The mortality profiles of Italy and France look very similar, conversely their causes of death are different. By a comparative approach, the study aims to analyze inequalities in the health status and the health service utilization of the disadvantaged categories in Italy and France. Taking into account such disparities, together with the social and economic context of these two Countries, this study could provide some hints to better understand the reasons behind the difference between the two cause-specific mortality patterns. Data come from the Italian Health Condition Survey (ISTAT-2013) and the French survey on Health and Health Care and Insurance (IRDES-2014). The analyses are conducted using logistic regression and the Heckman model is applied to account for sample selection for reducing the estimation bias. Preliminary findings show that health inequalities are related to age, sex, socio-economic position and place of birth.