Nathalie Bajos

Santé publique (2024-2025)

Collège de France

Année 2024-2025

Colloque - La production sociale des inégalités de santé : approches théoriques et données empiriques. Perspectives internationales

Remarques conclusives

Nathalie Bajos

Directrice de recherche (Inserm), directrice d'étude (EHESS), professeure invitée du Collège de France

Nathalie Bajos

Santé publique (2024-2025)

Collège de France

Année 2024-2025

Colloque - La production sociale des inégalités de santé : approches théoriques et données empiriques. Perspectives internationales

Session 3 : Interroger la structuration sociale des inégalités de santé en anthropologie et en épidémiologie

Pierre-Yves Geoffard : Discussion

Pierre-Yves Geoffard

Professeur, Paris School of Economics

Pierres-Yves Geoffard

Études de mathématiques (thèse de doctorat) et d'économie (DEA), visiting scholar à Stanford puis à l'Université de Chicago, chercheur au CNRS depuis 1995, directeur d'études à l'EHESS, professeur à l'École d'économie de Paris. Je travaille sur les systèmes de santé, et en particulier sur les inégalités sociales de santé.

Nathalie Bajos

Santé publique (2024-2025)

Collège de France

Année 2024-2025

Colloque - La production sociale des inégalités de santé : approches théoriques et données empiriques. Perspectives internationales

Session 3 : Interroger la structuration sociale des inégalités de santé en anthropologie et en épidémiologie

Seth Holmes : Enviro-Anthropo-Genesis: The Co-production and Destruction of Bodies of People, Land and Water

Seth Holmes

Chancellor's Professor, UC Berkeley Division of Society and Environment, Department of Environmental Science, Policy and Management, University of California, Berkeley ; ICREA Researcher, University of Barcelona

Résumé

Enviro-Anthropo-Genesis proposes a new way to understand the simultaneous co-production of environments and people on multiple levels. At certain junctures, the environments and people simultaneously destroy one another. Bodies of land and water may be made and unmade by social formations from the aftermaths of colonialism to the racializations of plantation societies, from solution-oriented high-tech food systems to movements for environmental sustainability. Social structures are, in turn, assembled and disassembled by environmental formations from protected waterways that irrigate intensive agriculture to borderlands that solidify racialized hierarchies and national imaginaries, from polluted air and water that intensifies sickness among certain racialized and classed populations to courts and governments approving legal rights to seas and mountains. This broad theoretical framework is being developed in relation to ongoing ethnographic research into transnational industrial food systems and the bodies – of land, water and people – making up their infrastructure. The presentation draws from ongoing research into the health and health care of Indigenous Mexican migrant farmworkers and food supply chain workers in the United States as well as of Latin American, North African and Eastern European migrant farmworkers and food supply chain workers in Western Europe.

Seth Holmes

Seth M. Holmes is a Chancellor's Professor in the UC Berkeley Division of Society and Environment, Department of Environmental Science, Policy and Management, and a researcher in ICREA Catalan Institution for Research and Advanced Studies and the Department of Social Anthropology at the Universitat de Barcelona. He is Co-Chair of the Berkeley Center for Social Medicine, Co-Director of the MD/PhD Track in Medical Anthropology coordinated between UC Berkeley and UC San Francisco and Director of the Interinstitutional Hub for Global Social Medicine at Barcelona. He is Principal Investigator of the ERC Project "FOODCIRCUITS: Hidden Connections between Migrants and Societies". A medical anthropologist and physician, Holmes works on social hierarchies, health inequities, and the ways in which such asymmetries are naturalized, normalized, and resisted in contexts of transnational im/migration, agro-food systems, and health care. He has received national and international awards from the fields of anthropology, sociology, geography, and documentary film, including the New Millennium Book Award, the Margaret Mead Award and the Textor Prize. In addition to scholarly publications, he has written for popular media such as The Guardian, The Huffington Post and Salon.com and spoken on multiple NPR, PRI, Pacifica Radio and Radio Bilingüe radio programs.

