Social Sustainability
#7Key Findings
France performs well in international comparison (rank 7) with regard to social sustainability.
Public expenditure on education is above the OECD average. Students performed slightly below the OECD average in the 2022 PISA study, with socioeconomic status strongly influencing student performance. Ongoing reforms have created some instability in the education system, especially in secondary education.
The welfare state in France is generous. Social transfers significantly reduce poverty. Housing costs and access are concerns, especially for migrants. The high-quality healthcare system provides good access to care, with low out-of-pocket payments. The pension system is generous, but faces persistent deficits even after reforms.
Gender equality has improved, but the gender wage gap persists. Childcare is affordable, but there is a shortage of facilities. Schooling is mandatory as of the age of three. Integration of second- and even third-generation immigrants has been a challenge. Right-wing parties have exploited the immigration issue, and have thereby helped shape the political agenda.
Public expenditure on education is above the OECD average. Students performed slightly below the OECD average in the 2022 PISA study, with socioeconomic status strongly influencing student performance. Ongoing reforms have created some instability in the education system, especially in secondary education.
The welfare state in France is generous. Social transfers significantly reduce poverty. Housing costs and access are concerns, especially for migrants. The high-quality healthcare system provides good access to care, with low out-of-pocket payments. The pension system is generous, but faces persistent deficits even after reforms.
Gender equality has improved, but the gender wage gap persists. Childcare is affordable, but there is a shortage of facilities. Schooling is mandatory as of the age of three. Integration of second- and even third-generation immigrants has been a challenge. Right-wing parties have exploited the immigration issue, and have thereby helped shape the political agenda.
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To what extent do policies and regulations in the education system hinder or facilitate high-quality education and training?
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Education policies are fully aligned with the goal of ensuring high-quality education and training.
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Education policies are largely aligned with the goal of ensuring high-quality education and training.
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Education policies are only somewhat aligned with the goal of ensuring high-quality education and training.
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1
Education policies are not at all aligned with the goal of ensuring high-quality education and training.
France’s education system is rather successful. Public expenditure on education amounted to 5.2% of GDP in 2022, slightly above the OECD average. Over the past 20 years, the share of university graduates among 25- to 34-year-olds has increased from 31% to 50%. Tertiary education very substantially increases employment opportunities; the employment rate reaches 86% for those with tertiary attainment, compared to 53% for those who did not finish secondary school, and 74% for those who did, but went no farther. Tertiary education also influences wages very substantially; wages among those with a tertiary qualification are on average 55% higher than among those with only a secondary degree.
Conversely, this means students with attainment levels below an upper secondary qualification are particularly disadvantaged in the French labor market. The public school system is not well aligned with labor market demands. Especially for young people with lower education attainment levels, it is particularly difficult to integrate into the labor market. While combined school and work-based learning programs (dual training) have become more common in recent years thanks to incentives provided by the Macron administration, they are still not sufficient. The traditionally high rate of youth unemployment in France is linked to this problem.
In the last PISA study (2022), French students overall performed slightly below the OECD average (but slightly above in the reading category). France ranks among the lower-performing countries (21st out of 30). Like most OECD countries, it experienced a decrease in performance over the 2018 – 2022 period, mostly as a result of the pandemic. Moreover, France is one of the countries in which performance most closely correlates to socioeconomic status, although the pandemic does not appear to have strengthened this link.
Higher education is dual, with a broad range of excellent elite institutions – prestigious lycées and grandes écoles – and a large mass university system, which is poorly funded and poorly managed and does not prepare its students well for successful entry into the labor market. Spending on universities is below the OECD average. More importantly, dropout rates are dramatic: Only 40% of initially registered students ultimately obtain a university degree.
Another worrying element concerns the growing share of private education, which currently accounts for about 17.6% of French students between the primary and high school levels. Recently, repeated teacher absences, especially in public secondary schools, have been a focus of public complaints. Average teacher salaries are below the OECD average, and pay increases have been slow to arrive.
While a number of reforms have been ongoing, they have created some degree of instability. For instance, a secondary reform temporarily offered students the possibility of opting out of math instruction for the last two years of high school. This has now been reversed, but illustrates a certain lack of direction and unclear general strategy.
Salary increases for teachers are slow at the start of their careers. After acquiring 10 or 15 years’ experience, the statutory salary earned by primary school teachers and secondary school teachers was at least 15% lower than the average salary (2021 – 2022 school year).
Education with a focus on sustainable development has become a cross-subject pedagogical goal. Specific activities have included a competition between schools to save energy, gardening projects on school premises and a labeling project (E3D) that denotes institutions that have enacted a global sustainable development strategy.
Citations:
Ministère de l’Education. “Education au développement durable.” https://www.education.gouv.fr/l-education-au-developpement-durable-7136
OECD. 2023. Education at a Glance: France.
Conversely, this means students with attainment levels below an upper secondary qualification are particularly disadvantaged in the French labor market. The public school system is not well aligned with labor market demands. Especially for young people with lower education attainment levels, it is particularly difficult to integrate into the labor market. While combined school and work-based learning programs (dual training) have become more common in recent years thanks to incentives provided by the Macron administration, they are still not sufficient. The traditionally high rate of youth unemployment in France is linked to this problem.
In the last PISA study (2022), French students overall performed slightly below the OECD average (but slightly above in the reading category). France ranks among the lower-performing countries (21st out of 30). Like most OECD countries, it experienced a decrease in performance over the 2018 – 2022 period, mostly as a result of the pandemic. Moreover, France is one of the countries in which performance most closely correlates to socioeconomic status, although the pandemic does not appear to have strengthened this link.
Higher education is dual, with a broad range of excellent elite institutions – prestigious lycées and grandes écoles – and a large mass university system, which is poorly funded and poorly managed and does not prepare its students well for successful entry into the labor market. Spending on universities is below the OECD average. More importantly, dropout rates are dramatic: Only 40% of initially registered students ultimately obtain a university degree.
Another worrying element concerns the growing share of private education, which currently accounts for about 17.6% of French students between the primary and high school levels. Recently, repeated teacher absences, especially in public secondary schools, have been a focus of public complaints. Average teacher salaries are below the OECD average, and pay increases have been slow to arrive.
While a number of reforms have been ongoing, they have created some degree of instability. For instance, a secondary reform temporarily offered students the possibility of opting out of math instruction for the last two years of high school. This has now been reversed, but illustrates a certain lack of direction and unclear general strategy.
