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Equality of Opportunity in Health and Healthcare  

Florence Jusot and Sandy Tubeuf

Recent developments in the analysis of inequality in health and healthcare have turned their interest into an explicit normative understanding of the sources of inequalities that calls upon the concept of equality of opportunity. According to this concept, some sources of inequality are more objectionable than others and could represent priorities for policies aiming to reduce inequality in healthcare use, access, or health status. Equality of opportunity draws a distinction between “legitimate” and “illegitimate” sources of inequality. While legitimate sources of differences can be attributed to the consequences of individual effort (i.e. determinants within the individual’s control), illegitimate sources of differences are related to circumstances (i.e. determinants beyond the individual’s responsibility). The study of inequality of opportunity is rooted in social justice research, and the last decade has seen a rapid growth in empirical work using this literature at the core of its approach in both developed and developing countries. Empirical research on inequality of opportunity in health and healthcare is mainly driven by data availability. Most studies in adult populations are based on data from European countries, especially from the UK, while studies analyzing inequalities of opportunity among children are usually based on data from low- or middle-income countries and focus on children under five years old. Regarding the choice of circumstances, most studies have considered social background to be an illegitimate source of inequality in health and healthcare. Geographical dimensions have also been taken into account, but to a lesser extent, and more frequently in studies focusing on children or those based on data from countries outside Europe. Regarding effort variables or legitimate sources of health inequality, there is wide use of smoking-related variables. Regardless of the population, health outcome, and circumstances considered, scholars have provided evidence of illegitimate inequality in health and healthcare. Studies on inequality of opportunity in healthcare are mainly found in children population; this emphasizes the need to tackle inequality as early as possible.


Education and Social Mobility  

Helena Holmlund and Martin Nybom

Family background is a strong determinant of an individual’s educational achievement and labor market success. Using an economics framework, intergenerational persistence in socioeconomic status can be explained by a variety of factors, including parental investment behavior, credit constraints, and the degree of inequality in society. Genetic transmission from parents to children may also play a role. In addition, the skill formation process is governed by dynamics between different stages of a child’s life, such as complementarities between early and late investments or between informal and formal education. Education policy holds the promise of breaking the strong ties between family background and socioeconomic position by providing publicly accessible education for children of all backgrounds. However, the education system may also perpetuate social inequalities if well-off families are able to protect their children from downward mobility by, for example, moving to neighborhoods with high-quality schools and by providing networks that offer opportunities to succeed. However, a growing number of studies show that educational interventions can have long-lasting effects on students’ outcomes, in particular for disadvantaged students, and that they can be cost-effective. For example, reducing class size, increasing general education spending, tutoring, and improving teacher quality are policy levers that are shown to be successful in this regard. Shifting from selective to comprehensive school systems is also a policy that enhances equality of opportunity. While the evidence on credit constraints and their role for access to higher education is evolving, but still mostly U.S. focused and largely inconclusive, it is a key domain for shaping social mobility given the life-changing impacts that a university degree can have.



Samuel Freeman

Liberalism in politics is associated with nonauthoritarianism, the rule of law, constitutional government with limited powers, and the guarantee of civil and political liberties. A liberal society is tolerant of different religious, philosophical, and ethical doctrines and allows individuals to freely form and express their conscientious convictions and opinions on all matters and live according to their chosen purposes and life paths. In economic terms, liberalism is associated with an unplanned economy with free and competitive markets, as well as private ownership and control of productive resources. The basic institutions that are characteristic of a liberal society are constitutionalism and the rule of law; equal basic rights and liberties; formal equality of opportunity; free, competitive markets with private property in means of production; government’s obligation to provide public goods and a social minimum; and the fiduciary nature of political power to impartially provide for the public good. Liberals interpret these basic institutions differently. Classical liberalism regards extensive property rights and economic liberties as basic, while libertarians see all rights as property rights and as absolute. High liberalism regards economic liberties as subordinate to personal and political liberties and subject to regulation, with redistribution of income and wealth to mitigate gross inequalities and provide all citizens with adequate resources to guarantee the worth of their basic liberties and opportunities.


Changing Global Gender Involvement in Higher Education Participation  

Miriam E. David

The global expansion of higher education since the last quarter of the 20th century reflects political and socioeconomic developments, including opening up economic opportunities and addressing neoliberal agendas such as corporatization, digitization, individualization, and marketization. This process of the so-called massification of higher education has also been called academic capitalism, whereby business models predominate what was once considered a public good and a form of liberal arts education. These transformations have implications for questions of equal opportunity and social justice in regard to gender and sexuality linked to diversity, race, and social class, or intersectionality. Transformations include involvement and participation for students, academics, faculty, and researchers. From a feminist perspective, the various transformations have not increased equality or equity but have instead reinforced notions of male power, misogyny and patriarchy, and social class and privilege, despite the massive increase in involvement of women as students and academics through policies of widening access or participation. The new models of global higher education exacerbate rather than erode inequalities of power and prestige between regions, institutions, and gendered, classed, and raced individuals.