L’analyse de la dynamique spatiale à Charlesbourg, un exemple de spécialisation de l’espace intra-urbain

Après avoir sommairement défini le concept de spécialisation de l'espace intra-urbain comme la fragmentation du tissu urbain en zones et secteurs unifonctionnels, le présent article retrace les principales transformations survenues à Charlesbourg entre 1954 et 1974 et tente d'y déceler les indices de spécialisation.L'étude comporte trois phases : L'analyse du dessin, celle de l'évolution, et enfin celle des forces et du cadre des transformations. La première partie (l'étude du dessin) fournit au lecteur les données essentielles sur Charlesbourg et lui permet de suivre plus aisément la discussion. Sont alors élaborées à partir des traits physiques (morphologie), administratifs (cadastre) et construits (espace bâti) les principales lignes du faciès de Charlesbourg d'avant la spécialisation. La seconde section, concernant l'évolution, tente de faire le bilan des transformations survenues entre 1954 et 1974. Elle montre, pour chacune des périodes étudiées, l'existence ainsi que l'organisation des zones et secteurs, et s'efforce de discerner et de caractériser le mouvement de spécialisation de l'espace. La troisième partie (étude des forces et du cadre) vise à rechercher les facteurs explicatifs de Ici spécialisation. Elle intègre l'essentiel des observations antérieures et les prolonge par la formation le lois ou principes directeurs, d'abord économiques puis spatiaux.The concept of specialization of intra-urban space is first defined as the fragmentation of the urban fabric into numerous unifunctional zones or sectors. The study then examines the main transformations which have occurred in Charlesbourg since 1954 and seeks to identify indices of specialization.The study is composed of three parts : analysis of pattern, analysis of evolution and analysis of factors underlying the spatial transformations. Part I provides data on Charlesbourg which permit the reader to easily follow the discussion. There, an elaboration of the various physical (morphology), administrative (cadastre) and developmental (built up space) characteristics serves to describe the pre-specialization Charlesbourg. Part II analysis the changes produced between 1954 and 1974. For each time period studied, the existence and organization of zones and sectors are illustrated. An attempt is made to characterize the tendency toward spatial specialization. Part II explores the factors underlying these tendencies. Taking into account parts I and II, part III develops a set of laws or principles, primarily economic but also spatial, which explain the specialization of urban space

Le repérage des unités de voisinage : Contribution d’une approche historique en milieu urbain, périurbain et rural dans la région de Québec

Cet article se veut une contribution originale à la définition d’unités de voisinage dans un contexte d’étude des inégalités sociales de santé. Après une revue de la notion de voisinage, le texte propose une approche de type historique afin de définir des unités de voisinage dans trois territoires de la région de Québec, soit les arrondissements de Limoilou et de Charlesbourg et la municipalité régionale de comté (MRC) de Portneuf. L’approche consiste d’abord à repérer toutes les limites territoriales que des institutions du milieu se sont données depuis le début des années 1960 afin de baliser leurs activités, puis d’en faire la somme et la synthèse. L’information de base a été obtenue de plusieurs sources, elle a été numérisée, introduite dans un SIG, pondérée à l’aide de critères, puis cartographiée. Le résultat fait apparaître, dans chaque territoire, un nombre variable d’espaces communs à la vie des institutions et de la population que celles-ci desservent. Comme ces espaces sont de faible dimension et le reflet d’interactions sociales, on peut les rapprocher de la notion de voisinage.This article is an original contribution to the definition of neighbourhood units in the context of a study on social inequalities with respect to health. After reviewing the concept of neighborhood, we propose an historical approach in order to define neighborhood units within three districts located in the Quebec City region: two Quebec City boroughs (Limoilou and Charlesbourg) and the municipal regional county (MRC) of Portneuf. This approach required collecting, adding together and summarizing all the modifications to administrative boundaries that these districts have undergone since the beginning of the 1960s. The original data was drawn from numerous sources, digitized, entered into a GIS, weighted according to certain criteria, and mapped. The results highlight a set of common areas shared by institutions and the population that they serve. As these areas are small and reflect social interactions. They can be linked with the notion of neighborhood

Les variations géographiques de la santé au Québec : une analyse de l’enquête Santé Québec par aire homogène.

