Income and mortality: an economic analysis of social inequalities in health in France.

Summary This thesis proposes an empirical analysis of the influence of income and income inequalities on mortality in France. To compensate for the lack of information on income in the available demographic data, this analysis was carried out using a case-control survey constructed from two tax databases: the 1988 Wealth at Death survey and the 1990 Household Tax Income survey. This approach makes it possible to identify the determinants of the probability of death in 1988 by comparing the characteristics of a sample of deceased persons with those of a sample of survivors. An initial analysis, carried out using a method of indirect estimation of mortality, shows that the survival function increases with income at each age. The exploitation of the case-control survey confirms the existence of a very strong correlation between income and mortality, after controlling for occupation. The protective effect of income exists at each level of the income distribution. The results indicate an excess mortality associated with poverty but also a less expected effect, an under-mortality associated with higher incomes. A multilevel analysis shows that the level of income inequality in the region of residence is in itself a determinant of mortality after control for health care provision. This thesis suggests that the risk of death depends very strongly on the absolute level of resources of the individual, but also more broadly on his or her economic and social environment.