[Does primary prevention contribute to increase social inequalities in health?].

In France, as in many countries, tackling social inequalities in health is a public health priority. However, primary prevention may sometimes contribute to increase such inequalities. This article aims to illustrate this point, considering the cases of smoking and obesity. The implicit hypotheses of prevention regarding its targets are discussed, as well as its stigmatization effects. On the one hand, prevention can increase the social differentiation of risky behaviors, as it is more effective among wealthier and more educated people. On the other hand, prevention policies intending to increase either the financial or the symbolic cost of risky behaviors may also increase social inequalities. Primary prevention needs more reflexivity regarding its potential unintended and deleterious side effects.