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

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.

► I analyze the contribution of education to changes in BMI inequality in French adults between 1981 and 2003. ► Educational expansion has reduced overall BMI inequality by 3.4% for women (2.3% for men). ► A steepening education gradient has produced a 10.9% increase in overall inequality for women (+7.6% for men). ► Educational expansion policies can thus reduce overall BMI inequalities. ► Yet, reduction of overall BMI inequality still requires that attention be paid to the education-BMI gradient