Nathalie Bajos

Santé publique (2024-2025)

Collège de France

Année 2024-2025

Colloque - La production sociale des inégalités de santé : approches théoriques et données empiriques. Perspectives internationales

Session 3 : Interroger la structuration sociale des inégalités de santé en anthropologie et en épidémiologie

Greta Bauer : A New Framework for Understanding Social Privilege and Health

Greta Bauer

Professor and Director, Eli Coleman Institute for Sexual and Gender Health, University of Minnesota Medical School

Résumé

While health research has increasingly included a role for stigma and discrimination in impacting health, privilege is often left to be implicitly understood as a lack of these. This undertheorization of privilege limits our understanding of how social power shapes health. I present a seven-fold model of privilege and its intersectional formation. Privilege is conceptualized as taking seven forms: just and fair experience, allowed harmful ignorance, promotion and facilitation, implicitly understood meaning, respect for autonomy and bodily integrity, successful moves to innocence, and assumed good intentions. Each form can be enacted through interpersonal or structural mechanisms. While this seven-fold model can be applied to individual conceptualizations of privilege (e.g., heterosexual privilege, white privilege), an intersectionality framework is key to understanding how power and privilege differentials operate relationally to affect health. Intersectionality helps explain, for example, why the traditional socioeconomic gradient of health has differential returns for people of different races, gender expressions, and disabilities, or why a generally privileged position such as maleness may not present an advantage when considered in relation to other social positions and contexts. I provide a set of thinking tools for incorporating this seven-fold and intersectional understanding of privilege into public health work.

Greta Bauer

Greta Bauer, PhD, MPH is a Professor and Director of the Eli Coleman Institute for Sexual and Gender Health in the University of Minnesota Medical School. She holds the endowed academic chair in sexual health. Prior to 2022, Dr. Bauer was a Professor in the Department of Epidemiology and Biostatistics in the Schulich School of Medicine & Dentistry at Western University in London, Canada, where she held a Sex and Gender Science Chair through the Canadian Institutes of Health Research (CIHR). Dr. Bauer has authored more than 150 peer-reviewed papers, book chapters, and technical reports related to health equity. As an epidemiologist, her focus on sexual and gender health has been both substantive and methodological, with a focus on the impacts of social marginalization. She is a leader in transgender and non-binary health, and in incorporating intersectionality into quantitative research methods.

Nathalie Bajos

Santé publique (2024-2025)

Collège de France

Année 2024-2025

Colloque - La production sociale des inégalités de santé : approches théoriques et données empiriques. Perspectives internationales

Session 2 : Saisir l'incorporation du social : socialisation (sociologie) et embodiment (social epidemiology)

Anne McMunn : Discussion

Anne McMunn

University College London

Anne McMunn is Professor of Social Epidemiology in the Research Department of Epidemiology & Public Health at UCL. Anne's research is concentrated on the social determinants of health within a life course epidemiological framework. More specifically, she investigates the influence on health and wellbeing of family care and unpaid care work, employment and social relationship characteristics, and she is also interested in how gender and socioeconomic position structure these associations. She is Co-Director of Equalise: ESRC Centre for Lifecourse Health and was recently PI of the EUROCARE international consortium investigating the impact of providing adult care at different stages of the life course across European countries in different

Nathalie Bajos

Santé publique (2024-2025)

Collège de France

Année 2024-2025

Colloque - La production sociale des inégalités de santé : approches théoriques et données empiriques. Perspectives internationales

Session 2 : Saisir l'incorporation du social : socialisation (sociologie) et embodiment (social epidemiology)

Michelle Kelly-Irving : Socio-Structural Processes Underlying the Production of Health Inequalities over the Life Course: Theoretical Tools and Empirical Evidence

Résumé

Understanding how structural, social and psychosocial factors come to affect our health resulting in health inequalities allows us to move beyond description towards policy interventions. Based on concepts developed by scholars from different disciplines, I will provide the backdrop to a conceptual framework for research on social-to-biological processes, which may be important contributors to health inequalities. I will explain the broad sets of mechanisms that may allow us to comprehend how socially structured exposures become embodied over the life course. I will describe an intersectional embodiment dynamic framework, its uses, and how it may serve to examine the manner through which intermeshed systems of oppression affect social exposures, which may be expressed biologically. Using empirical evidence over the last decade from the field of social epidemiology I will explain the usefulness of this framework as a tool for carrying-out and interpreting research through an equity lens, providing scientific evidence to challenge genetic and other forms of essentialism, often used to dismiss social inequalities in health.

Michelle Kelly Irving

Michelle Kelly-Irving est directrice de recherche à l'Inserm. Elle travaille sur la production des inégalités sociales de santé au cours de la vie par le biais des processus d'incorporation. Elle est épidémiologiste sociale et travaille au centre d'épidémiologie et de recherche sur les populations de santé (CERPOP) de l'Inserm-université de Toulouse, en France, où elle dirige l'équipe de recherche EQUITY.