Le présent article propose une lecture de l'enquête Santé Québec, réalisée en 1987, à travers une grille géographique par aire homogène (ou aire sociale). On procède d'abord à l'élaboration de cette grille par aire homogène, puis on en décrit les caractéristiques géo-socio-économiques pour finalement en tracer le bilan sanitaire. Il ressort de cette lecture d'importantes disparités entre les aires homogènes, tant dans les déterminants de l'état de santé (consommation d'alcool, de tabac, activité physique et soutien social), que dans l'état de santé lui-même (diverses pathologies) ou encore dans les conséquences de cet état de santé (incapacité, recours aux services, médication). Cette lecture retrace les populations les plus vulnérables au Québec, c'est-à-dire les résidants des vieux centres-villes et de certains secteurs limitrophes d'agglomérations et de villes, des capitales régionales et de la métropole, ainsi que les résidants de l'arrière-pays et de certaines petites villes de la périphérie.This article proposes to analyse the Québec Health Survey — carried out in 1987 — by using a geographic grid that covers each homogenous area (or social area). First, the grid is elaborated in terms of homogenous areas followed by a description of the geo-socio-economic characteristics of each area, which, in the end, allows for assessing the heath situation in homogenous areas. This analysis brings to light major discrepancies between homogenous areas in such sectors as heath status determinants (alcohol and tobacco consumption, physical activity and social or community support), the actual state of heath (various pathologies) and the consequences that may be attributed to the state of heath (incapacity, recourse to services, medication...). The analysis focuses on Quebec's most vulnerable populations : the low-income residents of the old inner cities and of certain border areas of agglomerations and cities, as well as their counterparts in the regional capitals and in Metropolitan Montréal. Disadvantaged inhabitants of the hinterland and of certain small towns on the periphery are also considered in the analysis

A multi-perspective approach for defining neighbourhood units in the context of a study on health inequalities in the Quebec City region

<p>Abstract</p> <p>Background</p> <p>Identification of socioeconomic and health inequalities at the local scale is facilitated by using relevant small geographical sectors. Although these places are routinely defined according to administrative boundaries on the basis of statistical criteria, it is important to carefully consider the way they are circumscribed as they can create spatial analysis problems and produce misleading information. This article introduces a new approach to defining neighbourhood units which is based on the integration of elements stemming from the socioeconomic situation of the area, its history, and how it is perceived by local key actors.</p> <p>Results</p> <p>Using this set of geographical units shows important socioeconomic and health disparities at the local scale. These disparities can be seen, for example, in a 16-year difference in disability-free life expectancy at birth, and a $10,000-difference in average personal income between close neighbourhoods. The geographical units also facilitate information transfer to local stakeholders.</p> <p>Conclusion</p> <p>The context of this study has made it possible to explore several relevant methodological issues related to the definition of neighbourhood units. This multi-perspective approach allows the combination of many different elements such as physical structures, historical and administrative boundaries, material and social deprivation of the population, and sense of belonging. Results made sense to local stakeholders and helped them to raise important issues to improve future developments.</p

Local Context Influence, Activity Space, and Foodscape Exposure in Two Canadian Metropolitan Settings: Is Daily Mobility Exposure Associated with Overweight?

It has become increasingly common to attribute part of the obesity epidemic to changes in the environment. Identification of a clear and obvious role for contextual risk factors has not yet been demonstrated. The objectives of this study were to explain differences in local overweight risk in two different urban settings and to explore sex-specific associations with estimated mobility patterns. Overweight was modeled within a multilevel framework using built environmental and socioeconomic contextual indicators and individual-level estimates of activity space exposure to fast-food restaurants (or exposure to visited places). Significant variations in local levels in overweight risk were observed. Physical and socioeconomic contexts explained more area-level differences in overweight among men than among women and among inhabitants of Montreal than among inhabitants of Quebec City. Estimated activity space exposure to fast-food outlets was significantly associated with overweight for men in Montreal. Local-level analyses are required to improve our understanding of contextual influences on obesity, including multiple influences in people's daily geographies

