Equality of Opportunity and Mortality in Europe

Abstract

Abstract Background This study investigates if intergenerational equality of opportunity is linked to mortality in 30 European countries. Equality of opportunity may lead to greater returns on health investments, and, consequently, improvement of health outcomes. In turn, a perceived lack of fairness in the distribution of life chances and limited possibilities for upward intergenerational mobility can cause anxiety among individuals and gradually compromise their health. Methods We used information on parents’ and their 163,467 children’s Socio-Economic Index of Occupational Status from a large survey data-set to generate three complementary measures of equality of opportunity and linked them to administrative data on total, gender- and cause-specific mortality rates derived from the national statistical offices. Results We found that lower equality of opportunity, measured by the attainment of individuals from the lowest and highest quartiles of socio-economic status and by the overall intergenerational correlation in socio-economic status, was related to higher mortality rates, particularly in relation to diseases of the nervous system and the sense organs, diseases of the respiratory system, and external causes of mortality. Our measures of equality of opportunity were more consistently linked with mortality of men than women. Conclusions Equality of opportunity may be an important explanation of mortality that warrants further research. Measures that aim at facilitating intergenerational social mobility can be justified, not only due to normative considerations of equality of opportunity, but also in terms of individuals’ chances to enjoy healthy lives. Key messages Intergenerational equality of opportunity was more consistently linked to mortality of men than that of women. Our key message is that equality of opportunity is not only fair but it is also good for health.