Sante Publique最新文献

{"title":"Réduire la pénurie des médecins généralistes en milieu rural : les leviers d’action prioritaires.","authors":"Dominique Henrion, Martin Desselles","doi":"10.3917/spub.hs1.2025.0117","DOIUrl":"10.3917/spub.hs1.2025.0117","url":null,"abstract":"<p><p>Belgium, like many European countries, is facing a shortage of general practitioners in rural areas. This uneven geographical distribution of doctors calls for multiple, integrated strategies to attract and retain practitioners in these regions. The rural origin of doctors is a key factor that has been largely overlooked by authorities until now. Measures such as quotas for rural students, conditional scholarships, and targeted awareness campaigns could be implemented. Financial incentives, while important, have shown mixed results and often prove ineffective in the long term if not combined with complimentary measures. The creation of single- or multi-disciplinary practices and improvements inon-call organization are essential to making work in rural areas more attractive. Quality of life also plays a decisive role. Investing in local infrastructure and supporting spousal employment are crucial measures. Finally, university curricula could include mandatory rural internships to help students become faniliar with these areas. This article presents proposals to balance the distribution of doctors and improve the attractiveness of rural areas in Belgium..</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 HS1","pages":"117-121"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Étude des conditions d’émergence d’une politique intersectorielle de promotion de la santé à l’échelon du territoire néocalédonien : fenêtre d’opportunité pour la santé à l’École.","authors":"Carmella Rebouillat, Pierre-Christophe Pantz, Didier Jourdan","doi":"10.3917/spub.hs1.2025.0037","DOIUrl":"https://doi.org/10.3917/spub.hs1.2025.0037","url":null,"abstract":"<p><strong>Introduction: </strong>Health promotion is a set of intersectoral actions aimed at improving the health of all individuals and at reducing health inequalities. Public health research faces the challenge of identifying the conditions necessary to develop health promotion policies at the territorial level.</p><p><strong>Method: </strong>To identify the conditions for the development of such a policy, we studied the case of the intersectoral health promotion policy in schools in New Caledonia. Drawing on the Kingdon model adapted to public health by Ridde et al., we conducted a detailed analysis of the context, actors, and mechanisms that enabled the publication of regulatory texts and financial commitments.</p><p><strong>Results: </strong>We noted a surge in the number of political entrepreneurs in the health and education sectors. These key actors have made health in schools a \"problem\" in the political sense of the term. Support from the health agency and its partners enabled credible solutions to be proposed, which, moreover, were acceptable to the institutions, in a political context conducive to reaching consensus among members of government who come from different political backgrounds.</p><p><strong>Discussion: </strong>A window of opportunity was opened in 2016 with the convergence of three key elements: awareness of the existence of a problem, solutions and a favorable political context, and the mobilization of political actors supported by experts who were able to substantiate the political project.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 HS1","pages":"37-46"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Une approche collective de la santé au cœur des territoires ruraux et insulaires de Bretagne : le savoir-faire communautaire des <i>Semeurs de Santé</i>.","authors":"Camille Astier, Hélène Denoual, Claire Cornelissen, Collectif Les Semeurs De Santé, Marie Rénée Guevel","doi":"10.3917/spub.hs1.2025.0065","DOIUrl":"https://doi.org/10.3917/spub.hs1.2025.0065","url":null,"abstract":"","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 HS1","pages":"65-74"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La décolonisation de la santé publique en Bolivie ou la fragmentation de tout un secteur.","authors":"Amélie Aubert Plard","doi":"10.3917/spub.251.0043","DOIUrl":"https://doi.org/10.3917/spub.251.0043","url":null,"abstract":"<p><strong>Introduction: </strong>During its first ten years (2006-2016), the government of Evo Morales led Bolivia through a wave of reforms aimed at establishing a popular nationalism, free from what it calls \"Western imperialism.\"</p><p><strong>Purpose of the study: </strong>This article analyzes the implementation of the decolonization process, particularly in the reproductive health sector. It highlights the effects generated on those involved and the mechanisms of appropriation and/or rejection. To do this, it focuses on three measures: the My Health program, the professionalization of traditional midwives, and the cultural adaptation of delivery rooms.</p><p><strong>Results: </strong>While the deployment of the My Health program is developing community medicine that is appreciated by users, it is also giving rise to deep rivalries among healthcare professionals and decision-makers alike. Furthermore, when it comes to intercultural childbirth, the study reveals a lack of both supply and demand.