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Equality of opportunity is linked to lower mortality in Europe
  1. Alexi Gugushvili1,2,
  2. Caspar Kaiser1
  1. 1 Department of Social Policy and Intervention and Nuffield College, University of Oxford, Oxford, UK
  2. 2 Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to Dr Alexi Gugushvili, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Postbus 1738, 3000 DR Rotterdam, The Netherlands; gugushvili{at}


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, improved 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 163 467 individuals’ and their parents’ Socio-Economic Index of Occupational Status from a large survey data set—the European Social Survey—to generate three complementary measures of equality of opportunity. We then linked these to administrative data on total, gender-specific and cause-specific mortality rates assembled by Eurostat 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 socioeconomic status and by the overall intergenerational correlation in socioeconomic 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.

Conclusion 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 via normative considerations of equality of opportunity but also in terms of individuals’ chances to enjoy healthy lives.

  • mortality
  • social epidemiology
  • social inequalities
  • health inequalities
  • socio-economic

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  • Contributors AG and CK devised the study. AG and CK acquired and prepared the data. AG and CK conducted the analyses and interpretation of data. AG and CK wrote the manuscript.

  • Funding Authors acknowledge financial support from the Oxford University Press John Fell Fund—reference number 162/037.

  • Disclaimer The sponsor did not play any role in study design; in the analysis and interpretation of data; in the writing of the report and in the decision to submit the article for publication.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study did not require ethical approval as it used publicly available secondary survey and administrative data.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository.

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