IDEAS home Printed from
   My bibliography  Save this article

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


  • Etile, Fabrice


This paper contributes to the debate over the effectiveness of education policies in reducing overall health inequalities as compared to public health actions directed at the less-educated. Recentered Influence Function (RIF) regressions are used to decompose the contribution of education to the changing distribution of Body Mass Index (BMI) in France, between 1981 and 2003, into a composition effect (the shift in population education due to a massive educational expansion), and a structure effect (a changing educational gradient in BMI). Educational expansion has reduced overall BMI inequality by 3.4% for women and 2.3% for men. However, the structure effect on its own has produced a 10.9% increase in overall inequality for women, due to a steeper education gradient starting from the second quartile of the distribution. This structure effect on overall inequality is also large (7.6%) for men, albeit insignificant as it remains concentrated in the last decile. Educational expansion policies can thus reduce overall BMI inequalities; but attention must still be paid to the BMI gradient in education even for policies addressing overall rather than socioeconomic health inequalities.

Suggested Citation

  • Etile, Fabrice, 2014. "Education policies and health inequalities: Evidence from changes in the distribution of Body Mass Index in France, 1981–2003," Economics & Human Biology, Elsevier, vol. 13(C), pages 46-65.
  • Handle: RePEc:eee:ehbiol:v:13:y:2014:i:c:p:46-65 DOI: 10.1016/j.ehb.2013.01.002