</p><p><strong>Conclusion: </strong>Far from reforming it structurally, the decolonization process seems to have caused a deep ideological and organizational split within the health sector. The new measures have been implemented in the form of additional, competing programs, which has caused difficulties regarding their acceptance and integration within the established healthcare system. What's more, while in its discourse the government rejects Western colonization, in practice it remains heavily dependent on international aid.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"43-51"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact des violences subies sur la santé de femmes migrantes consultant dans deux policliniques parisiennes.","authors":"Bacha Kaoutar, Sigolène Roumieu, Laeticia Audiffred, Olivier Cha","doi":"10.3917/spub.252.0073","DOIUrl":"https://doi.org/10.3917/spub.252.0073","url":null,"abstract":"<p><strong>Introduction: </strong>Migrants are people who settle in a foreign country. In 2020, the global migrant population was estimated at about 281 million. Of the patients seen by the Comité pour la santé des exilés (a French non-profit that works to improve the health of refugees), 62% report having experienced violence. Migrant women are particularly exposed to gender-based violence. Among women who have migrated from the Democratic Republic of the Congo to Cameroon, 39% report having experienced sexual violence, significantly more than the rate among the host population (3.9%).</p><p><strong>Purpose of the study: </strong>To analyze the impact of violence on the physical and mental health of migrant women consulting primary health care centers in Paris.</p><p><strong>Methods: </strong>This was a cross-sectional analytical study carried out in two Parisian outpatient clinics. Migrant women were interviewed about whether they had experienced violence prior to their arrival in France. Their medical history and current state of health were also analyzed in light of the violence experienced.</p><p><strong>Results: </strong>131 migrant female patients were included over a period of three weeks. They were mainly from sub-Saharan Africa (75%), with an average age of 43 years, and 59% of them had experienced violence. Post-traumatic stress disorder (PTSD) was found in 66% of patients who had experienced violence, and half had symptoms of depression or anxiety, while these symptoms were only present in 22% and 20% respectively of migrant women in the group that had not experienced violence. Furthermore, among the patients who had experienced violence, 48% had cardiac symptoms versus 26%, 53% had respiratory symptoms versus 20%, and 58% had gastrointestinal symptoms versus 23% (p&amp;lt;0.05).</p><p><strong>Conclusions: </strong>These results indicate the need for particular vigilance regarding the history of violence in the migrant population, due to an increased risk of post-traumatic stress disorder frequently associated with physical symptoms.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 2","pages":"73-88"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Évolution des troubles mentaux liés au travail au Québec entre 2012 et 2021.","authors":"Jaunathan Bilodeau, Martin Lebeau, Marc-Antoine Busque, Alain Marchand","doi":"10.3917/spub.252.0229","DOIUrl":"https://doi.org/10.3917/spub.252.0229","url":null,"abstract":"<p><strong>Introduction: </strong>Several countries have seen an increase in the number of accepted mental disorders in recent years, but the possible variations of this change in the workforce are yet to be explored.</p><p><strong>Purpose of the study: </strong>This study examines the breakdown over time in accepted mental disorders by occupation, industrial sector, sex, and age in Quebec.</p><p><strong>Results: </strong>Incidence rates and trends in mental disorders vary by occupation and industrial sector. While the rate is generally higher in mixed occupations and the tertiary sector, the increase in these rates is more marked in non-manual occupations and the primary sector. Significant variations are also observed by sex and for certain age groups.</p><p><strong>Conclusions: </strong>The use of administrative data on accepted mental disorders complements survey data on mental health at work for different groups of workers. The growth in rates of accepted mental disorders points to the groups to be prioritized for prevention of this category of occupational injury..</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 2","pages":"229-238"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aborder les disparités de genre en France pour promouvoir l’équité en matière de santé des femmes.","authors":"Alexandre Vallée, Jean-Marc Ayoubi","doi":"10.3917/spub.251.0081","DOIUrl":"https://doi.org/10.3917/spub.251.0081","url":null,"abstract":"<p><p>Despite the firm entrenchment of gender equality in the laws and values of our modern societies, undeniable disparities between genders continue to exist. It's important to note that health disparities between genders are not solely a result of biological differences but are also due to sociological dynamics and the French healthcare system. The leading cause of death among women is not cancer but cardiovascular disease. Cancer occupies the second position, with breast cancer being the primary cause of mortality. Despite a very large number of cases, too little is still known about endometriosis and it is diagnosed late, with an average delay of seven years in France. Menopause is a physiological state in women, but various health problems can gradually develop as a result, like the climacteric syndrome. By placing women's health at the heart of concerns, we can transform this unacceptable situation into a victory for gender equality and justice in health.