Empirical explorations of the limitations of the Equality of Opportunity framework

This thesis reflects on how to assess unfair inequality in health. Its main arguments are that the Equality of Opportunity framework may be more adequate for this task compared to the framework of socioeconomic health inequalities, but that there are several limitations regarding how the Equality of Opportunity framework has been implemented. The thesis features a systematic literature review and five empirical applications, including three questionnaire-experimental studies. The literature review in Chapter 2 explores how the framework of Equality of Opportunity has been used to assess health inequalities. The third chapter looks at socioeconomic health inequalities in Chile and it shows for the first time that socioeconomic differences in life expectancy have increased in the last two decades. Four limitations of the theory of Equality of Opportunity are explored. Chapter 4 argues that the ‘control approach’ has failed to provide an operational definition of effort. In this respect, it was found that the requirements needed to provide a definition of effort according to such an approach are not satisfied empirically. Chapter 5 shows that there are several challenges to compensate for the indirect effect of circumstances. It was found that an alternative compensation criteria has moderate acceptance among Chilean members of the public. Chapter 6 uses the theory of equivalent income to provide a basis to reduce inequalities among individuals who face the same constraints. This idea finds some support among a representative sample of Chilean adults. Chapter 7 suggests that the ‘preference approach’ may be a better strategy to operationalise effort and circumstances. In this chapter an empirical study assesses Equality of Opportunity according to this approach. The thesis concludes with the proposition that the preference approach and the theory of equivalent income may offer a better alternative to assess unfair inequalities.inequality, equality of opportunity, lifestyles,