ABSTRACT
OBJECTIVES: To discuss the evidence of social health inequalities in France and, in this context, to examine the association of social ties and socio-economic status (SES) with self-reported health (SRH). STUDY DESIGN: A literature search and a nationally representative cross-sectional study of 5046 French adults with data about SRH, socio-economic status and relationships with family and friends etc. METHODS: SRH was analysed by three measures of SES: income, education and socioprofessional group. The frequency of five single and four composite measures of social ties by SES was calculated. Logistic regression models estimated the association between SRH and the social ties variables. RESULTS: Compared with other countries in Western Europe, France has large social class health inequalities, particularly in relation to premature male mortality. This study found that 'less than good' SRH was significantly more likely to be reported by people in lower education, lower socioprofessional and lower income groups. Social isolation and weak social relationships were associated with low SES. For eight of the nine variables, weak social ties were associated with 'less than good' SRH even after adjusting for SES. CONCLUSION: Weak social ties are associated with poor health. In the context of a country with large health inequalities, the effect of social isolation on health is independent of SES.