Salary increases for teachers are slow at the start of their careers. After acquiring 10 or 15 years’ experience, the statutory salary earned by primary school teachers and secondary school teachers was at least 15% lower than the average salary (2021 – 2022 school year).
Education with a focus on sustainable development has become a cross-subject pedagogical goal. Specific activities have included a competition between schools to save energy, gardening projects on school premises and a labeling project (E3D) that denotes institutions that have enacted a global sustainable development strategy.
Citations:
Ministère de l’Education. “Education au développement durable.” https://www.education.gouv.fr/l-education-au-developpement-durable-7136
OECD. 2023. Education at a Glance: France.
To what extent does the current policy approach in the education system hinder or facilitate equitable access to high-quality education and training?
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Education policies are fully aligned with the goal of ensuring equitable access to high-quality education and training.
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Education policies are largely aligned with the goal of ensuring equitable access to high-quality education and training.
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Education policies are only somewhat aligned with the goal of ensuring equitable access to high-quality education and training.
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1
Education policies are not at all aligned with the goal of ensuring equitable access to high-quality education and training.
Compulsory education in France begins at age three, which means 100% of these children attend preschool institutions. It ends at age 16, although 90% of the population is enrolled until age 17. There is a de facto training obligation until age 18. The overall child-teacher ratio is comparatively high at 23:1 (compared to 15:1 in the OECD overall), but the ratio falls 14:1 in primary schools, thanks to specialized preschool helpers.
Although public expenditure per student is above the OECD average at the secondary level, it remains lower at the primary level, despite catch-up efforts that have been ongoing since 2012 (Girard 2023).
The 2022 PISA study confirmed that French students’ performance was more strongly correlated with socioeconomic status than was the case elsewhere. France places in the lower third of OECD countries regarding math attainment and socioeconomic background. It also has an above-average share of low achievers across all three PISA test categories.
A recent study suggests that the influence of socioeconomic status on performance is evident beginning as early as preschool (see Goudeau et al. 2023).
Citations:
Goudeau, Sébastien, et al. 2023. “Unequal Opportunities from the Start: Socioeconomic Disparities in Classroom Participation in Preschool.” Journal of Experimental Psychology: General 152 (11): 3135–3152. https://doi.org/10.1037/xge0001437.
Girard. 2023. “Dépenses d’éducation: la France investit peu par rapport aux autres pays de l’OCDE.” L’Étudiant/EducPros, June 1. Retrieved 11 March 2024 from https://www.letudiant.fr/educpros/actualite/depenses-deducation-la-france-investit-peu-par-rapport-aux-autres-pays-de-locde.html
Although public expenditure per student is above the OECD average at the secondary level, it remains lower at the primary level, despite catch-up efforts that have been ongoing since 2012 (Girard 2023).
The 2022 PISA study confirmed that French students’ performance was more strongly correlated with socioeconomic status than was the case elsewhere. France places in the lower third of OECD countries regarding math attainment and socioeconomic background. It also has an above-average share of low achievers across all three PISA test categories.
A recent study suggests that the influence of socioeconomic status on performance is evident beginning as early as preschool (see Goudeau et al. 2023).
Citations:
Goudeau, Sébastien, et al. 2023. “Unequal Opportunities from the Start: Socioeconomic Disparities in Classroom Participation in Preschool.” Journal of Experimental Psychology: General 152 (11): 3135–3152. https://doi.org/10.1037/xge0001437.
Girard. 2023. “Dépenses d’éducation: la France investit peu par rapport aux autres pays de l’OCDE.” L’Étudiant/EducPros, June 1. Retrieved 11 March 2024 from https://www.letudiant.fr/educpros/actualite/depenses-deducation-la-france-investit-peu-par-rapport-aux-autres-pays-de-locde.html
Graph View
To what extent do existing institutions ensure equal access to essential services and basic income support for those in need?
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Existing essential public services and basic income support are fully aligned with the goal of ensuring equal access for those in need.
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Existing essential public services and basic income support are largely aligned with the goal of ensuring equal access for those in need.
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Existing essential public services and basic income support are only somewhat aligned with the goal of ensuring equal access for those in need.
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Existing essential public services and basic income support are not at all aligned with the goal of ensuring equal access for those in need.
By international and European standards, the French welfare state is generous and covers all possible dimensions affecting collective and individual welfare, not only for citizens but also for foreign residents. The impact of social transfers on poverty reduction is relatively high, with poverty rates remaining comparatively low. Therefore, programs providing minimum incomes, health protection and financial support to the poor and to families can be deemed satisfactory, as they effectively support social inclusion. The state moreover made considerable efforts to maintain income levels despite the pandemic. The minimum salary does guarantee a decent standard of living. This is less clear for the minimum social income (Revenu social d’activité, RSA), which currently amounts to €607 per month. Approximately 1.88 million French were receiving the RSA at the time of writing.
A problem remains concerning effective access to basic social services and basic income support. For instance, 34% of citizens eligible for the RSA minimum income did not apply for it in 2018 (Caisse des dépôts 2022). Public policies have sought to improve this situation. The national anti-poverty strategy launched in 2018 has simplified procedures, improved information via online services and mobile service buses that visit recipients’ neighborhoods, and made other improvements. Progress seems to be slow, however (Caisse des dépôts 2022; Vie publique 2022).
The share of young people neither in employment or in training (NEET) remains very high, with France ranking only 24th out of the 30 OECD countries (with a high NEET share corresponding to a low rating). Similarly, the share of the population experiencing severe levels of material or social deprivation remains comparatively high, as does the share of the population that cannot afford a broadband internet connection.
Gaining access to housing is difficult and expensive. Housing is the largest expenditure item for the vast majority of households, accounting for nearly 21% on average, but often rising to near 30% for those without access to public housing (Fondation Abbé Pierre 2023, p. 253). Housing subsidies have been cut under the current government. Research has shown that access to housing is even more difficult for migrants, due to discrimination. New measures presented in 2023 focused on access to home ownership.
Citations:
Fondation Abbé Pierre. 2023. 28e Rapport sur l’etat du mal-logement en France.
