Adult health and inequality of opportunity in Spain

We apply the theory of inequality of opportunity to examine health inequality among adults in Spain. Using a survey module conducted by the Centro de Investigaciones Sociológicas (CIS) in 2017, we assess the role played by and disentangle the contributions of circumstances, efforts and lifestyles, and demographic variables in explaining adult health inequality. Additionally, we analyse the mediating role of individual education in the relationship between circumstances and health. Our findings underscore the significant relevance of unfair factors (circumstances) and demographics in the generation of adult health inequality, as opposed to the minimal contribution of fair factors (efforts and lifestyles). Furthermore, we show that education significantly influences health, mitigating the impact of certain circumstances and serving as a transmission channel for others. In light of these findings, individuals' efforts and lifestyles alone are insufficient to counterbalance unfair circumstances beyond their control. Therefore, improving circumstances and early-life factors, or reducing their impact on health through the implementation of compensatory policies, is essential for reducing health inequality and promoting equal opportunities for inclusive development.