Effort or Circumstances: Which one matters in health inequality?

This paper attempts to quantify the contribution of inequalities of opportunities and inequalities due to differences in effort to be in good health to overall health inequality in France. It examines three alternative specifications of legitimate and illegitimate inequalities drawing on Roemer, Barry and Swift‟s considerations of circumstances and effort. The issue at stake is how to treat the correlation between circumstances and effort. Using a representative French health survey undertaken in 2006 and partly designed for this purpose, and the natural decomposition of the variance, the contribution of circumstances to inequalities in health ranges between 43% and up to 52% according to the scenario, whereas the contribution of efforts is not beyond 10%. The remaining part is due to the impact of age and sex.