{"id":7070,"date":"2026-02-23T14:43:58","date_gmt":"2026-02-23T18:43:58","guid":{"rendered":"http:\/\/nccdh.ca\/resource\/lets-talk-moving-upstream\/"},"modified":"2026-06-22T15:52:18","modified_gmt":"2026-06-22T19:52:18","slug":"lets-talk-moving-upstream","status":"publish","type":"resource","link":"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/lets-talk-moving-upstream\/","title":{"rendered":"Se diriger vers l&#8217;amont : Parlons-en"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><em>This resource is also available <a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/lets-talk-moving-upstream\/\">in English<\/a>.<\/em>&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Cette ressource remplace la version pr\u00e9c\u00e9dente (2014) de\u00a0<em>Se diriger vers l\u2019amont\u202f: Parlons-en<\/em>.\u00a0<em><a href=\"https:\/\/nccdh-dev.media-doc.ca\/wp-content\/uploads\/2024\/10\/Se_diriger_vers_lamont__finale_fr1.pdf\">Cliquez ici pour acc\u00e9der \u00e0 la version 2014.<\/a><\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>L\u2019analogie&nbsp;d\u2019une rivi\u00e8re<\/strong>&nbsp;<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">L\u2019analogie&nbsp;d\u2019une rivi\u00e8re&nbsp;est souvent utilis\u00e9e en sant\u00e9 publique pour montrer&nbsp;que r\u00e9pondre&nbsp;aux urgences sanitaires et aux besoins de sant\u00e9 imm\u00e9diats \u00e9quivaut \u00e0 secourir les personnes en aval, tandis que les interventions sur les d\u00e9terminants structurels et sociaux de la sant\u00e9 dirigent leur attention vers l\u2019amont&nbsp;pour pr\u00e9venir et \u00e9viter que les personnes ne tombent dans le cours d\u2019eau au d\u00e9part.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Cette ressource utilise l\u2019analogie&nbsp;d\u2019une&nbsp;rivi\u00e8re pour d\u00e9crire les diff\u00e9rents niveaux d\u2019intervention et de moyens d\u2019action en sant\u00e9 publique pour faire progresser l\u2019\u00e9quit\u00e9 en sant\u00e9 en agissant sur les d\u00e9terminants structurels et sociaux de la sant\u00e9.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Que veut dire \u00ab\u202fen amont\u202f\u00bb?<\/strong>&nbsp;<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dans ce document,&nbsp;le terme \u00ab\u202fen amont\u202f\u00bb est utilis\u00e9 comme\u202f:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>un&nbsp;concept<\/strong>\u202fpour d\u00e9crire les points d\u2019intervention relatifs pour s\u2019attaquer aux causes profondes de la mauvaise sant\u00e9;&nbsp;<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>une&nbsp;justification<\/strong>&nbsp;pour axer le travail de la sant\u00e9 publique sur les syst\u00e8mes et les structures qui influent sur l\u2019\u00e9quit\u00e9 en sant\u00e9;&nbsp;<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>une&nbsp;approche&nbsp;<\/strong>pour guider la r\u00e9flexion et le travail.&nbsp;<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">La ressource r\u00e9pertorie les caract\u00e9ristiques&nbsp;du&nbsp;travail en amont et met en \u00e9vidence les interventions en amont qui ciblent les racines&nbsp;de la sant\u00e9, soit&nbsp;les forces&nbsp;structurelles et sociales&nbsp;qui influent sur l\u2019\u00e9tat de sant\u00e9.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Se&nbsp;diriger vers l\u2019amont<\/strong>&nbsp;<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Cette ressource d\u00e9crit plus en d\u00e9tail les approches en aval, \u00e0 l\u2019interm\u00e9diaire et en amont, et stimule la r\u00e9flexion sur la position des pratiques et des politiques le long du cours d\u2019eau.&nbsp; Elle fournit \u00e9galement des exemples d\u2019interventions&nbsp;afin d\u2019orienter&nbsp;la sant\u00e9 publique&nbsp;\u00e0&nbsp;se d\u00e9placer en amont et \u00e0 prendre en compte des syst\u00e8mes plus larges et des forces motrices qui contribuent aux mauvais r\u00e9sultats en sant\u00e9 et aux in\u00e9galit\u00e9s sociales de sant\u00e9. Enfin, cette ressource comprend des questions de discussion pour orienter la r\u00e9flexion individuelle et organisationnelle sur la position du travail actuel et pour inciter \u00e0 une intervention plus en amont.