This study contributes to the literature about the effects of space and place on health by introducing a socio-territorial approach to urban health disparities in West Africa. It explores how urban spaces, specifically neighbourhoods, are shaped by social and economic relations and strategies of territorial control. We examine the potential influence of socio-territorial processes on vulnerability to disease, access to medical care, healthscapes, and illness experiences. Our research was conducted in Senegal and relied on a mixed methods design. We identified four neighbourhoods that represent the socio-spatial heterogeneity of the city of Saint-Louis and utilized the following methods: geographic and anthropological field research, household surveys, health knowledge and behaviour surveys, clinical exams, and illness interviews. Our results highlight the socio-territorial processes at work in each neighbourhood, clinical findings on three health measures (overweight, high blood pressure, and hyperglycaemia) and health experiences of individuals with hypertension or type II diabetes. We found significant differences in the prevalence of the three health measures in the study sites, while experiences managing hypertension and diabetes were similar. We conclude that a socio-territorial approach offers insight into the complex constellation of forces that produce health disparities in urban settings.
This study contributes to the literature about the effects of space and place on health by introducing a socio-territorial approach to urban health disparities in West Africa. It explores how urban spaces, specifically neighbourhoods, are shaped by social and economic relations and strategies of territorial control. We examine the potential influence of socio-territorial processes on vulnerability to disease, access to medical care, healthscapes, and illness experiences. Our research was conducted in Senegal and relied on a mixed methods design. We identified four neighbourhoods that represent the socio-spatial heterogeneity of the city of Saint-Louis and utilized the following methods: geographic and anthropological field research, household surveys, health knowledge and behaviour surveys, clinical exams, and illness interviews. Our results highlight the socio-territorial processes at work in each neighbourhood, clinical findings on three health measures (overweight, high blood pressure, and hyperglycaemia) and health experiences of individuals with hypertension or type II diabetes. We found significant differences in the prevalence of the three health measures in the study sites, while experiences managing hypertension and diabetes were similar. We conclude that a socio-territorial approach offers insight into the complex constellation of forces that produce health disparities in urban settings.
Titre
en
Toward a Socio-Territorial Approach to Health: Health Equity in West Africa
Auteur(s)
Lucie Vialard1
, Clara Squiban1
, Gilles Riveau2
, Emmanuel Hermann3
, Doudou Diop2
, Florence Fournet4
, Gérard Salem1, 5
, Ellen E. Foley6
1
LADYSS -
Laboratoire Dynamiques Sociales et Recomposition des Espaces
( 1096 )
- Université Paris Ouest Nanterre La Défense Bâtiment T 200 avenue de la République 92001 Nanterre cedex
- France
Université Paris 1 Panthéon-Sorbonne UMR7533 ( 7550 )
;
Université Paris 8 Vincennes-Saint-Denis UMR7533 ( 11141 )
;
Université Paris Nanterre UMR7533 ( 116205 )
;
Université Paris Diderot - Paris 7 UMR7533 ( 300301 )
;
Centre National de la Recherche Scientifique UMR7533 ( 441569 )
2
CRB EPLS -
Centre de Recherche Biomédicale Espoir Pour La Santé [Saint-Louis, Sénégal]
( 569970 )
- Sénégal
3
CIIL -
Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204
( 106189 )
- 1 Rue du Professeur Calmette - Lille Cedex - 59019 - BP 245
- France
Institut Pasteur de Lille UMR8204 ( 300166 )
;
Réseau International des Instituts Pasteur ( 301247 )
;
Institut National de la Santé et de la Recherche Médicale U1019 ( 303623 )
;
Centre National de la Recherche Scientifique UMR9017 ( 441569 )
4
MIVEGEC-DEEVA -
Diversity, ecology, evolution & Adaptation of arthropod vectors
( 1052755 )
- France
Evolution des Systèmes Vectoriels ( 1052714 )
;
Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle ( 166573 )
;
Université de Montpellier UMR5290 ( 410122 )
;
Centre National de la Recherche Scientifique UMR5290 ( 441569 )
;
Institut de Recherche pour le Développement 224 ( 451860 )
5
CEPED - UMR_D 196 -
Centre population et développement
( 86890 )
- 45 rue des Saints-Pères
75006 Paris
- France
Institut de Recherche pour le Développement ( 67872 )
;
Université Paris Descartes - Paris 5 UMR_D 196 ( 301664 )
6
Clarkson University
( 346914 )
- 8 Clarkson Ave., Potsdam, New York 13699
- États-Unis
Nom de la revue
IJERPH -
International Journal of Environmental Research and Public Health
(ISSN : 1661-7827, ISSN électronique : 1660-4601)
MDPI
Publié par MDPI
https://www.mdpi.com/journal/ijerph
Revue non référencée dans Sherpa-Romeo
We thank Gilles Riveau, Emmanuel Hermann, and Doudou Diop from the Biomedical Research Centre Espoir pour la Santé who organized and supervised the medical survey. We also thank the survey team and the population of Saint-Louis for their collaboration.
Financement
Core funding was provided by the Agence Nationale de la Recherche (ANR12-INEG-007) and the Centre National de la Recherche Scientifique (CNRS, PEPS107-IE) provided methodological support.
Mots-clés
en
hypertension, health disparities, socio-territorial approach, urban health, diabetes, West Africa
Lucie Vialard, Clara Squiban, Gilles Riveau, Emmanuel Hermann, Doudou Diop, et al.. Toward a Socio-Territorial Approach to Health: Health Equity in West Africa. International Journal of Environmental Research and Public Health, 2017, 14 (1), ⟨10.3390/ijerph14010106⟩. ⟨hal-01471468⟩