Association between Activity Space Exposure to Food Establishments and Individual Risk of Overweight

Objective: Environmental exposure to food sources may underpin area level differences in individual risk for overweight. Place of residence is generally used to assess neighbourhood exposure. Yet, because people are mobile, multiple exposures should be accounted for to assess the relation between food environments and overweight. Unfortunately, mobility data is often missing from health surveys. We hereby test the feasibility of linking travel survey data with food listings to derive food store exposure predictors of overweight among health survey participants. Methods: Food environment exposure measures accounting for non-residential activity places (activity spaces) were computed and modelled in Montreal and Quebec City, Canada, using travel surveys and food store listings. Models were then used to predict activity space food exposures for 5,578 participants of the Canadian Community Health Survey. These food exposure estimates, accounting for daily mobility, were used to model self-reported overweight in a multilevel framework. Median Odd Ratios were used to assess the proportion of between-neighborhood variance explained by such food exposure predictors. Results: Estimates of food environment exposure accounting for both residential and non-residential destinations were significantly and more strongly associated with overweight than residential-only measures of exposure for men. For women, residential exposures were more strongly associated with overweight than non-residential exposures. In Montreal, adjusted models showed men in the highest quartile of exposure to food stores were at lesser risk of being overweight considering exposure to restaurants (OR = 0.36 [0.21–0.62]), fast food outlets (0.48 [0.30–0.79]), or corner stores (0.52 [0.35–0.78]). Conversely, men experiencing the highest proportion of restaurants being fast-food outlets were at higher risk of being overweight (2.07 [1.25–3.42]). Women experiencing higher residential exposures were at lower risk of overweight. Conclusion: Using residential neighbourhood food exposure measures may underestimate true exposure and observed associations. Using mobility data offers potential for deriving activity space exposure estimates in epidemiological models

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

Reducing avoidable inequalities in health: a new criterion for setting health care capitation payments

Traditionally, most health care systems which pretend to any sort of rationality and cost control have sought to allocate their limited funds in order to secure equal opportunity of access for equal need. The UK government is implementing a fundamental change of resource allocation philosophy towards contributing to the reduction of avoidable health inequalities. The purpose of this essay is to explore some of the economic issues that arise when seeking to allocate health care resources according to the new criterion. It indicates that health inequalities might arise because of variations in the quality of health services, variations in access to those services, or variations in the way people produce health, and that the resource allocation consequences differ depending on which source is being addressed. The paper shows that an objective of reducing health inequalities is not necessarily compatible with an objective of equity of access, nor with the objective of maximising health gain. The results have profound consequences for approaches towards economic evaluation, the role of clinical guidelines and performance management, as well as for resource allocation methods

Sex, age, deprivation and patterns in life expectancy in Quebec, Canada: a population-based study

<p>Abstract</p> <p>Background</p> <p>Little research has evaluated disparities in life expectancy according to material deprivation taking into account differences across the lifespan between men and women. This study investigated age- and sex-specific life expectancy differentials related to area-level material deprivation for the province of Québec, Canada from 1989-2004.</p> <p>Methods</p> <p>Age- and sex-specific life expectancy across the lifespan was calculated for three periods (1989-1992, 1995-1998, and 2001-2004) for the entire Québec population residing in 162 community groupings ranked according to decile of material deprivation. Absolute and relative measures were calculated to summarize differences between the most and least deprived deciles.</p> <p>Results</p> <p>Life expectancy differentials between the most and least deprived deciles were greatest for men. Over time, male differentials increased for age 20 or more, with little change occurring at younger ages. For women, differentials increased across the lifespan and were comparable to men at advanced ages. Despite gains in life expectancy among men relative to women, differentials between men and women were greater for most deprived relative to least deprived deciles.</p> <p>Conclusions</p> <p>Similar to the US, differentials in life expectancy associated with area-level material deprivation increased steadily in Québec from 1989-2004 for males and females of all ages. Differentials were comparable between men and women at advanced ages. Previous research indicating that life expectancy differentials between most and least deprived areas are greater in men may be due to a focus on younger age groups.</p