{"id":6564,"date":"2023-11-09T11:59:00","date_gmt":"2023-11-09T11:59:00","guid":{"rendered":"http:\/\/nccdh.local\/resource\/what-do-we-mean-by-structure\/"},"modified":"2025-11-06T17:15:23","modified_gmt":"2025-11-06T17:15:23","slug":"what-do-we-mean-by-structure","status":"publish","type":"resource","link":"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/what-do-we-mean-by-structure\/","title":{"rendered":"What do we mean by \u2018structure\u2019 when we talk about structural influences on the social determinants of health inequalities?"},"content":{"rendered":"<p><em>Cette ressource est disponible en anglais seulement.<\/em><\/p>\n<p>L&rsquo;article de revue traite de la notion de structure dans le contexte des facteurs structuraux influant sur l&rsquo;&eacute;quit&eacute; en sant&eacute;. En sant&eacute; publique, l&rsquo;un des objectifs est de comprendre le concept et de chercher &agrave; en modifier l&rsquo;incidence. En utilisant le tabagisme comme exemple de base, les auteurs analysent les interactions entre les facteurs structurels et les comportements li&eacute;s &agrave; la sant&eacute;.<\/p>\n<p>Les auteurs proposent ensuite une nouvelle conceptualisation de la notion de structure, en s&rsquo;inspirant du travail de Pierre Bourdieu et du concept de gouvernementalit&eacute; de Michel Foucault. Ils affirment que toute observation au sujet de la structure en sant&eacute; publique doit reposer sur les trois faits suivants :<\/p>\n<ol>\n<li>Les diff&eacute;rences d&rsquo;attitude et de comportement s&rsquo;av&egrave;rent tr&egrave;s marqu&eacute;es &agrave; l&rsquo;int&eacute;rieur de chaque classe.<\/li>\n<li>Le pouvoir d&rsquo;influencer ces attitudes et ces comportements ne r&eacute;side pas uniquement dans la classe sociale.<\/li>\n<li>Certains discours sont structurellement tr&egrave;s r&eacute;pandus, sans d&eacute;terminer les comportements.<\/li>\n<\/ol>\n<p>Pour modifier le sens habituellement donn&eacute; &agrave; la notion de structure, il faut changer trois choses (p. 95) :&nbsp;<\/p>\n<ol>\n<li>Nous devons rejeter l&rsquo;id&eacute;e que les facteurs changeants comme le niveau de revenu viendront influer sur les comportements individuels li&eacute;s &agrave; la sant&eacute;.<\/li>\n<li>Nous devons explicitement reconna&icirc;tre les limites de nos efforts pour documenter ce qui influence la sant&eacute;.<\/li>\n<li>L&rsquo;analyse &eacute;pid&eacute;miologique doit porter sur les diff&eacute;rences au sein de groupes sociaux et les similitudes entre les groupes sociaux.<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<h3>Servez-vous de cet outil pour :<\/h3>\n<ul>\n<li>ancrer la compr&eacute;hension des acteurs de la sant&eacute; concernant les influences structurelles dans les perspectives th&eacute;oriques;<\/li>\n<li>animer des discussions au sujet de l&rsquo;implication et de la compr&eacute;hension des facteurs structurels par rapport aux d&eacute;terminants sociaux de la sant&eacute;;<\/li>\n<li>plaider pour des changements aux approches &eacute;pid&eacute;miologiques et aux m&eacute;thodes de recherche en mati&egrave;re d&rsquo;interventions structurelles.<br \/>\n\t&nbsp;<\/li>\n<\/ul>\n<h3>Connexit&eacute; avec le travail du CCNDS :<\/h3>\n<p>La notion de d&eacute;terminants sociaux de la sant&eacute; ne date pas d&rsquo;aujourd&rsquo;hui et se situe depuis toujours au c&oelig;ur du travail du CCNDS. Depuis peu, de nouveaux qualificatifs font leur apparition dans le domaine de la sant&eacute; publique pour d&eacute;crire d&rsquo;autres d&eacute;terminants de la sant&eacute; <span style=\"background-color:white\"><span style=\"color:black\">&mdash; structurels, politiques, moraux et commerciaux, par exemple.<\/span><\/span><\/p>\n<p>Chacun des qualificatifs permet de mieux comprendre l&rsquo;influence d&rsquo;un facteur donn&eacute; sur notre &eacute;tat de sant&eacute;. Le CCNDS commence &agrave; se pencher sur ces d&eacute;terminants de la sant&eacute; et &agrave; incorporer des ressources comme celles &eacute;num&eacute;r&eacute;es ci-dessous dans son travail de transfert des connaissances.