An Economist's Perspective on What We Know, Can Know and Need to Know About the Causes of Health Inequality

Session 1: Explaining health inequalities in economics and sociology

Discussion: Cyrille Delpierre (Inserm)

Résumé

Socioeconomic health inequality is substantial, ubiquitous and persistent. From an economics perspective, I review what is known about its causes in high-income countries and consider what can be known and needs to be known. Causal analyses have not yet delivered strong, consistent evidence that education, income and wealth impact health in adulthood, but there is evidence that cash benefits paid to low-income households often improve infant and child health outcomes. Changes in adult health have large effects on income and wealth, and childhood ill-health both persists into adulthood and constrains economic outcomes in that phase of life. What can be known about the causes of health inequality is constrained by the limited scope for causal analysis to identify effects of socioeconomic exposures that potentially take their toll on health over the life course, cumulatively and multiplicatively. To reduce health inequality, its causes need not necessarily be known, provided health policies that improve the health of the socioeconomically disadvantaged can be identified and implemented. Political support for such policies may, however, depend on knowledge (or beliefs) about the causes of health inequality.

Cyrille Delpierre

Cyrille Delpierre is an epidemiologist and Inserm research director. Since 2021, he has headed the Centre d'Épidémiologie et de Recherche en santé des POPulations (CERPOP), a joint Inserm-Université Toulouse III research unit, and is co-leader of the EQUITY team dedicated to the study of social inequalities in health (SII). Her research focuses on the mechanisms by which the social environment is biologically incorporated, how it can affect biological functioning and thus promote the development and progression of disease. His work has two general objectives: i) to explain SSIs not only in terms of physico-chemical exposures, health behaviours and socially distributed care, but also in terms of psychosocial exposures that can modify biological processes and promote the development of pathologies at a distance; ii) to develop or participate in interventions that can reduce SSIs.

Cyrille Delpierre

Cyrille Delpierre is an epidemiologist and Inserm research director. Since 2021, he has headed the Centre d'Épidémiologie et de Recherche en santé des POPulations (CERPOP), a joint Inserm-Université Toulouse III research unit, and is co-leader of the EQUITY team dedicated to the study of social inequalities in health (SII). Her research focuses on the mechanisms by which the social environment is biologically incorporated, how it can affect biological functioning and thus promote the development and progression of disease. His work has two general objectives: i) to explain SSIs not only in terms of physico-chemical exposures, health behaviours and socially distributed care, but also in terms of psychosocial exposures that can modify biological processes and promote the development of pathologies at a distance; ii) to develop or participate in interventions that can reduce SSIs.