Caisse des dépôts. 2022. “Améliorer l’accès des plus fragiles à leurs droits sociaux.” https://politiques-sociales.caissedesdepots.fr/ameliorer-lacces-des-plus-fragiles-leurs-droits-sociaux
Vie publique. 2022. “Stratégie de lutte contre la pauvreté : un état de sa mise en oeuvre.” https://www.vie-publique.fr/en-bref/285957-strategie-de-lutte-contre-la-pauvrete-un-etat-de-sa-mise-en-oeuvre
A problem remains concerning effective access to basic social services and basic income support. For instance, 34% of citizens eligible for the RSA minimum income did not apply for it in 2018 (Caisse des dépôts 2022). Public policies have sought to improve this situation. The national anti-poverty strategy launched in 2018 has simplified procedures, improved information via online services and mobile service buses that visit recipients’ neighborhoods, and made other improvements. Progress seems to be slow, however (Caisse des dépôts 2022; Vie publique 2022).
The share of young people neither in employment or in training (NEET) remains very high, with France ranking only 24th out of the 30 OECD countries (with a high NEET share corresponding to a low rating). Similarly, the share of the population experiencing severe levels of material or social deprivation remains comparatively high, as does the share of the population that cannot afford a broadband internet connection.
Gaining access to housing is difficult and expensive. Housing is the largest expenditure item for the vast majority of households, accounting for nearly 21% on average, but often rising to near 30% for those without access to public housing (Fondation Abbé Pierre 2023, p. 253). Housing subsidies have been cut under the current government. Research has shown that access to housing is even more difficult for migrants, due to discrimination. New measures presented in 2023 focused on access to home ownership.
Citations:
Fondation Abbé Pierre. 2023. 28e Rapport sur l’etat du mal-logement en France.
Caisse des dépôts. 2022. “Améliorer l’accès des plus fragiles à leurs droits sociaux.” https://politiques-sociales.caissedesdepots.fr/ameliorer-lacces-des-plus-fragiles-leurs-droits-sociaux
Vie publique. 2022. “Stratégie de lutte contre la pauvreté : un état de sa mise en oeuvre.” https://www.vie-publique.fr/en-bref/285957-strategie-de-lutte-contre-la-pauvrete-un-etat-de-sa-mise-en-oeuvre
To what extent do existing institutions and policies ensure high-quality services and basic income support?
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Existing essential public services and basic income support are fully aligned with the goal of satisfying basic human needs.
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Existing essential public services and basic income support are largely aligned with the goal of satisfying basic human needs.
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Existing essential public services and basic income support are only somewhat aligned with the goal of satisfying basic human needs.
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Existing essential public services and basic income support are not at all aligned with the goal of satisfying basic human needs.
Minimum income requirements do – in principle – allow for the satisfaction of basic human needs, whereas the situation is more complicated for persons living on the basic social income (RSA). The latter will usually limit access to decent housing.
By law, every legal resident in France is entitled to a bank account. An individual that has trouble opening an account may demand support from the French central bank, whose services will designate a bank that must open an account on behalf of that person.
Public transport is accessible to more than 70% of French residents. Yet France’s large size limits access to public transportation services outside urban areas. Moreover, rising fuel prices have raised the cost of private transport since Russia’s invasion of Ukraine. Although the government initially subsidized fuel massively to keep prices low, most aid has been phased out since early 2023. Residents can still apply for a conditional €100 subsidy.
Finally, significant inequalities remain in the digital infrastructure, with an estimated 4.5 million people lacking internet access. This also creates an increasingly pressing inequality with regard to people’s effective ability to access (public) services that are increasingly and sometimes exclusively provided on the internet.
Citations:
Union des transports publics et ferroviaires. 2023. “Le chiffres clés du transport public.”
By law, every legal resident in France is entitled to a bank account. An individual that has trouble opening an account may demand support from the French central bank, whose services will designate a bank that must open an account on behalf of that person.
Public transport is accessible to more than 70% of French residents. Yet France’s large size limits access to public transportation services outside urban areas. Moreover, rising fuel prices have raised the cost of private transport since Russia’s invasion of Ukraine. Although the government initially subsidized fuel massively to keep prices low, most aid has been phased out since early 2023. Residents can still apply for a conditional €100 subsidy.
Finally, significant inequalities remain in the digital infrastructure, with an estimated 4.5 million people lacking internet access. This also creates an increasingly pressing inequality with regard to people’s effective ability to access (public) services that are increasingly and sometimes exclusively provided on the internet.
Citations:
Union des transports publics et ferroviaires. 2023. “Le chiffres clés du transport public.”
Graph View
To what extent does current health policy hinder or facilitate health system resilience?
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Health policies are fully aligned with the goal of achieving a resilient health system.
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Health policies are largely aligned with the goal of achieving a resilient health system.
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Health policies are only somewhat aligned with the goal of achieving a resilient health system.
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Health policies are not at all aligned with the goal of achieving a resilient health system.
France has a high-quality health system that is generous and largely inclusive. Since its inception, it has been a public system based on compulsory, uniform insurance for all French citizens, with employers’ and employees’ contributions calculated according to wage levels. In addition, a general social contribution taxes different sources of income. Together with widespread complementary insurance programs, these cover most individual costs. About 12% of GDP is spent on healthcare – one of the highest such ratios in Europe.
The pandemic tested the resilience of the health system. It has left a lasting imprint, and the insufficiencies exposed in the system have not been resolved despite a significant increase in public spending on health in 2021 to 12.3% of GDP, over one percentage point above pre-pandemic levels. Many hospital services are understaffed, as nurses resigned following the pandemic despite efforts to improve salaries. The physician-population ratio is lower than in most Nordic countries, but also lower than in Italy or Spain. In certain regions, it has become difficult to find a general practitioner to consult. This is especially true of rural and semi-rural areas, but also of poorer urban neighborhoods (OECD 2023, p. 10). As physicians are free to choose their places of practice, certain areas have been systematically avoided. A number of measures – especially financial incentives – have been implemented over the past decade with the intention of countering this trend, but with little success.
Some of these shortcomings may be due to coordination costs and inefficient management. The current administration has focused on primary healthcare with the aim of alleviating pressure on hospitals. Regional health authorities (ARS) are now co-managing health expenditures with the ministry at the regional level.
Citations:
European Observatory on Health Systems and Policies. 2023. “France: Health System Review.”
François Langlot. 2023. “Système de santé : sortir de la ‘crise sans fin’ n’est pas qu’une question de moyens.” The Conversation, January 10.
