Sante Publique最新文献

IGAS has issued a report on "taking scientific data into account in disease prevention and health promotion." This report takes a behaviorist approach marked by social paresis. We discuss this report in relation to four issues: a problematic definition of "disease prevention and health promotion," the disproportionate emphasis placed on scientific evidence, the imbalance between research and expertise, and a behaviorist approach masking the issues of health equity.

Introduction: The care paths and lives of cystic fibrosis patients were profoundly altered during the health crisis in France. Patient experiences can be used to provide lessons on how to adapt to a crisis.

Purpose of the study: The ExPaParM collaborative study analyzed the experiences of a varied sample of patients and identified changes in practices in Cystic Fibrosis Centers (CFC), with the aim of characterizing adaptations made and destabilizing events experienced during this crisis, using a systemic approach.

Results: Adaptation practices aiming to minimize the impact of the crisis or maintain the recommended quality of care, as far as possible, have been identified. These adaptations concern the individual level (patient and family), local care, care management at CFCs, and hospital organization. When the crisis has negatively affected patients, resilience factors based on individual and family skills, a relationship of trust with professionals, and informal solidarity networks have enabled complex situations to be overcome.

Conclusion: Strong points prior to the crisis proved decisive: the structuring of CFC teams, digital resources, therapeutic patient education, and a circuit for disseminating information related to cystic fibrosis. Reducing vulnerability to a future crisis also means securing essential medicines for the disease, organizing protected hospital circuits, and developing patient preparedness plans.

Introduction: The agricultural population stands out from other working populations due to a higher mortality rate from suicide. As part of the interministerial roadmap to combat distress in the agricultural sector, Santé publique France has explored the feasibility of using data from emergency department visits to implement reactive territorial targeting of the most at-risk agricultural areas.

Methods: Data on emergency department visits for suicidal behavior (SB) from 2018 to 2022, sourced from the Surveillance sanitaire des urgences et des décès system (Health Surveillance of Emergency Visits and Deaths), were analyzed and cross-referenced with data from the 2020 Agricultural Census. Trends in the rate of emergency department visits for SB were broken down by agricultural density quartiles at the national level and by region to monitor evolving patterns.

Results: In mainland France, the rate of emergency department visits for suicidal behavior increases with agricultural density. The average rate of emergency department visits in municipalities with the highest agricultural density is significantly higher than in those with the lowest agricultural density. This trend is observed in most regions. Regarding regional temporal trends, these are generally upward, although disparities exist.

Conclusion: By cross-referencing data on emergency department visits for suicidal behavior with agricultural density at the municipal level, we can construct a tool for monitoring the evolution of SB. These preliminary results open up opportunities for territorial targeting to prioritize the deployment of local public health policies, particularly training for the early detection of SB.

Purpose: In 2018, the Isère department implemented a promotional campaign for HPV vaccination called "StopHV." Our article aims to examine the impact of this campaign on the evolution of HPV vaccination coverage in Isère.

Method: The research study adopted a mixed-methods approach, incorporating qualitative components (focus groups) to contextualize quantitative results (surveys conducted in various secondary schools across the department), combined with vaccination coverage data.

Results: In Isère, vaccination coverage for one dose of the HPV vaccine increased from 21.7% in 2017 to 49.7% in 2022 (Santé Publique France). In 2022-2023, the main reason for non-vaccination remained fear of side effects, followed by lack of time. Among the survey participants, 95% reported having consulted their general practitioner for information about vaccination. A significant association was found between girls' vaccination status and parents' socio-professional category, as well as between Priority Education Network (REP) status and awareness of the HPV vaccine.

Discussion: Our study suggests that the StopHPV campaign was effective in achieving its goal of doubling HPV vaccination coverage by 2022. Our evaluation highlights the importance of maintaining training for general practitioners on HPV vaccination and the relevance of implementing school-based vaccination campaigns. It also appears essential to address socio-cultural inequalities by delivering targeted messages in schools belonging to Priority Education Networks.

The rural territory of Tarn-et-Garonne faces multiple health challenges, including access to rights and health care services. To meet these needs, the Proxi'Santé 82 program, led by APAS 82 (Association Promotion Autonomie et Santé 82) and funded by the Regional Health Agency ARS Occitanie, highlights key strategies for integrating health into territorial development through on-the-ground experience. Some examples demonstrate the added value of aligning territorial dynamics with health initiatives, such as carrying out activities linked to national cancer screening campaigns. Co-constructing health projects with partners is crucial as it leverages experiential knowledge and helps understand the specific characteristics of the targeted territory. The emergence of the health mediator profession, illustrated in this article, helps reduce territorial inequalities by improving access to information. In conclusion, the creation of the mobile team within a dynamic association, supported by a strong departmental and local partnership network, mediation practices, team mobility, and the use of experiential data has contributed to developing effective and impactful initiatives for the Tarn-et-Garonne region. Through these examples and identified strategies, Proxi'Santé 82 illustrates a proactive approach to health prevention and promotion at both departmental and local levels.

Introduction: Access to health care for trans and gender-diverse individuals is marked by persistent inequalities, often rooted in stigma and discrimination. The limited involvement of health care and social service professionals further restricts these individuals' access to adequate care. This article offers a novel analytical perspective by examining the experiences, motivations, and perceived enablers highlighted by professionals in the medical and social fields who are actively engaged in supporting the health care of trans people.

Methods: Thirteen professionals took part in the study through individual interviews and a focus group. Thematic analysis identified several key barriers and enablers in their practices.

Results: Enablers included a strong commitment to social justice, the establishment of egalitarian care relationships, and prior familiarity with the trans community. Major barriers included a lack of training and official guidelines, fear of overstepping one's professional boundaries, and structural constraints tied to a binary male/female health care model. Participants suggested several avenues for improvement, including the development of guidelines by the French National Health Authority, the generation of robust scientific data, and the integration of specific content on trans health into both initial and continuing education. These measures, they emphasized, must be developed in collaboration with the communities concerned. Ultimately, participants stressed that reducing health care access inequalities depends on increasing the number of professionals who are both committed and adequately trained to support trans individuals.

Discussion: Transforming the health care system into a more inclusive space for trans people requires the commitment of professionals, institutional reforms, and the active participation of those directly concerned, in order to improve access to care and enhance the quality and equity of health care for all.