Process of Urbanisation and Health Dynamics · Process of Urbanisation and Health Dynamics Pr....
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Process of Urbanisation and Health Dynamics Pr. Gérard J. Salem, University Paris Ouest- Ceped 8th Global Conference on Health Promotion Helsinki, 2013, June 10th- 14th, 2013 1
Transcript of Process of Urbanisation and Health Dynamics · Process of Urbanisation and Health Dynamics Pr....
Process of Urbanisation and
Health Dynamics
Pr. Gérard J. Salem,
University Paris Ouest- Ceped
8th Global Conference on Health PromotionHelsinki, 2013,
June 10th- 14th, 2013 1
World Urbanization Prospects : 2007, the URBAN YEAR !
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An urban world
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1- Urban Health ? 2- Urban process and Health Dynamics
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1- Impacts of Urbanisation on Infectious Morbidity
1) High Human Population Densities :
2) Spatial and Social Heterogeneity
3) Spaces are open and interconnected
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11- Impacts of Urbanisation on Chronic and Degenerative Diseases
Urban diet overweight, obesity, and ….stunting Diabetes
Urban pollutions and hazards, water, air, industrial risks, traffic injury, etc
cancer, disability, etc.
Urban Stress and Habits HBP, Cancers, stress, mental disorders, etc.
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12- Cities as main places of «Health Transitions» ?
• Demographic transition
• Epidemiologic transition
• Nutritionnal transition
• An history written in advance??7
2- Urban process and Health Dynamics
Is it really an universal phenomena?
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Venice, Italy
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Dogon cities, Mali, West Africa
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2- Urban process and Health Dynamics
Is it really an universal phenomena?
Need comparative approaches between Cities ex : France
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Inter-urban comparisons : the exemple of France
Female
Male
Expe
ctan
cy o
f life
at b
irth
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France : Size of the city and Male Expectancy of Life : 1973-2001
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INEQUALITIES OF EXPECTANCY OF LIFE AT BIRTH IN FRENCH CITIES 1973-2001
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Standardized Rates of Avoidable Mortality related to Health Care System (urban areas scale), 2004-2008
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PARIS : the best and the worst…
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Rio de Janeiro: the best and the worst…
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2- Urban process and Health Dynamics
Need intra-urban approaches of Health inequalitiesParis agglomeration (France)Ouagadougou (Burkina Faso)San Francisco (USA)
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Standardized Ratio Mortality in Paris Agglomeration 1973- 1977/ 2004-2008
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Burkina Faso, OuagadougouSpatio-temporal development
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237 km2 in 2005
A double process of urbanization:
legal (143 km2) vs
illegal(94 km2)
Burkina Faso, OuagadougouCities in the City
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The C.B.D
Burkina Faso, OuagadougouCities in the City
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Heterogeneity of legal zones
Burkina Faso, OuagadougouCities in the City
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Contrasts between legal and illegal settlements in the suburb
Burkina Faso, OuagadougouCities in the City
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High Density in Illegal Districts
Low density in Illegal Districts
Burkina Faso, OuagadougouCities in the City
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Trafic accidents in
Ouagadougou
Burkina Faso, Ouagadougou
Cities in the City
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Problems of Hygiene and Sanitation in
Ouagadougou (Burkina Faso)
Burkina Faso, OuagadougouCities in the City
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Number of cases of Cholera related to Water Pumps location in Ouagadougou
Burkina Faso, OuagadougouCities in the City
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12,3
13,3
9,2
18,8
30,129,7
34,5
27,5
Prevalences of Malaria in 2006Ouagadougou
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United States of America, San FranciscoCities in the City
Sources : J. Corburn, Un. Berkeley
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United States of America, San FranciscoCities in the City
Sources : J. Corburn, Un. Berkeley
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United States of America, San FranciscoCities in the City
Sources : J. Corburn, Un. Berkeley
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United States of America, San FranciscoCities in the City
Sources : J. Corburn, Un. Berkeley
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High school grads: 90%Unemployment: 4%
Poverty: 7%Home ownership: 64%
Non-White: 49%
Sources : J. Corburn, Un. Berkeley
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High school grads: 81%Unemployment: 6%
Poverty: 10%Home ownership: 52%
Non-White: 59%
Sources : J. Corburn, Un. Berkeley
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High school grads: 65%Unemployment: 12%
Poverty: 25%Home ownership: 38%
Non-White: 89%Sources : J. Corburn, Un. Berkeley
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High school grads: 90%Unemployment: 4%
Poverty: 7%Home ownership: 64%
Non-White: 49%
High school grads: 81%Unemployment: 6%
Poverty: 10%Home ownership: 52%
Non-White: 59%
High school grads: 65%Unemployment: 12%
Poverty: 25%Home ownership: 38%
Non-White: 89%
Life Expectancy
>80
74.3 - 80
<74.3
Sources : J. Corburn, Un. Berkeley
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HE
ALT
HC
AR
E
AC
CE
SS
Medical Model
Sources : J. Corburn, Un. Berkeley
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Medical ModelSocio-Ecological
HE
ALT
HC
AR
E
AC
CE
SS
Sources : J. Corburn, Un. Berkeley
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Conclusion…
1°) IT’S NOT AN HISTORY WRITTEN IN ADVANCE No urban determinism ! No urban fatality !
2°) THE CHALLENGES ? - FOR ACTIONS - FOR RESEARCH- FOR TRAINING
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Priority for multidisciplinary Research
1- Morbidity
« New old diseases », New diseases, co-morbidity
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Priority for Research
1- Morbidity
2- Society, Territories and Health
Links between Territorial Dynamics and Health Dynamics
ex : areas at risk, accessibility to Health Care SystemSocial Change, Social Control, Territorial Control and Health
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Intersectorial actions on Determinants of Health : Water, Sanitation, Housing, School, etc
There are Cities in the City: Populations and Areas at Risks
Central question of Information System
Priority for Action
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Problems are environmental, social, economic, and cultural:
Developing Systemic Approaches on Determinants of Health Fill the Gap between Specialists of Cities and Specialists of Health Fill the Gap between Researchers and Decisions Makers
Priority for training
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