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Local disadvantages and health: Constructing indices to analyse social and geographic health inequalities in France and their trends Volume 10, issue 3, Mai-Juin 2011

Authors
Inserm-CépiDc Hôpital de Bicêtre 80, rue du Général Leclerc Bâtiment La Force porte 58 94270 Le Kremlin-Bicêtre cedex, Université Paris-Ouest - Nanterre-la-Défense Espace santé et territoires (LEST) EA 3983, Irdes (Institut de recherche et documentation en économie de la santé), École des hautes études en santé publique (EHESP), Unité de recherche épidémiologique en santé périnatale et santé des femmes Inserm U953, Unité d’épidémiologie nutritionnelle (Inserm U557/Inra U1125/Cnam/Universite Paris 13/ CRNH IdF) UREN), Institut national de santé publique du Québec (INSPQ), Université de Paris-Est Créteil Institut d’Urbanisme de Paris Lab-Urba Créteil France

After many years of focusing on individual social, economic and cultural characteristics, the analysis of health inequalities today highlights the need to consider the social, environmental and political context in which these individuals develop. These analyses require the construction of indices that make it possible to identify local situations that tend to promote or undermine the health status of individuals or entire populations. In addition to their use for monitoring health inequalities and analyzing determinants associated with these inequalities, these synthetic indicators can also serve as decision support tools for allocating resources and designing prevention or management policies focused on specific populations. Widely used in studies from English-speaking countries since the end of the 1980s, their universality and the relevance of their components are nonetheless debated today. There is not yet any consensual localised index that is sufficiently standardised to allow comparisons between the different studies conducted in the field of health inequalities. The objective of this project, which brings together different research team working on the influence of the residential setting in health, is to obtain a consensus about the definition, construction and conditions of use of local deprivation indicators associated with health inequalities in France. We will also examine the ability of such indices to take current or future health vulnerability into account as well as their potential for use in the management of health resources.