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Background: People in socially disadvantaged groups face a myriad of challenges to their health. Discrimination, based on group status such as gender, immigration generation, race/ethnicity, or religion, are a well-documented health challenge. However, less is known about experiences of discrimination specifically within healthcare settings, and how it may act as a barrier to healthcare. Methods: Using data from a nationally representative survey of France (N = 21,761) with an oversample of immigrants, we examine rates of reported discrimination in healthcare settings, rates of foregoing healthcare, and whether discrimination could explain disparities in foregoing care across social groups. Results: Rates of both reporting discrimination within healthcare and reporting foregone care in the past 12 months were generally highest among women, immigrants from Africa or Overseas France, and Muslims. For all of these groups, experiences of discrimination potentially explained significant proportions of their disparity in foregone care (Percent disparity in foregone care explained for: women = 17%, second-generation immigrants = 8%, Overseas France = 13%, North Africa = 22%, Sub-Saharan Africa = 32%, Muslims = 26%). Rates of foregone care were also higher for those of mixed origin and people who reported "Other Religion", but foregone healthcare was not associated with discrimination for those groups. Conclusions: Experiences of discrimination within the healthcare setting may present a barrier to healthcare for people that are socially disadvantaged due to gender, immigration, race/ethnicity, or religion. Researchers and policymakers should consider barriers to healthcare that lie within the healthcare experience itself as potential intervention targets.

BACKGROUND The Healthy Immigrant Effect (HIE) refers to the fact that recent migrants are in better health than the nonmigrant population in the host country. Central to explaining the HIE is the idea that migrants are positively selected in terms of their socioeconomic and health characteristics when compared to nonmigrants in their country of origin. However, due to a lack of reliable and comparable data, most existing studies rely on socioeconomic and health measures as collected in the host country after migration and do not actually measure selection. OBJECTIVE We directly test selection as an explanation of the HIE among migrants living in France. METHODS Using the French Trajectories and Origins (TeO) survey and Barro-Lee dataset, we construct a direct measure of migrants' educational selectivity. We then test its effect on health differences between migrants and nonmigrants using measures self-rated health, health limitations, and chronic illnesses, by fitting logistic regression and Karlson-Holm-Breen (KHB) decompositions. RESULTS After demonstrating that migrants in France experience an HIE, especially males, we also show that educational level as measured in the host country cannot account for the HIE. By contrast, we provide important evidence that educational selectivity constitutes a significant factor in explaining health disparities between migrant and nonmigrant populations. Ichou & Wallace: The role of educational selectivity in the good health of migrants http://www.demographic-research.org CONTRIBUTION Capitalizing on a novel measure of migrants' educational selectivity, we give credit to the oft-cited but rarely tested theory that the HIE is a consequence of migrants' positive selection.

Immigrants experience an ambiguous social position: on the one hand, they tend to be positively selected on resources from the origin country; on the other, they often occupy the lower rungs of the status ladder in receiving countries. This study explores the implications of this ambiguity for two important individual outcomes: subjective social status and perceived financial situation. We study the diverse sample of immigrants in the European Social Survey and use the fact that, due to country differences in educational distributions, a given education level can entail a very different rank in the sending and receiving countries. We document a robust relationship whereby immigrants who ranked higher in the origin than in the destination country see themselves as being comparatively worse off. This finding suggests that the social position before migration provides an important reference point by which immigrants judge their success in the new country.

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This work examines the validity of the two main assumptions of relative risk-aversion models of educational inequality. We compare the Breen-Goldthorpe (BG) and the Breen-Yaish (BY) models in terms of their assumptions about status maintenance motives and beliefs about the occupational risks associated with educational decisions. Concerning the first assumption, our contribution is threefold. First, we criticise the assumption of the BG model that families aim only at avoiding downward mobility and are insensitive to the prospects of upward mobility. We argue that the loss-aversion assumption proposed by BY is a more realistic formulation of status-maintenance motives. Second, we propose and implement a novel empirical approach to assess the validity of the loss-aversion assumption. Third, we present empirical results based on a sample of families of lower secondary school leavers indicating that families are sensitive to the prospects of both upward and downward mobility, and that the loss-aversion hypothesis of BY is empirically supported. As regards the risky choice assumption, we argue that families may not believe that more ambitious educational options entail occupational risks relative to less ambitious ones. We present empirical evidence indicating that, in France, the academic path is not perceived as a risky option. We conclude that, if the restrictive assumptions of the BG model are removed, relative-risk aversion needs not drive educational inequalities.

Cet article a pour objectif de décrire et d’interpréter empiriquement les différences de résultats scolaires qui se constituent tout au long de la scolarité obligatoire entre enfants de natifs et enfants d’immigrés, et au sein des enfants d’immigrés en France. L’étude se fonde sur l’exploitation de deux enquêtes quantitatives : le « Panel 1997 » du ministère de l’Éducation nationale (N = 9 641) et l’enquête « Trajectoires et origines » de l’Ined (N = 21 761). La contribution de cet article à la sociologie des inégalités scolaires tient à quatre éléments : l’usage de catégories d’origines précises, qui montre l’importance de l’hétérogénéité scolaire au sein de l’ensemble « enfants d’immigrés » ; l’usage de la méthode d’appariement exact, qui permet de ne pas supposer un effet uniforme des propriétés sociales sur les résultats scolaires dans tous les groupes ; l’étude de la formation précoce des inégalités scolaires dès la première année de l’école primaire ; l’interprétation des différences de résultats scolaires par la prise en compte de caractéristiques sociales prémigratoires des immigrés.

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