Social inequalities in health : an epidemiological perspective. Large social inequalities in mortality are observed in France as in most countries. In a context of decrease in mortality rates, the situation is encouraging among men, with a decrease over time of the difference in mortality between the most and least educated. On the contrary, social inequalities among women are on the rise, mostly due to trends in smoking-related mortality. The determinants of social inequalities in health are diverse and complex. Research is needed to precisely understand the mechanisms at stake and assess the role of the personal and work environment as well as the health care system, which are major determinants of social inequalities regardless individual behaviors.