{"id":6666,"date":"2022-01-29T22:21:00","date_gmt":"2022-01-29T22:21:00","guid":{"rendered":"http:\/\/nccdh.local\/resource\/what-do-we-mean-by-structure-when-we-talk-about-structural-influences-on-the-social-determinants-of-health-inequalities\/"},"modified":"2025-11-06T17:16:11","modified_gmt":"2025-11-06T17:16:11","slug":"what-do-we-mean-by-structure-when-we-talk-about-structural-influences-on-the-social-determinants-of-health-inequalities","status":"publish","type":"resource","link":"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/what-do-we-mean-by-structure-when-we-talk-about-structural-influences-on-the-social-determinants-of-health-inequalities\/","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 seulement en anglais.<\/em><\/p>\n<p>On sait que les structures sociales, &eacute;conomiques et politiques influent sur l&rsquo;&eacute;tat de sant&eacute; des populations. Ces structures contribuent &agrave; un gradient o&ugrave; la position sociale relative d&rsquo;un individu peut servir d&rsquo;estimation de l&rsquo;&eacute;tat de sant&eacute; pour faire une comparaison avec un individu ayant une position sociale plus &eacute;lev&eacute;e ou avec un individu ayant une position sociale moins &eacute;lev&eacute;e.<br \/>\n&nbsp;<\/p>\n<h3>Habitus et gouvernementalit&eacute;<\/h3>\n<p>Gemma Carey et Bradley Crammond font valoir que le jugement habituellement port&eacute; sur ces structures, c&rsquo;est-&agrave;-dire qu&rsquo;elles sont de profondes causes d&rsquo;iniquit&eacute;s, ne tient pas compte d&rsquo;un &eacute;l&eacute;ment cl&eacute; du comportement li&eacute; &agrave; la sant&eacute;. En s&rsquo;appuyant sur les concepts d&rsquo;<em>habitus<\/em> et de <em>gouvernementalit&eacute;<\/em>, ils examinent les conditions sociales davantage li&eacute;es &agrave; l&rsquo;individu que les grandes structures typiquement consid&eacute;r&eacute;es dans les propos sur les d&eacute;terminants sociaux de la sant&eacute;.<br \/>\n&nbsp;<\/p>\n<h3>Int&eacute;riorisation des conditions sociales<\/h3>\n<p>Les auteurs estiment que l&rsquo;int&eacute;riorisation des conditions sociales est plus susceptible de pr&eacute;dire certains comportements li&eacute;s &agrave; la sant&eacute; que la position d&rsquo;un individu dans la hi&eacute;rarchie sociale et &eacute;conomique, m&ecirc;me si la position change avec le temps. Ainsi, les mesures prises en sant&eacute; publique portent davantage de fruits si elles visent &agrave; donner aux individus une option qui semble reposer sur un consentement libre donn&eacute; de plein gr&eacute;, plut&ocirc;t que d&rsquo;imposer des r&egrave;glements pour obtenir un changement.<br \/>\n&nbsp;<\/p>\n<h3>Trois nouvelles fa&ccedil;ons de voir la structure<\/h3>\n<p>Les auteurs concluent en sugg&eacute;rant trois nouvelles fa&ccedil;ons d&rsquo;aborder la structure en sant&eacute; publique&nbsp;:<\/p>\n<ol>\n<li>Arr&ecirc;ter de penser que les changements aux plus hautes sph&egrave;res de la structure am&egrave;neront les individus &agrave; faire des choix diff&eacute;rents et &agrave; adopter un mode de vie sain.<\/li>\n<li>Discuter ouvertement des limites de la sant&eacute; publique en ce qui concerne la collecte et la diffusion des donn&eacute;es sur ce qui influence les r&eacute;sultats dans l&rsquo;&eacute;tat de sant&eacute; parce qu&rsquo;aucune population ne fait l&rsquo;exp&eacute;rience des m&ecirc;mes structures de la m&ecirc;me fa&ccedil;on.<\/li>\n<li>L&rsquo;&eacute;pid&eacute;miologie devrait porter sur les diff&eacute;rences au sein d&rsquo;un groupe social et sur les similitudes d&rsquo;un groupe social &agrave; un autre, et non pas sur les constances au sein d&rsquo;un groupe social et les diff&eacute;rences d&rsquo;un groupe social &agrave; un autre.<br \/>\n\t&nbsp;<\/li>\n<\/ol>\n<h3>Servez-vous de cet outil pour&nbsp;:<\/h3>\n<ul>\n<li>r&eacute;fl&eacute;chir sur votre fa&ccedil;on de voir les structures et les effets de celles-ci sur l&rsquo;&eacute;tat de sant&eacute;;<\/li>\n<li>revoir votre perception de l&rsquo;importance relative des diff&eacute;rents &eacute;chelons d&rsquo;une structure au regard des d&eacute;terminants de la sant&eacute;;<\/li>\n<li>orienter le processus d&rsquo;&eacute;laboration des interventions de sant&eacute; publique (politiques et strat&eacute;gies) qui visent &agrave; changer les comportements li&eacute;s &agrave; la sant&eacute;.<\/li>\n<\/ul>\n<h3>Ressources connexes&nbsp;<\/h3>\n<p><a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/taking-action-on-the-social-determinants-of-health-insights-from-politician\" target=\"_self\" rel=\"noopener\">Taking action on the social determinants of health: Insights from politicians, policymakers and lobbyists<\/a> (2014) (en anglais)<\/p>\n<p><a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/health-equity\" target=\"_self\" rel=\"noopener\">L&rsquo;&eacute;quit&eacute; en sant&eacute; : Parlons-en<\/a> (2013)<\/p>\n<p><a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/just-societies-health-equity-and-dignified-lives\" target=\"_self\" rel=\"noopener\">Just societies: Health equity and dignified lives<\/a> (2019) (en anglais)<\/p>\n<hr \/>\n<h3>R&eacute;f&eacute;rence bibliographique<\/h3>\n<p>Crammond, B.&nbsp;R. et G.&nbsp;Carey. (2017). What do we mean by &lsquo;structure&rsquo; when we talk about structural influences on the social determinants of health inequalities? <em>Social Theory &amp; Health<\/em>, <em>15<\/em>, p. 84-98.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Gemma Carey et Bradley Crammond soutiennent dans leur article que l\u2019int\u00e9riorisation des influences structurelles est tout aussi susceptible de d\u00e9terminer l\u2019\u00e9tat de sant\u00e9 d\u2019un individu que les structures sociales, politiques et \u00e9conomiques en place.  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