Capital, Migration and Health Status: a French Data Analysis

Presenter: Florence Jusot, Paris-Dauphine University

Abstract

As social health inequalities are well documented in general population in France, few studies have focused on migrants population due to the lack of information on nationality and country of birth in most of health survey, and social capital is scarcely considered as potential explanatory factors of health status. And yet, a growing body of literature suggests that a high level of social capital enhances population health outcomes and reduces health differences. Moreover, social capital seems to be a particularly relevant health determinant for vulnerable populations, such as migrant population. However, the causal impact of social capital on health status needs to be explored.
The purpose of this paper is then to examine health differences between migrants and native population in France and to explore the role of social capital in the explanation of inequalities in health.
We use a general health survey representative of the French population, the 2006 French Health, Health Care and Insurance Survey (ESPS: Enquête sur la Santé et la Protection Sociale”), which is the unique data source in France providing information on self-reported health status, nationality and three indicators for social capital (civic engagement, social isolation and sense of control at work). We first compare health status and access to social capital between migrants and native population and estimate the correlation between health and social capital. Then, to estimate the causal impact of social capital on health status we attempt to solve the endogeneity problem by using instrumentals variables (religious rituals and spoken language during childhood).
Our results show that migrant population has poorer self assessed health and less access to social capital than native population in France. Being migrant and having a high level of social capital (i.e. to participate in association, not to have suffered from isolation and to have some autonomy at work) is also associated to a better health status. However, our results suggest that the causality between social capital and health is ambiguous. When we rely on IV estimators, civic engagement and social isolation do not explain any more health status. Unlike, sense of control at work is related to health but not in the expected direction since individuals who state having autonomy at work are in poorer health status.
These findings suggest that migratory status and access to social capital are associated with individual health status and therefore explain social inequalities in health in France. We could not prove hardly the causal relationship between social capital and health. Those results suggest further research to properly address to the endogeneity issue of social capital.