OECD. 2023. “France: Country Health Profile 2023.” https://eurohealthobservatory.who.int/publications/m/france-country-health-profile-2023
The pandemic tested the resilience of the health system. It has left a lasting imprint, and the insufficiencies exposed in the system have not been resolved despite a significant increase in public spending on health in 2021 to 12.3% of GDP, over one percentage point above pre-pandemic levels. Many hospital services are understaffed, as nurses resigned following the pandemic despite efforts to improve salaries. The physician-population ratio is lower than in most Nordic countries, but also lower than in Italy or Spain. In certain regions, it has become difficult to find a general practitioner to consult. This is especially true of rural and semi-rural areas, but also of poorer urban neighborhoods (OECD 2023, p. 10). As physicians are free to choose their places of practice, certain areas have been systematically avoided. A number of measures – especially financial incentives – have been implemented over the past decade with the intention of countering this trend, but with little success.
Some of these shortcomings may be due to coordination costs and inefficient management. The current administration has focused on primary healthcare with the aim of alleviating pressure on hospitals. Regional health authorities (ARS) are now co-managing health expenditures with the ministry at the regional level.
Citations:
European Observatory on Health Systems and Policies. 2023. “France: Health System Review.”
François Langlot. 2023. “Système de santé : sortir de la ‘crise sans fin’ n’est pas qu’une question de moyens.” The Conversation, January 10.
OECD. 2023. “France: Country Health Profile 2023.” https://eurohealthobservatory.who.int/publications/m/france-country-health-profile-2023
To what extent does current health policy hinder or facilitate achieving high-quality healthcare?
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Health policies are fully aligned with the goal of achieving high-quality healthcare.
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Health policies are largely aligned with the goal of achieving high-quality healthcare.
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Health policies are only somewhat aligned with the goal of achieving high-quality healthcare.
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Health policies are not at all aligned with the goal of achieving high-quality healthcare.
Created in 2016, the French Public Health Agency (Santé publique France, SPF) is the principal agency in charge of public health policy. Its competencies include health promotion and education, public health surveillance, disease prevention, and health monitoring. It works in part through regional branches offices located within regional health authorities.
The SPF uses national information campaigns to promote healthy eating, physical exercise or smoking cessation. Since 2017, general practitioners have been allowed to prescribe physical exercise to patients with certain types of conditions, such as diabetes or heart problems. The SPF has also overseen the implementation of an official food rating system, called “nutriscore,” which became mandatory in 2021.
The Ministry of Health has implemented three national cancer screening programs (breast, cervical and colon). Since 2004, all women between 50 and 74 have had access to a biannual mammogram and examination free of charge. A new Cancer Plan 2021 – 2030 aims to increase the number of tests and reduce avoidable deaths by 50,000 per year. The program has benefited from increased funding compared to earlier periods. Other forms of screening and follow-ups are provided by GPs and gynecologists, especially during pregnancy, with patients receiving 100% reimbursement.
There have been important efforts to promote “integrated care,” especially for the elderly, based on substantial experimental evidence. Several programs of this kind have been organized at the regional level. There is little available evidence at this stage as to their effectiveness.
Smoking rates remain high in France, with 24% of the adult population smoking compared to an OECD average of 17%. France also has relatively high levels of alcohol consumption with an average of 11 liters per adult per year (2019) compared to nine across the OECD as a whole. Rates of self-reported obesity are slightly lower than in neighboring countries, but have been increasing among adolescents. The food rating system appears to be having positive effects in this area.
Citations:
“Icope à Toulouse.” La Santé en Action no. 459, March 2022.
The SPF uses national information campaigns to promote healthy eating, physical exercise or smoking cessation. Since 2017, general practitioners have been allowed to prescribe physical exercise to patients with certain types of conditions, such as diabetes or heart problems. The SPF has also overseen the implementation of an official food rating system, called “nutriscore,” which became mandatory in 2021.
The Ministry of Health has implemented three national cancer screening programs (breast, cervical and colon). Since 2004, all women between 50 and 74 have had access to a biannual mammogram and examination free of charge. A new Cancer Plan 2021 – 2030 aims to increase the number of tests and reduce avoidable deaths by 50,000 per year. The program has benefited from increased funding compared to earlier periods. Other forms of screening and follow-ups are provided by GPs and gynecologists, especially during pregnancy, with patients receiving 100% reimbursement.
There have been important efforts to promote “integrated care,” especially for the elderly, based on substantial experimental evidence. Several programs of this kind have been organized at the regional level. There is little available evidence at this stage as to their effectiveness.
Smoking rates remain high in France, with 24% of the adult population smoking compared to an OECD average of 17%. France also has relatively high levels of alcohol consumption with an average of 11 liters per adult per year (2019) compared to nine across the OECD as a whole. Rates of self-reported obesity are slightly lower than in neighboring countries, but have been increasing among adolescents. The food rating system appears to be having positive effects in this area.
Citations:
“Icope à Toulouse.” La Santé en Action no. 459, March 2022.
To what extent does current health policy hinder or facilitate equitable access to high-quality healthcare?
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Health policies are fully aligned with the goal of achieving equitable access to high-quality healthcare.
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Health policies are largely aligned with the goal of achieving equitable access to high-quality healthcare.
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Health policies are only somewhat aligned with the goal of achieving equitable access to high-quality healthcare.
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Health policies are not at all aligned with the goal of achieving equitable access to high-quality healthcare.
The French healthcare system provides good access to care with low out-of-pocket payments (OECD 2023).
Two sources of inequality can be identified: one financial and one geographical. Cost-sharing, in which the statutory health insurance program often reimburses only a tiny share of the patient’s expenditure, may constitute an insurmountable burden for low-income households. This being said, there are specific schemes for protecting very low-income and chronically ill populations from cost-sharing and up-front payments. Furthermore, the situation has improved recently for basic dentures, hearing aids and optical services, but remains problematic when it comes to consulting certain specialists. However, most of the population relies on complementary health insurance programs that are not tied to incomes, and thus create significant differences in access.
These problems may become particularly problematic when combined with geographical inequalities. Even basic primary care can be very difficult to access in certain areas. Despite the advertised goal of creating multidisciplinary primary care units, there has not been a substantial improvement in coverage. Access times for outpatient settings may diverge widely; waiting times can be significant, and appear to be increasing. According to Eurostat figures, unmet care needs in France were slightly higher than the EU average in 2021.
