, chiefly reflecting modifications in the relationship of education to BMI in the period, and composition effects, linked to changes in population characteristics, in particular, the increase in academic achievement. He shows that without the democratisation of information, the prevalence of obesity would have been 14.1 per cent in 2003 (that is, 2.7 points, or 23 per cent greater). In addition, the democratisation of information limited the growth of BMI inequalities (the “spread” of the distribution of BMI, measured by the variance or the Gini coefficient). On the other hand, when we examine BMI inequalities among social groups, the less educated have a greater risk of obesity, which has increased relative to the risk for the more educated.
Democratisation of education has contributed to limiting the growth of obesity in the general population, but there are pronounced inequalities among social groups, which confirm the need to maintain public health programmes that target the least privileged.
Original title of the article : “Education policies and health inequalities: Evidence from changes in the distribution of Body Mass Index in France, 1981-2003”
Published in : Economics & Human Biology, Volume 13, Pages 46–65 - March 2014
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