Inequalities of Opportunities in Health and Natural Reward: a European Perspective

Purpose: This paper aims to quantify inequalities of opportunities in health in Europe and to assess whether the way the correlation between effort towards health and circumstances empirically matters for the magnitude of inequalities of opportunities. Methodology: This paper considers two alternative normative ways of treating the correlation between effort and circumstances championed by Barry and Roemer, and combine regression analysis with inequality measures to compare inequality of opportunities in health within Europe. This paper uses the Retrospective Survey of SHARELIFE focusing on life histories of European people aged 50 and over. Findings: Our results show considerable inequalities of opportunity in health in Germany, Spain, Italy, Denmark, Greece and Belgium whereas Sweden and Switzerland show low inequalities of opportunities in health. The normative principle considered makes little difference in Austria, France, Czech Republic, Sweden and Switzerland whereas it appears to matter in the Netherlands, Poland, Germany, Spain, Italy, Denmark, Greece and Belgium. Research implications: Our results suggest a strong social and family determinism of lifestyles in the Netherlands, Poland, Germany, Denmark, Belgium and the Mediterranean which emphasized the importance of inequalities of opportunities in health within those countries. In terms of public health and social policies, it appears that reducing social and unhealthy lifestyles reproduction across generations would provide important benefits on health. On the other hand Austria, France, and Czech Republic show high inequalities of opportunities in health mainly driven by social and family background affecting adult health directly, and so would require policies compensating for poorer initial conditions