Citations:
OECD. 2023. “France: Country Health Profile 2023.” https://eurohealthobservatory.who.int/publications/m/france-country-health-profile-2023
Two sources of inequality can be identified: one financial and one geographical. Cost-sharing, in which the statutory health insurance program often reimburses only a tiny share of the patient’s expenditure, may constitute an insurmountable burden for low-income households. This being said, there are specific schemes for protecting very low-income and chronically ill populations from cost-sharing and up-front payments. Furthermore, the situation has improved recently for basic dentures, hearing aids and optical services, but remains problematic when it comes to consulting certain specialists. However, most of the population relies on complementary health insurance programs that are not tied to incomes, and thus create significant differences in access.
These problems may become particularly problematic when combined with geographical inequalities. Even basic primary care can be very difficult to access in certain areas. Despite the advertised goal of creating multidisciplinary primary care units, there has not been a substantial improvement in coverage. Access times for outpatient settings may diverge widely; waiting times can be significant, and appear to be increasing. According to Eurostat figures, unmet care needs in France were slightly higher than the EU average in 2021.
Citations:
OECD. 2023. “France: Country Health Profile 2023.” https://eurohealthobservatory.who.int/publications/m/france-country-health-profile-2023
Graph View
How committed is the government to ensuring gender equality in all respects?
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The government is clearly committed to the goal of ensuring gender equality.
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The government is largely committed to the goal of ensuring gender equality.
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The government is only somewhat committed to the goal of ensuring gender equality.
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The government is not at all committed to the goal of ensuring gender equality.
Gender equality has improved over the past decades. The European Institute of Gender Equality ranks France fifth in the EU on this measure; within the OECD, France has average-to-good equality outcomes compared to the other countries. It does well in terms of school performance and the share of women among graduates of master’s programs. The labor force participation rate among women is one of the OECD’s highest.
During the pandemic period, more women than men took on caring duties. Survey data on the division of household chores show significant patterns of inequality in this area.
The gender wage gap remains above the OECD average, hovering around 15% (see Vie publique 2024). These gaps tend to widen when children arrive. The introduction of a comprehensive gender gap reporting system in 2019, the Professional Equality Index, could help improve the situation over time. Since 2021, market-listed firms have been obliged to achieve gender parity on their boards. This has placed France at the top of all OECD countries on this measure. In the political realm, the 2017 parliament had the most female members in French history, at around 40%. The 2022 parliament lagged behind in this regard. France has never had a female president, but Élisabeth Borne (2022 – 2024) was the second female prime minister in French history. Public rules stipulating gender equality for candidacies have various effects, with the best performance coming in local and regional elections (between 40% and 50% of mandates are held by women). In the 2021 local elections, 12 of the 42 biggest cities elected a woman mayor.
France encourages parental leave to be shared among both parents, but fewer fathers than mothers take advantage of the low flat-rate leave benefit. While substantial public support means that childcare itself is affordable, there is a shortage of public crèche facilities for children under three years of age. Mandatory schooling at the age of three allows mothers to return to the labor market, and the share of women working 30 hours or less is lower than the OECD average (21% compared to 25%).
Since 2013, data on gender violence has been systematically collected by governmental actors. The current executive launched an information campaign on this issue in 2019.
Citations:
OECD. 2023. “Joining Forces for Gender Equality - Country Note: France.”
Vie publique. 2024. “Droit des femmes: où en est l’égalité professionnelle?” https://www.vie-publique.fr/eclairage/19602-droits-des-femmes-ou-en-est-legalite-professionnelle
During the pandemic period, more women than men took on caring duties. Survey data on the division of household chores show significant patterns of inequality in this area.
The gender wage gap remains above the OECD average, hovering around 15% (see Vie publique 2024). These gaps tend to widen when children arrive. The introduction of a comprehensive gender gap reporting system in 2019, the Professional Equality Index, could help improve the situation over time. Since 2021, market-listed firms have been obliged to achieve gender parity on their boards. This has placed France at the top of all OECD countries on this measure. In the political realm, the 2017 parliament had the most female members in French history, at around 40%. The 2022 parliament lagged behind in this regard. France has never had a female president, but Élisabeth Borne (2022 – 2024) was the second female prime minister in French history. Public rules stipulating gender equality for candidacies have various effects, with the best performance coming in local and regional elections (between 40% and 50% of mandates are held by women). In the 2021 local elections, 12 of the 42 biggest cities elected a woman mayor.
France encourages parental leave to be shared among both parents, but fewer fathers than mothers take advantage of the low flat-rate leave benefit. While substantial public support means that childcare itself is affordable, there is a shortage of public crèche facilities for children under three years of age. Mandatory schooling at the age of three allows mothers to return to the labor market, and the share of women working 30 hours or less is lower than the OECD average (21% compared to 25%).
Since 2013, data on gender violence has been systematically collected by governmental actors. The current executive launched an information campaign on this issue in 2019.
Citations:
OECD. 2023. “Joining Forces for Gender Equality - Country Note: France.”
Vie publique. 2024. “Droit des femmes: où en est l’égalité professionnelle?” https://www.vie-publique.fr/eclairage/19602-droits-des-femmes-ou-en-est-legalite-professionnelle
Graph View
To what extent does the current family policy approach support or hinder unpaid family care work?
10
9
9
Family policies are fully aligned with the goal of creating the conditions for strong families.
8
7
6
7
6
Family policies are largely aligned with the goal of creating the conditions for strong families.
5
4
3
4
3
Family policies are only somewhat aligned with the goal of creating the conditions for strong families.
2
1
1
Family policies are not at all aligned with the goal of creating family-friendly conditions.
There is a long tradition of support for families going back to the 1930s. The comprehensive policy mix that has developed since then has been successful in providing childcare, financial support and parental leave, and has resulted in generous fiscal policies (income is not taxed individually, but in each family unit, dividing up total income by the number of people in a family).
Beginning in 2019, nursery schooling has been mandatory from the age of three, a policy that will strengthen inclusion for immigrant children. In addition, families using childcare support at home are given rebates on their social contributions. The fact that income taxes are calculated on the basis of the family unit and not individually is also very favorable to families, since (nonworking or lower-paid) spouses and children lower the amount of taxable income per head. These policies have been effective. Not only is the birth rate in France one of Europe’s highest – despite a slight fall from an average of two births per woman before 2014 to 1.83 births per woman in 2020 – but the percentage of women integrated into the labor market also compares favorably to that seen in the Scandinavian countries, Europe’s leaders in this domain.