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    1. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    2. DiNardo, John & Fortin, Nicole M & Lemieux, Thomas, 1996. "Labor Market Institutions and the Distribution of Wages, 1973-1992: A Semiparametric Approach," Econometrica, Econometric Society, vol. 64(5), pages 1001-1044, September.
    3. David M. Cutler & Edward Glaeser, 2005. "What Explains Differences in Smoking, Drinking, and Other Health-Related Behaviors?," American Economic Review, American Economic Association, vol. 95(2), pages 238-242, May.
    4. Paul Contoyannis & John Wildman, 2007. "Using relative distributions to investigate the body mass index in England and Canada," Health Economics, John Wiley & Sons, Ltd., vol. 16(9), pages 929-944.
    5. Gary S. Becker & Casey B. Mulligan, 1997. "The Endogenous Determination of Time Preference," The Quarterly Journal of Economics, Oxford University Press, vol. 112(3), pages 729-758.
    6. Komlos, John & Brabec, Marek, 2011. "The trend of BMI values of US adults by deciles, birth cohorts 1882-1986 stratified by gender and ethnicity," Economics & Human Biology, Elsevier, vol. 9(3), pages 234-250, July.
    7. Fortin, Nicole & Lemieux, Thomas & Firpo, Sergio, 2011. "Decomposition Methods in Economics," Handbook of Labor Economics, Elsevier.
    8. repec:aph:ajpbhl:10.2105/ajph.2005.084343_4 is not listed on IDEAS
    9. Dean Jolliffe, 2004. "Continuous and robust measures of the overweight epidemic: 1971–2000," Demography, Springer;Population Association of America (PAA), vol. 41(2), pages 303-314, May.
    10. Oaxaca, Ronald, 1973. "Male-Female Wage Differentials in Urban Labor Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 14(3), pages 693-709, October.
    11. David M. Cutler & Edward L. Glaeser & Jesse M. Shapiro, 2003. "Why Have Americans Become More Obese?," Journal of Economic Perspectives, American Economic Association, vol. 17(3), pages 93-118, Summer.
    12. David Madden, 2012. "A profile of obesity in Ireland, 2002–2007," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 175(4), pages 893-914, October.
    13. John M. Evans & Douglas C. Lippoldt & Pascal Marianna, 2001. "Trends in Working Hours in OECD Countries," OECD Labour Market and Social Policy Occasional Papers 45, OECD Publishing.
    14. Grossman, Michael, 2000. "The human capital model," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 7, pages 347-408 Elsevier.
    15. Adam Wagstaff & Eddy van Doorslaer, 2004. "Overall versus socioeconomic health inequality: a measurement framework and two empirical illustrations," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 297-301.
    16. Grossman, Michael, 2004. "The demand for health, 30 years later: a very personal retrospective and prospective reflection," Journal of Health Economics, Elsevier, vol. 23(4), pages 629-636, July.
    17. Costa-Font, Joan & Fabbri, Daniele & Gil, Joan, 2009. "Decomposing body mass index gaps between Mediterranean countries: A counterfactual quantile regression analysis," Economics & Human Biology, Elsevier, vol. 7(3), pages 351-365, December.
    18. Sergio Firpo & Nicole M. Fortin & Thomas Lemieux, 2009. "Unconditional Quantile Regressions," Econometrica, Econometric Society, vol. 77(3), pages 953-973, May.
    19. Fabrice Etilé, 2007. "Social norms, ideal body weight and food attitudes," Health Economics, John Wiley & Sons, Ltd., vol. 16(9), pages 945-966.
    20. Koch, Daniel, 2011. "Waaler revisited: The anthropometrics of mortality," Economics & Human Biology, Elsevier, vol. 9(1), pages 106-117, January.
    21. Jones, Andrew M. & Wildman, John, 2008. "Health, income and relative deprivation: Evidence from the BHPS," Journal of Health Economics, Elsevier, vol. 27(2), pages 308-324, March.
    22. Ruhm Christopher J, 2007. "Current and Future Prevalence of Obesity and Severe Obesity in the United States," Forum for Health Economics & Policy, De Gruyter, vol. 10(2), pages 1-28, September.
    23. Hamermesh, Daniel S., 2010. "Incentives, time use and BMI: The roles of eating, grazing and goods," Economics & Human Biology, Elsevier, vol. 8(1), pages 2-15, March.
    24. repec:dau:papers:123456789/10510 is not listed on IDEAS
    25. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
    26. Eric Maurin & Sandra McNally, 2008. "Vive la Révolution! Long-Term Educational Returns of 1968 to the Angry Students," Journal of Labor Economics, University of Chicago Press, vol. 26, pages 1-33.
    27. Farrell, Phillip & Fuchs, Victor R. & Fuchs, Victor R., 1982. "Schooling and health : The cigarette connection," Journal of Health Economics, Elsevier, vol. 1(3), pages 217-230, December.
    28. Singh-Manoux, Archana & Gourmelen, Julie & Ferrie, Jane & Silventoinen, Karri & Guéguen, Alice & Stringhini, Silvia & Nabi, Hermann & Kivimaki, Mika, 2010. "Trends in the association between height and socioeconomic indicators in France, 1970-2003," Economics & Human Biology, Elsevier, vol. 8(3), pages 396-404, December.
    29. Anderson, Patricia M. & Butcher, Kristin F. & Levine, Phillip B., 2003. "Maternal employment and overweight children," Journal of Health Economics, Elsevier, vol. 22(3), pages 477-504, May.
    30. Burkhauser, Richard V. & Cawley, John, 2008. "Beyond BMI: The value of more accurate measures of fatness and obesity in social science research," Journal of Health Economics, Elsevier, vol. 27(2), pages 519-529, March.
    31. Elo, Irma T. & Preston, Samuel H., 1996. "Educational differentials in mortality: United States, 1979-1985," Social Science & Medicine, Elsevier, vol. 42(1), pages 47-57, January.
    32. Eric Maurin & Theodora Xenogiani, 2007. "Demand for Education and Labor Market Outcomes: Lessons from the Abolition of Compulsory Conscription in France," Journal of Human Resources, University of Wisconsin Press, vol. 42(4).
    33. Mackenbach, Johan P., 2012. "The persistence of health inequalities in modern welfare states: The explanation of a paradox," Social Science & Medicine, Elsevier, vol. 75(4), pages 761-769.
    34. José Mata & José A. F. Machado, 2005. "Counterfactual decomposition of changes in wage distributions using quantile regression," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 20(4), pages 445-465.
    35. repec:aph:ajpbhl:2004:94:9:1560-1566_2 is not listed on IDEAS
    36. David Lessault & Cris Beauchemin, 2009. "Les migrations d’Afrique subsaharienne en Europe : un essor encore limité," Population et Sociétés 452, Institut National d'Études Démographiques (INED).
    37. Lerman, Robert I. & Yitzhaki, Shlomo, 1984. "A note on the calculation and interpretation of the Gini index," Economics Letters, Elsevier, vol. 15(3-4), pages 363-368.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Fiorillo, Damiano & Sabatini, Fabio, 2015. "Structural social capital and health in Italy," Economics & Human Biology, Elsevier, vol. 17(C), pages 129-142.
    2. Apouey, Bénédicte H. & Geoffard, Pierre-Yves, 2016. "Parents’ education and child body weight in France: The trajectory of the gradient in the early years," Economics & Human Biology, Elsevier, vol. 20(C), pages 70-89.
    3. Dang, Rui, 2015. "Explaining the body mass index gaps between Turkish immigrants and Germans in West Germany 2002-2012: A decomposition analysis of socio-economic causes," Ruhr Economic Papers 580, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    4. repec:hal:wpaper:halshs-01223321 is not listed on IDEAS
    5. Averett, Susan L. & Stacey, Nicholas & Wang, Yang, 2014. "Decomposing race and gender differences in underweight and obesity in South Africa," Economics & Human Biology, Elsevier, vol. 15(C), pages 23-40.

    More about this item


    Body Mass Index; Health inequality; Education; Decomposition analysis; Recentered Influence Function regressions;

    JEL classification:

    • C1 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General
    • I1 - Health, Education, and Welfare - - Health


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:ehbiol:v:13:y:2014:i:c:p:46-65. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.