We develop a method for comparing levels and trends in inequality in mortality in the United States and France between 1990 and 2010 in a similar framework. The comparison shows that while income inequality has increased in both the United States and France, inequality in mortality in France remained remarkably low and stable. In the United States, inequality in mortality increased for older groups (especially women) while it decreased for children and young adults. These patterns highlight the fact that despite the strong cross-sectional relationship between income and health, there is no necessary connection between changes in income inequality and changes in health inequality.
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Between 1990 and 1999, a funding reform for public hospitals introduced global budgeting, and Act #91-748 aimed to balance health-care delivery across French regions and to introduce strategic planning for hospitals. The 1996 reform aimed to create “universal health insurance” giving the right to social security to anyone over the age of 18 regularly residing in French territory. Many changes occurred after 2000 as well, including the reorganization of the health insurance governance system starting in 2004.
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We thank the Center for Health and Wellbeing at Princeton University for supporting this research and CépiDc for providing the data used in the analysis. Josselin Thuilliez benefited from a research fellowship at Princeton University and a Fulbright fellowship (2016–2017). We are also thankful to Magali Barbieri, Pierre-Yves Geoffard, Jean-Paul Moatti, and two anonymous referees for useful comments.
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Currie, J., Schwandt, H. & Thuilliez, J. Pauvreté, Egalité, Mortalité: mortality (in)equality in France and the United States. J Popul Econ 33, 197–231 (2020). https://doi.org/10.1007/s00148-019-00736-7
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