After a series of reforms under President Hollande that restricted child allowances for high income earners, Macron’s presidency has added both more restrictive and more generous measures (e.g., parental leave has been extended from 14 to 28 days) without major impact on the existing pattern of family policy. Child poverty rates and the risk of poverty are greater than the OECD average and remain a concern.
Beginning in 2019, nursery schooling has been mandatory from the age of three, a policy that will strengthen inclusion for immigrant children. In addition, families using childcare support at home are given rebates on their social contributions. The fact that income taxes are calculated on the basis of the family unit and not individually is also very favorable to families, since (nonworking or lower-paid) spouses and children lower the amount of taxable income per head. These policies have been effective. Not only is the birth rate in France one of Europe’s highest – despite a slight fall from an average of two births per woman before 2014 to 1.83 births per woman in 2020 – but the percentage of women integrated into the labor market also compares favorably to that seen in the Scandinavian countries, Europe’s leaders in this domain.
After a series of reforms under President Hollande that restricted child allowances for high income earners, Macron’s presidency has added both more restrictive and more generous measures (e.g., parental leave has been extended from 14 to 28 days) without major impact on the existing pattern of family policy. Child poverty rates and the risk of poverty are greater than the OECD average and remain a concern.
Graph View
To what extent does the current pension policy approach prevent poverty among senior citizens?
10
9
9
Pension policies are fully aligned with the goal of preventing old-age poverty.
8
7
6
7
6
Pension policies are largely aligned with the goal of preventing old-age poverty.
5
4
3
4
3
Pension policies are only somewhat aligned with the goal of preventing old-age poverty.
2
1
1
Pension policies are not at all aligned with the goal of preventing old-age poverty.
The French pension system is relatively generous and largely prevents poverty among the elderly. Public expenditure on pensions as a share of GDP is high. It reached 14.7% in 2020 – a peak due to the pandemic – but is expected to decrease and stabilize at a level of 13.7% by 2030. The 2023 pensions reform ended four special schemes outside the general regime (reserved for specific professions) with the aim of enhancing pension system equality, although this will apply only to future beneficiaries. Another highly contested part of the reform affected the pension age for virtually everyone. To prevent future financial deficits, the minimum age of pension eligibility was increased from 62 to 64. In line with this, the number of contributing years necessary to benefit from a full pension was increased. The reform also – very slightly – increased small pensions as a means of reducing old-age poverty, but the effects of this portion of the reform are disputed.
The heated debate about the benefits of the recent pension system reform has focused particularly on the necessity of the reform. There is now consensus that the persistent deficit will not be resolved by the reform, but that this deficit is viable in the medium term (Bozio 2022).
Individuals in nonstandard employment or with interrupted employment biographies sometimes face significant disadvantages regarding their pension income. For instance, the pension of independent (self-employed) workers is on average more than 30% lower than that of conventionally employed workers (OECD 2022). A study by the national statistics institute INSEE found that 16% of individuals between the ages of 55 and 69 did not have either a pension or work income in 2021 (INSEE 2023). There are specific compensation mechanisms for individuals who have had a full employment career but with low wages, for example, to guarantee a minimum pension of €961 (Paribas 2024).
For people with interrupted employment biographies, the situation differs according to the specific cases (for instance, due to the reasons for and duration of unemployment). However, the state does offer solidarity mechanisms compensating for the loss of pension rights, for instance for people who have experienced a period of unemployment lasting at least five years (COR 2023: 221ff, 235 ff).
One major challenge associated with the reform bill is the need to increase the employment rate among older workers. The employment rate among those 55 years and older is about 10 percentage points lower than the OECD average. The reform has thus created a major source of economic uncertainty for older workers. Part of the problem is that change has to come from the workfare policies relating to older workers at companies. To facilitate a solution, the government initiated a round of negotiations between employers’ organizations and trade unions at the end of 2023. Results are not expected before mid-2024.
Citations:
Antonio Bozio. 2022. “Le système de retraite français est-il en péril?” Blog IPP. https://blog.ipp.eu/2022/12/07/le-systeme-de-retraite-francais-est-il-en-peril/
Paribas. 2024. “Le ‘minimum vieillesse ou Aspa.’“ 7 March. Retrieved 12 March 2024 from https://www.la-retraite-en-clair.fr/depart-retraite-age-montant/montants-minimums-retraite/minimum-vieillesse-aspa
COR. 2023. “Comité d’orientation des retraites, Évolutions et perspectives des retraites en France. Rapport annuel, Juin 2023.” Retrieved 12 March 2024 from https://www.cor-retraites.fr/sites/default/files/2023-06/RA_2023.pdf
INSEE. 2023. “En 2021, une personne de 55 à 69 ans sur six ni en emploi ni en retraite, une situation le plus souvent subie.” https://www.insee.fr/fr/statistiques/7617420
OECD. 2022. “Formes d’emploi atypiques et pensions.” Retrieved 11 March 2024 from https://www.oecd-ilibrary.org/sites/43fe47c5-fr/index.html?itemId=/content/component/43fe47c5-fr
The heated debate about the benefits of the recent pension system reform has focused particularly on the necessity of the reform. There is now consensus that the persistent deficit will not be resolved by the reform, but that this deficit is viable in the medium term (Bozio 2022).
Individuals in nonstandard employment or with interrupted employment biographies sometimes face significant disadvantages regarding their pension income. For instance, the pension of independent (self-employed) workers is on average more than 30% lower than that of conventionally employed workers (OECD 2022). A study by the national statistics institute INSEE found that 16% of individuals between the ages of 55 and 69 did not have either a pension or work income in 2021 (INSEE 2023). There are specific compensation mechanisms for individuals who have had a full employment career but with low wages, for example, to guarantee a minimum pension of €961 (Paribas 2024).
For people with interrupted employment biographies, the situation differs according to the specific cases (for instance, due to the reasons for and duration of unemployment). However, the state does offer solidarity mechanisms compensating for the loss of pension rights, for instance for people who have experienced a period of unemployment lasting at least five years (COR 2023: 221ff, 235 ff).