Nathalie Bajos

Santé publique (2024-2025)

Collège de France

Année 2024-2025

Colloque - La production sociale des inégalités de santé : approches théoriques et données empiriques. Perspectives internationales

Session 2 : Saisir l'incorporation du social : socialisation (sociologie) et embodiment (social epidemiology)

Muriel Darmon : Qu'est-ce qu'une approche en termes de socialisation permet d'apporter à l'étude des inégalités de santé ?

Muriel Darmon

Directrice de recherche, CNRS, CESSP

Résumé

La socialisation peut être définie comme la façon dont la société forme et transforme les individus, et son étude vise à rendre compte empiriquement des processus de sociogenèse des dispositions individuelles. Après avoir tracé les grandes lignes de ce modèle, et déploré qu'il ait été peu appliqué au domaine de la santé, je montrerai ses contributions à l'étude de pathologies très diverses, dans mes propres travaux sur l'anorexie et l'AVC et plus largement dans ceux de l'équipe Gendhi sur les familles d'enfants en bas âge et leurs consultations avec un large spectre de professionnels de santé, les groupes adolescents et les infirmeries scolaires, les patients et professionnels de différents services de prise en charge des pathologies cardiovasculaires, du cancer colorectal ou des démences. Analyser ces terrains en sociologues de la socialisation, c'est d'abord se donner les moyens d'éclairer à la fois la production sociale des corps et de la santé, et les processus de recours et d'accès aux soins qui se différencient selon le ressenti des symptômes et leur expression. C'est ensuite donner à voir les relations entre patients et médecins comme des interactions sociales entre des individus socialement disposés (à agir comme ils agissent, et à penser comme ils pensent), et montrer que le travail médical opère sur des patients qui ne sont pas des individus génériques mais qui sont construits par des processus de socialisation antérieurs. Les approches en termes de socialisation fournissent par conséquent une grille de lecture puissante pour mettre au jour, notamment, les mécanismes de classe et de genre qui expliquent l'existence et la reproduction des inégalités de santé, et pour identifier les lieux et les modalités d'action contre elles.

Muriel Darmon

Muriel Darmon est sociologue et directrice de recherche au CNRS dans le Centre européen de sociologie et de science politique (CNRS-EHESS-Paris 1), et coresponsable de l'ERC Gendhi (« Gender Health Inequalities », Synergy 2019). Elle est notamment l'auteure de Devenir anorexique. Une approche sociologique (La Découverte, 2003, 2008), La Socialisation (Armand Colin, 2006, 2010, 2016, 2023), Classes préparatoires. La fabrique d'une jeunesse dominante (La Découverte, 2013, 2015), Socialization (Polity Press, 2024), ainsi que de Réparer les cerveaux. Sociologie des pertes et des récupérations post-AVC (La Découverte, 2020). Elle a occupé la fonction de présidente de l'Association française de sociologie entre 2017 et 2021, de membre du groupe d'expert(e)s chargé par le Conseil supérieur des programmes et le MEN de rédiger les nouveaux programmes de sciences économiques et sociales pour le lycée en 2018-2019, et de membre du groupe de travail de la Haute Autorité de santé « Guide du parcours de santé de l'accident vasculaire cérébral (AVC) » en 2023-2024. Elle est membre du comité de rédaction de la revue International Sociology Reviews, de la revue Sociology et de la collection Princeton University Press « studies in Cultural Sociology », et a été membre du comité éditorial de la revue Sociological Theory (2021-2024) et du comité de rédaction et directrice de la revue Sociétés Contemporaines (2008-2024).

Nathalie Bajos

Santé publique (2024-2025)

Collège de France

Année 2024-2025

Colloque - La production sociale des inégalités de santé : approches théoriques et données empiriques. Perspectives internationales

Session 1 : Expliquer les inégalités de santé en économie et sociologie

Cyrille Delpierre : Discussion

Cyrille Delpierre

Directeur de recherche, CERPOP, Inserm, Université Toulouse III

Cyrille Delpierre est épidémiologiste, directeur de recherche Inserm. Depuis 2021, il dirige le Centre d'Épidémiologie et de Recherche en santé des POPulations (CERPOP), unité mixte de recherche Inserm-Université Toulouse III, et est coresponsable de l'équipe EQUITY dédiée à l'étude des inégalités sociales de santé (ISS). Ses recherches portent sur les mécanismes par lesquels l'environnement social est biologiquement incorporé, comment il peut affecter le fonctionnement biologique et ainsi favoriser le développement de maladies et leur progression. Ses travaux ont deux objectifs généraux : i) expliquer les ISS non seulement par des expositions physico-chimiques, des comportements de santé et une prise en charge par le système des soins socialement distribués, mais aussi par des expositions psychosociales susceptibles de modifier des processus biologiques et favoriser le développement de pathologies à distance ; ii) développer ou participer à des interventions susceptibles de réduire les ISS.