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Servez-vous de cet outil pour<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Approfondir la compr\u00e9hension&nbsp;de ce que signifie&nbsp;travailler en amont;&nbsp;<\/li>\n\n\n\n<li>Orienter les interventions pour agir sur les d\u00e9terminants structurels et sociaux de la sant\u00e9 et faire progresser l\u2019\u00e9quit\u00e9 en sant\u00e9;&nbsp;<\/li>\n\n\n\n<li>R\u00e9orienter les perspectives, les valeurs et les pratiques qui peuvent renforcer les approches en aval et limiter la capacit\u00e9 d\u2019intervention en amont.&nbsp;<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Ressources connexes&nbsp;<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/lets-talk-determinants-of-health\/\" target=\"_blank\" rel=\"noreferrer noopener\">D\u00e9terminants de la sant\u00e9\u202f: Parlons-en<\/a>&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/resources\/entry\/lets-talk-language-of-health-equity\/\" target=\"_blank\" rel=\"noreferrer noopener\">Terminologie propre \u00e0 l\u2019\u00e9quit\u00e9 en sant\u00e9 : Parlons-en<\/a>&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/learn\/glossaire\/\" target=\"_blank\" rel=\"noreferrer noopener\">Glossaire des principaux concepts li\u00e9s \u00e0 l\u2019\u00e9quit\u00e9 en sant\u00e9<\/a>&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/nccdh-dev.media-doc.ca\/fr\/learn\/serie-parlons-en\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Voir les autres ressources de la s\u00e9rie \u00ab\u2009Parlons-en\u2009\u00bb<\/strong><\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">R\u00e9f\u00e9rence<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Centre de collaboration nationale des d\u00e9terminants de la sant\u00e9. (2025).\u00a0<em>Se diriger vers l\u2019amont : Parlons-en<\/em> (2<sup>e<\/sup> \u00e9d.).\u00a0Antigonish\u00a0(NS) : CCNDS, Universit\u00e9 St. Francis Xavier.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Cette ressource de la s\u00e9rie \u00ab\u202fParlons-en\u202f\u00bb utilise l\u2019analogie d\u2019une rivi\u00e8re pour explorer diff\u00e9rents niveaux d\u2019intervention en sant\u00e9 publique afin de faire progresser l\u2019\u00e9quit\u00e9 en sant\u00e9. \u00c0 l\u2019aide de descriptions d\u2019approches en amont, \u00e0 l\u2019interm\u00e9diaire et en aval, et des exemples de pratiques, il encourage les praticiens de la sant\u00e9 publique, les responsables de l\u2019\u00e9laboration des politiques et les d\u00e9cideurs \u00e0 travailler \u00e0 contre-courant et \u00e0 d\u00e9placer les efforts en amont pour agir sur les d\u00e9terminants structurels et sociaux de la sant\u00e9.<\/p>\n","protected":false},"featured_media":16381,"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":"14191,14149,14169,14173,14203,14153","_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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Vossen","author_link":"https:\/\/nccdh-dev.media-doc.ca\/fr\/author\/"},"uagb_comment_info":0,"uagb_excerpt":"Cette ressource de la s\u00e9rie \u00ab\u202fParlons-en\u202f\u00bb utilise l\u2019analogie d\u2019une rivi\u00e8re pour explorer diff\u00e9rents niveaux d\u2019intervention en sant\u00e9 publique afin de faire progresser l\u2019\u00e9quit\u00e9 en sant\u00e9. \u00c0 l\u2019aide de descriptions d\u2019approches en amont, \u00e0 l\u2019interm\u00e9diaire et en aval, et des exemples de pratiques, il encourage les praticiens de la sant\u00e9 publique, les responsables de l\u2019\u00e9laboration des\u2026","_links":{"self":[{"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/resource\/7070","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":4,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/resource\/7070\/revisions"}],"predecessor-version":[{"id":16742,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/resource\/7070\/revisions\/16742"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/media\/16381"}],"wp:attachment":[{"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/media?parent=7070"}],"wp:term":[{"taxonomy":"keyword","embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/keyword?post=7070"},{"taxonomy":"nccdh-series","embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/nccdh-series?post=7070"},{"taxonomy":"producer","embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/producer?post=7070"},{"taxonomy":"resource-type","embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/resource-type?post=7070"},{"taxonomy":"role","embeddable":true,"href":"https:\/\/nccdh-dev.media-doc.ca\/fr\/wp-json\/wp\/v2\/role?post=7070"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}