One major challenge associated with the reform bill is the need to increase the employment rate among older workers. The employment rate among those 55 years and older is about 10 percentage points lower than the OECD average. The reform has thus created a major source of economic uncertainty for older workers. Part of the problem is that change has to come from the workfare policies relating to older workers at companies. To facilitate a solution, the government initiated a round of negotiations between employers’ organizations and trade unions at the end of 2023. Results are not expected before mid-2024.
Citations:
Antonio Bozio. 2022. “Le système de retraite français est-il en péril?” Blog IPP. https://blog.ipp.eu/2022/12/07/le-systeme-de-retraite-francais-est-il-en-peril/
Paribas. 2024. “Le ‘minimum vieillesse ou Aspa.’“ 7 March. Retrieved 12 March 2024 from https://www.la-retraite-en-clair.fr/depart-retraite-age-montant/montants-minimums-retraite/minimum-vieillesse-aspa
COR. 2023. “Comité d’orientation des retraites, Évolutions et perspectives des retraites en France. Rapport annuel, Juin 2023.” Retrieved 12 March 2024 from https://www.cor-retraites.fr/sites/default/files/2023-06/RA_2023.pdf
INSEE. 2023. “En 2021, une personne de 55 à 69 ans sur six ni en emploi ni en retraite, une situation le plus souvent subie.” https://www.insee.fr/fr/statistiques/7617420
OECD. 2022. “Formes d’emploi atypiques et pensions.” Retrieved 11 March 2024 from https://www.oecd-ilibrary.org/sites/43fe47c5-fr/index.html?itemId=/content/component/43fe47c5-fr
To what extent does the current pension policy approach hinder or promote intergenerational equity?
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9
9
Pension policies are fully aligned with the goal of achieving intergenerational equity.
8
7
6
7
6
Pension policies are largely aligned with the goal of achieving intergenerational equity.
5
4
3
4
3
Pension policies are only somewhat aligned with the goal of achieving intergenerational equity.
2
1
1
Pension policies are not at all aligned with the goal of achieving intergenerational equity.
Before the 2023 pension reform, the elderly were provided for rather generously. Rather liberal early retirement schemes used to allow firms to get rid of high-salary employees and replace them with early-career workers who might work at higher levels of productivity. This policy has changed as a result of successive reforms, culminating in the 2023 reform. As a result, early retirement schemes have been gradually abolished, the legal age of retirement has increased, and the number of years of contribution necessary to receive a full-term pension has gone up. The long-term effects of this reform are difficult to predict, but one of the crucial goals is to increase the employment rate among older people. In terms of intergenerational equity, the generations born after 1980 will have to pay more for their pensions than older generations. Their replacement rate (the percentage of their pension compared to their past working incomes) will be lower, but the duration of their employment will also be shorter, and they will on average receive their pensions for a longer time (COR 2023: 209 – 219).
Pension policies do not account for intergenerational differences in wealth. It is true that wealth distribution appears to cluster among older generations that are living longer and transfer their wealth later than previous generations.
Citations:
COR. 2023. “Comité d’orientation des retraites, Évolutions et perspectives des retraites en France. Rapport annuel, Juin 2023.” https://www.cor-retraites.fr/sites/default/files/2023-06/RA_2023.pdf
Pension policies do not account for intergenerational differences in wealth. It is true that wealth distribution appears to cluster among older generations that are living longer and transfer their wealth later than previous generations.
Citations:
COR. 2023. “Comité d’orientation des retraites, Évolutions et perspectives des retraites en France. Rapport annuel, Juin 2023.” https://www.cor-retraites.fr/sites/default/files/2023-06/RA_2023.pdf
Graph View
To what extent does the current policy approach hinder or facilitate the inclusion of migrants into society and the labor market?
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9
9
Integration policies are fully aligned with achieving the sustainable inclusion of migrants in society.
8
7
6
7
6
Integration policies are largely aligned with achieving the sustainable inclusion of migrants in society.
5
4
3
4
3
Integration policies are only somewhat aligned with achieving the sustainable inclusion of migrants in society.
2
1
1
Integration policies are not at all aligned with achieving the sustainable inclusion of migrants in society.
France has traditionally maintained an open policy toward immigrants, relying on the jus soli tradition. Every person born in France is considered French or is eligible for French citizenship. Integration policies in terms of long-term residence permits, access to citizenship and family reunification are open and generous. Presently, most new legal immigrants come to the country through family reunification programs. This migration is thus not based on language or professional skills, which possibly makes integration more difficult.
Integration of the so-called second – in fact, often the third – generation of immigrants, especially those whose families are from Maghreb countries, has also proved difficult for many reasons, including education system failures, community concentration in urban/suburban ghettos, high unemployment rates, cultural identity issues, labor market discrimination and so on. As a consequence, France ranks in the lower group of OECD countries with regard to secondary education attainment levels and integration into the labor market, performing below the OECD average. The Migrant Integration Policy Index (2020) offers a look at better results for France, with stronger outcomes in the areas of health, access to citizenship and anti-discrimination policy, but this assessment relates to 2019.
Since that time, immigration from Eastern Europe, the southern Balkans and more recently from the Middle East has become a very sensitive subject. It is exploited by the National Rally party (former the National Front) and more generally by the extreme right, which has been able to set the political agenda and force a focus on migration and identity issues. President Macron has declared his intention to review France’s immigration policy, combining acceptance and integration policies for immigrants and refugees with accelerated asylum-application procedures and more rigorous efforts to repatriate people whose applications have been rejected. The process of screening requests has improved, but there has also been a deliberate policy to restrict residence permits. As it is very difficult to implement administrative or judicial decisions to expel illegal migrants, the number of migrants living in a kind of legal and social limbo without legal residential status – “sans-papier” – is growing.
A migration bill adopted in December 2023 introduced several important new measures. As it was unable to secure a majority in the lower chamber, the government had to accept several restrictive measures from the right (and, de facto, from the extreme right). In particular, the new version introduces the obligation to have a job or to have resided legally in France for five years in order to claim certain types of social benefits. The bill also creates yearly “quotas” of foreigners. Finally, bringing back an old debate introduced by President Hollande, criminals with dual citizenship who have been convicted of homicide may be stripped of their French citizenship.