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"81-87"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lorsque les vécus d’oppression se propagent des patient.es aux chercheur.es : comment intégrer les données expérientielles à la recherche en santé mondiale ?","authors":"Émilie Pigeon-Gagné, Élise Bourgeois-Guérin, Sophie Gilbert","doi":"10.3917/spub.251.0067","DOIUrl":"https://doi.org/10.3917/spub.251.0067","url":null,"abstract":"<p><strong>Introduction: </strong>Global health researchers tend to focus on the social and structural determinants of health and offer solutions for the \"decolonization of public health\" by addressing these determinants. These solutions address the root causes of social inequalities in health, but too often ignore the affective and intersubjective dimensions that underlie the complex human relationships in global health.</p><p><strong>Methods: </strong>In this article, we focus on experiential data through the concept of geo-corpo-political knowledge (Tlostanova &amp; Mignolo, 2009). We explore the emotional experiences we can have as researchers engaging in authentic dialogue in research sites. We draw on collaborative research with Doctors of the World in Montreal, Quebec, focusing on barriers to health care for undocumented migrants to inform our analysis.</p><p><strong>Results: </strong>In qualitative interviews with caregivers working with this population, we identified paradoxes, areas of silence, and difficulties in verbalizing their lived and emotional experiences.</p><p><strong>Discussion: </strong>In this paper we go beyond what can be put into words. We aim to explore our feelings as researchers to offer a systemic understanding of the oppression experienced by patients in their interactions with healthcare institutions. We argue that to reach the most marginalized populations and better understand their experiences, it is important to develop research methods that integrate the emotional world of researchers.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"67-80"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La sécurisation culturelle est-elle suffisante pour prévenir le racisme systémique et réduire les iniquités en santé ? Regard critique sur le projet de loi 32.","authors":"Loubna Belaid, Tatiana Garakani, Lara Maillet","doi":"10.3917/spub.251.0053","DOIUrl":"https://doi.org/10.3917/spub.251.0053","url":null,"abstract":"<p><strong>Introduction: </strong>Faced with the glaring inequities between Indigenous and non-Indigenous populations, the Quebec government has proposed a bill to increase cultural safety in its health and social services for Indigenous populations.</p><p><strong>Objective: </strong>This article aims to critically examine this bill.</p><p><strong>Results: </strong>We show that it is marked by a colonial rationale. This rationale is as evident in the content of the bill as it is in its form. Regarding the content, Indigenous stakeholders were not consulted to jointly develop the bill, which fails to include any Indigenous demands. It denies the existence of systemic racism within healthcare institutions and neglects the inherent power dynamics integral to the concept of cultural safety. Regarding its form, the drafting of the bill is marked by paternalism, and the use of the \"us/them\" dichotomy reinforces a racialized and binary discourse between the dominant culture and Indigenous cultures. This dichotomy perpetuates ideologies of superiority and inferiority among population groups.</p><p><strong>Conclusion: </strong>By focusing on Indigenous cultural realities, the government sidesteps addressing the root causes of health inequities. Instead, the government should collaborate closely with Indigenous stakeholders and support policies addressing the structural determinants of health. It must also support the self-determination of Indigenous peoples.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"53-58"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Éducation Thérapeutique du Patient dans les maladies rares : bilan des appels à projets DGOS 2019-2020 et perspectives d’amélioration.","authors":"Robin Bouillé, Soumaya Balbolia, Audrey Barbet, Caroline Barry, Émilie Cappelle, Ariane David, Laurine Durot, Géraldine Fayet, Nicolas Guérin, Éric Hachulla, Christine Hassler, Elisabeth Lehu, Hélène Maillard, Rachel Pamart, Thomas Sannié, Laurence Schuller, Hélène Thiollet, Frédéric Gottrand, Stéphanie Ringenbach, Sophie Susen, Géraldine Wojtasik, Meryem-Maud Farhat","doi":"10.3917/spub.255.0179","DOIUrl":"https://doi.org/10.3917/spub.255.0179","url":null,"abstract":"","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 3","pages":"179-201"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}