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There is little evidence on the explanation of health inequalities based on a gender sensitive perspective. The aim was to investigate to what extent health behaviours mediate the association between educational inequalities and life satisfaction of boys and girls. Data were derived from the German part of the Health Behaviour in School-aged Children (HBSC) study 2010 (n= 5,005). Logistic regression models were conducted to investigate educational inequalities in life satisfaction among 11- to 15-year-old students and the relative impact of health behaviour in explaining these inequalities. Educational inequalities in life satisfaction were more pronounced in boys than in girls from lower educational tracks (OR 2.82, 95 % CI 1.97–4.05 and OR 2.30, 95 % CI 1.68–3.14). For adolescents belonging to the lowest educational track, behavioural factors contributed to 18 % (boys) and 39 % (girls) in the explanation of educational inequalities in life satisfaction. The relationship between educational track and life satisfaction is substantially mediated by health-related behaviours. To tackle inequalities in adolescent health, behavioural factors should be targeted at adolescents from lower educational tracks, with special focus on gender differences.

To evaluated the female–male health–survival paradox by estimating the contribution of women’s mortality advantage versus women’s disability disadvantage.Disability prevalence was measured from the 2006 Survey on Income and Living Conditions in 25 European countries. Disability prevalence was applied to life tables to estimate healthy life years (HLY) at age 15. Gender differences in HLY were split into two parts: that due to gender inequality in mortality and that due to gender inequality in disability. The relationship between women’s mortality advantage or disability disadvantage and the level of population health between countries was analysed using random-effects meta-regression.Women’s mortality advantage contributes to more HLY in women; women’s higher prevalence of disability reduces the difference in HLY. In populations with high life expectancy women’s advantage in HLY was small or even a men’s advantage was found. In populations with lower life expectancy, the hardship among men is already evident at young ages.The results suggest that the health–survival paradox is a function of the level of population health, dependent on modifiable factors.