As drafted, the would have introduced a sharp turn in French migration policy. Many of its measures were controversial from a constitutional point of view. Therefore, President Macron referred the law to the Constitutional Council, which rejected a considerable number of measures (40%) as unconstitutional in its ruling on 25 January 2024. The government then implemented the reform without the rejected articles.
Integration of the so-called second – in fact, often the third – generation of immigrants, especially those whose families are from Maghreb countries, has also proved difficult for many reasons, including education system failures, community concentration in urban/suburban ghettos, high unemployment rates, cultural identity issues, labor market discrimination and so on. As a consequence, France ranks in the lower group of OECD countries with regard to secondary education attainment levels and integration into the labor market, performing below the OECD average. The Migrant Integration Policy Index (2020) offers a look at better results for France, with stronger outcomes in the areas of health, access to citizenship and anti-discrimination policy, but this assessment relates to 2019.
Since that time, immigration from Eastern Europe, the southern Balkans and more recently from the Middle East has become a very sensitive subject. It is exploited by the National Rally party (former the National Front) and more generally by the extreme right, which has been able to set the political agenda and force a focus on migration and identity issues. President Macron has declared his intention to review France’s immigration policy, combining acceptance and integration policies for immigrants and refugees with accelerated asylum-application procedures and more rigorous efforts to repatriate people whose applications have been rejected. The process of screening requests has improved, but there has also been a deliberate policy to restrict residence permits. As it is very difficult to implement administrative or judicial decisions to expel illegal migrants, the number of migrants living in a kind of legal and social limbo without legal residential status – “sans-papier” – is growing.
A migration bill adopted in December 2023 introduced several important new measures. As it was unable to secure a majority in the lower chamber, the government had to accept several restrictive measures from the right (and, de facto, from the extreme right). In particular, the new version introduces the obligation to have a job or to have resided legally in France for five years in order to claim certain types of social benefits. The bill also creates yearly “quotas” of foreigners. Finally, bringing back an old debate introduced by President Hollande, criminals with dual citizenship who have been convicted of homicide may be stripped of their French citizenship.
As drafted, the would have introduced a sharp turn in French migration policy. Many of its measures were controversial from a constitutional point of view. Therefore, President Macron referred the law to the Constitutional Council, which rejected a considerable number of measures (40%) as unconstitutional in its ruling on 25 January 2024. The government then implemented the reform without the rejected articles.
Graph View
How committed is the government to helping build the capacity to reduce poverty and provide social protection in low- and middle-income countries?
10
9
9
The government’s development cooperation strategy is fully aligned with the goal of improving capacity-building for poverty reduction in low- and middle-income countries.
8
7
6
7
6
The government’s development cooperation strategy is largely aligned with the goal of improving capacity-building for poverty reduction in low- and middle-income countries.
5
4
3
4
3
The government’s development cooperation strategy is only somewhat aligned with the goal of improving capacity-building in poverty reduction in low- and middle-income countries.
2
1
1
The government’s development cooperation strategy is not all aligned with the goal of improving capacity-building for poverty reduction in low- and middle-income countries.
France has a long tradition of supporting poor countries both financially and through the promotion of favorable policies. It ranks fifth worldwide in terms of the provision of official development assistance (ODA, $15.9 billion in 2022), and has recently increased its contribution, reaching 0.56% of gross national income in 2022. A total of €505 million went to Ukraine alone, while €392.8 million was related to the COVID-19 response. Bilateral ODA is mainly tied to issues of peace and justice (OECD 2022). Gender equality has become a significant objective in almost half of the aid provided, and in 21% of the country’s humanitarian aid. France has also subscribed to the 2030 Agenda for Sustainable Development.
Several elements need to be specified in this context: First, France has proved reluctant to regard free trade as one of the most effective instruments of support. As a consequence, France is often an obstacle to the lowering of tariffs and trade barriers, for instance in agriculture. Second, French aid is concentrated on African countries (36.8% of the total in 2021), where the country has traditionally had strong economic interests. A significant portion of France’s multilateral contributions are also earmarked for African countries. The temptation to link aid to imports from the donor country is quite common. France is active within the framework of international organizations, but for the above reasons, its policy preferences are deeply influenced by path dependencies such as past colonization and the global network of French-speaking countries.
On a different front, France has tried to impose a tax on air travel to finance the fight against AIDS in poor countries. However, it has convinced only a few countries to follow suit. During the French EU presidency beginning in January 2022, President Macron highlighted the need to launch a significant EU investment plan in Africa, and pushed for such an initiative. This initiative seems judicious as, given the continent’s persistent underdevelopment despite sustained growth, there is a need to increase EU support to sub-Saharan countries where poverty and Islamist terrorism are together pushing an increasing number of people to migrate to Europe. Given the demographic pressures ahead (Africa will soon have 1 billion inhabitants) and the attractiveness of Europe, development in Africa is an emergency issue both for Africans and Europeans.
Citations:
OECD. 2022. “Development Co-operation Profiles: France.”
Global Partnership for Effective Development Co-operation. 2020. “France Country Profile.”
Several elements need to be specified in this context: First, France has proved reluctant to regard free trade as one of the most effective instruments of support. As a consequence, France is often an obstacle to the lowering of tariffs and trade barriers, for instance in agriculture. Second, French aid is concentrated on African countries (36.8% of the total in 2021), where the country has traditionally had strong economic interests. A significant portion of France’s multilateral contributions are also earmarked for African countries. The temptation to link aid to imports from the donor country is quite common. France is active within the framework of international organizations, but for the above reasons, its policy preferences are deeply influenced by path dependencies such as past colonization and the global network of French-speaking countries.
On a different front, France has tried to impose a tax on air travel to finance the fight against AIDS in poor countries. However, it has convinced only a few countries to follow suit. During the French EU presidency beginning in January 2022, President Macron highlighted the need to launch a significant EU investment plan in Africa, and pushed for such an initiative. This initiative seems judicious as, given the continent’s persistent underdevelopment despite sustained growth, there is a need to increase EU support to sub-Saharan countries where poverty and Islamist terrorism are together pushing an increasing number of people to migrate to Europe. Given the demographic pressures ahead (Africa will soon have 1 billion inhabitants) and the attractiveness of Europe, development in Africa is an emergency issue both for Africans and Europeans.
Citations:
OECD. 2022. “Development Co-operation Profiles: France.”
Global Partnership for Effective Development Co-operation. 2020. “France Country Profile.”