<\/p>\n<p><a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/lets-talk-redistributing-power-to-advance-health-equity\" style=\"color:blue; text-decoration:underline\">Repenser la r&eacute;partition du pouvoir pour favoriser l&rsquo;&eacute;quit&eacute; en sant&eacute;&nbsp;: Parlons-en<\/a><\/p>\n<p><a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/structural-interventions-that-affect-racial-inequities-and-their-impact-on-population-health-outcomes-a-systematic-review\" style=\"color:blue; text-decoration:underline\" title=\"Structural interventions that affect racial inequities and their impact on population health outcomes: a systematic review\">Structural interventions that affect racial inequities and their impact on population health outcomes: a systematic review<\/a> (en anglais, avec r&eacute;sum&eacute; en fran&ccedil;ais)<\/p>\n<p><a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/health-equity-frameworks-as-a-tool-to-support-public-health-action-a-rapid-review-of-the-literature\" style=\"color:blue; text-decoration:underline\">Cadres d&rsquo;&eacute;quit&eacute; en sant&eacute; comme outils pour faciliter les interventions en sant&eacute; publique&nbsp;: Revue rapide de la litt&eacute;rature<\/a><\/p>\n<p>&nbsp;<\/p>\n<p><strong><a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/type\/category\/structural-determinants\" style=\"color:blue; text-decoration:underline\">Consultez les autres ressources sur les d&eacute;terminants structurels de la sant&eacute;<\/a>.<\/strong><\/p>\n<hr \/>\n<h3>R&eacute;f&eacute;rence bibliographique :<\/h3>\n<p>Crammond, B. R. et Carey, G. (2017). What do we mean by &lsquo;structure&rsquo; when we talk about structural influences on the social determinants of health inequalities?&nbsp;<em>Social Theory &amp; Health,<\/em> <em>15<\/em>(1), 84-98. <a href=\"https:\/\/doi.org\/10.1057\/s41285-016-0020-3\" style=\"color:blue; text-decoration:underline\">https:\/\/doi.org\/10.1057\/s41285-016-0020-3<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Quelle d\u00e9finition donne-t-on \u00e0 la structure quand il est question de son influence sur les d\u00e9terminants sociaux de la sant\u00e9? Les auteurs de l\u2019article de revue proposent une nouvelle conceptualisation de la structure en sant\u00e9 publique.<\/p>\n","protected":false},"featured_media":8798,"template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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Les auteurs de l\u2019article de revue proposent une nouvelle conceptualisation de la structure en sant\u00e9 publique.","_links":{"self":[{"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/resource\/6564","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/resource"}],"about":[{"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/types\/resource"}],"version-history":[{"count":1,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/resource\/6564\/revisions"}],"predecessor-version":[{"id":7219,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/resource\/6564\/revisions\/7219"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/media\/8798"}],"wp:attachment":[{"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/media?parent=6564"}],"wp:term":[{"taxonomy":"keyword","embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/keyword?post=6564"},{"taxonomy":"nccdh-series","embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/nccdh-series?post=6564"},{"taxonomy":"producer","embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/producer?post=6564"},{"taxonomy":"resource-type","embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/resource-type?post=6564"},{"taxonomy":"role","embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/role?post=6564"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}