Inégalités sociales de santé : influence des milieux de vie

Dans cet article sont présentés les résultats d’une recherche réalisée de 2002 à 2005 dans trois territoires de la région de Québec (centre-ville, banlieue et milieu rural) pour éclairer les causes d’états de santé différenciés en utilisant une approche territoriale. Cet article traite plus spécifiquement du milieu local et des éléments associés à la construction sociale des inégalités observées dans les territoires étudiés. On y fait ressortir les liens entre la défavorisation sociale et matérielle et l’état sociosanitaire des populations. On y explore ensuite comment le contexte socioéconomique et culturel et les rapports sociaux agissent sur les représentations du milieu et sur les perceptions de l’état de santé et des capacités individuelles et collectives d’agir.This article provides research results of a study conducted between 2002 and 2005 in three areas of the Quebec Region (centre city, suburb and rural setting). The goal of this territorial-based analysis is to understand the causes of different health outcomes. The article focuses in particular on local conditions and the factors associated with the social construction of inequalities in the three areas. The authors document the links between social and material disadvantage and the health status of the population. They then examine the effects of socio-economic and cultural contexts and social relations on representations of the setting and on perceptions of health outcomes and individual and collective capacities to act

Perception of place and health: Differences between neighbourhoods in the Québec City region

This paper addresses two questions: (1) Can people's perceptions of problems and social cohesion in the neighbourhood be considered as contextual variables; and (2) are these perceptions related to people's health? Data come from a general health survey carried out in 2004 among 1634 individuals living in three localities of the region of Québec City, namely a downtown, a suburban and a rural area, which were further subdivided into 34 smaller spatial units, hereafter called neighbourhoods. The survey included questions on individuals' perception of problems (social and environmental) and social cohesion (attraction to neighbourhood, neighbouring and psychological sense of community) in the neighbourhood, as well as questions on self-rated health, long-term disability and self-mastery. A first set of logistic multilevel models was performed to ascertain the existence of neighbourhood variations in the perception of problems and social cohesion, after accounting for individual attributes. A second set of multilevel models was carried out to examine the association between perceived problems and social cohesion in the neighbourhood and people's health. Results show that, after accounting for individual attributes, the perception of problems and social cohesion varies significantly by neighbourhood and/or localities and can be considered as contextual variables. Furthermore, these perceptions of place appear to be significant predictors of people's health.Canada Neighbourhood Health status Local problems Social cohesion