Nathalie Bajos

Santé publique (2024-2025)

Collège de France

Année 2024-2025

Colloque - La production sociale des inégalités de santé : approches théoriques et données empiriques. Perspectives internationales

Session 1 : Expliquer les inégalités de santé en économie et sociologie

Janet Shim : Sociological Tools for Understanding the Social Production of Health Inequalities

Janet Shim

Professor, University of California, San Francisco

Résumé

This presentation will cover some commonly used theoretical concepts and frameworks used in the sociology of health and illness, to understand and analyze the social production of health inequalities. These theoretical tools have been used to interrogate and examine how structural forces, institutional processes, cultural discourses and ideologies, and interactional dynamics intersect to influence the myriad pathways through which health is produced. These range from the scientific knowledge base we use to intervene on illness and disease, to the social determinants that stratify our exposures to health risks, to the ways in which we organize our healthcare and healing systems, to the encounters – both within and outside the clinic – in which bodies, wellbeing, risk, and difference are regulated and intervened on. The presentation will also include some exploration of how these theoretical tools interact with empirical approaches, as well as the interdisciplinary works and possibilities that exist.

Janet Shim

Janet K. Shim, PhD, MPP, is Professor of Sociology in the Department of Social and Behavioral Sciences at the University of California, San Francisco. Her program of research focuses on two areas: the sociological analysis of knowledge production in the health sciences, particularly how they understand social difference and health inequality; and the study of healthcare interactions and how they produce unequal outcomes. Her work has been funded by the US National Institutes of Health and the National Science Foundation. Dr. Shim is currently a member of the U.S. NIH Genomics and Society Working Group, and Senior Editor of Social Science & Medicine. Her books include Heart-Sick: The Politics of Risk, Inequality, and Heart Disease (New York University Press, 2014), and the co-edited volume, Biomedicalization: Technoscience, Health, and Illness in the U.S. (Duke University Press, 2010). Her articles have appeared in journals such as Science, American Sociological Review, Journal of Health and Social Behavior, AJOB Empirical Bioethics, Social Science & Medicine, Social Studies of Science, and Sociology of Health and Illness.

Nathalie Bajos

Santé publique (2024-2025)

Collège de France

Année 2024-2025

Colloque - La production sociale des inégalités de santé : approches théoriques et données empiriques. Perspectives internationales : Introduction

Session 1 : Expliquer les inégalités de santé en économie et sociologie

Owen O'Donnell : An Economist's Perspective on What We Know, Can Know and Need to Know About the Causes of Health Inequality

Owen O'Donnell

Professeur, Erasmus University Rotterdam

Résumé

Socioeconomic health inequality is substantial, ubiquitous and persistent. From an economics perspective, I review what is known about its causes in high-income countries and consider what can be known and needs to be known. Causal analyses have not yet delivered strong, consistent evidence that education, income and wealth impact health in adulthood, but there is evidence that cash benefits paid to low-income households often improve infant and child health outcomes. Changes in adult health have large effects on income and wealth, and childhood ill-health both persists into adulthood and constrains economic outcomes in that phase of life. What can be known about the causes of health inequality is constrained by the limited scope for causal analysis to identify effects of socioeconomic exposures that potentially take their toll on health over the life course, cumulatively and multiplicatively. To reduce health inequality, its causes need not necessarily be known, provided health policies that improve the health of the socioeconomically disadvantaged can be identified and implemented. Political support for such policies may, however, depend on knowledge (or beliefs) about the causes of health inequality.

Owen O'Donnell

Owen O'Donnell is Professor of Applied Economics in the School of Economics and the School of Health Policy & Management at Erasmus University Rotterdam, and a Research Fellow of the Tinbergen Institute. His research is in the field of health economics, particularly health inequality, health insurance and health behaviour. He has published in leading field journals in economics and in demography, epidemiology and medicine. He is an Editor of the Journal of Health Economics.