Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: Access to health care is a global public problem. In French Guiana, there exists social inequalities which are specially marked amongst immigrants who make up a third of the population. Health care inequalities are prevalent. The objective of this study was to determine factors associated with why health care amongst the poor population of Cayenne was renounced.Study design The study was cross sectional. It focused on knowledge, attitudes, practices and beliefs of the population living in poor neighborhoods of the Cayenne area. Methods: Populations coming at the Red Cross mobile screening unit in poor urban areas of Cayenne were surveyed from July 2013 to June 2014. Structured questionnaires consisted of 93 questions. Written informed consent was requested at the beginning of the questionnaire. The predictors for renouncing medical care were determined using logistic regression models and tree analysis. Results: Twenty percent of persons had renounced care. Logistic regression showed that renouncement of health care was negatively associated with having no regular physician Adjusted Odds Ratio (AOR)=0.43 (95%CI=0.24-0.79) and positively associated with being embarrassed to ask certain questions AOR=6.81 (95%CI=3.98-11.65) and having been previously refused health care by a doctor AOR=3.08 (95%CI=1.43-6.65) . Tree analysis also showed that three of these variables were linked to renouncement, with feeling shy to ask certain questions as the first branching.Conclusion: Although most people felt it was easy to see a doctor, one in five had renounced health care. The variables identified by the models suggest vulnerable persons generally had previous negative encounters with the health system and felt unwanted or non eligible for healthcare. Health care mediation and welcoming staff may be simple solutions to the above problems which were underscored in our observations.
ISSN: 1472-6963

hal-01288656
https://hal.archives-ouvertes.fr/hal-01288656
https://hal.archives-ouvertes.fr/hal-01288656/document
https://hal.archives-ouvertes.fr/hal-01288656/file/Predictive%20factors%20for%20renouncing%20to%20care%20in%20FG.pdf
PUBMEDCENTRAL : PMC4731954

Éditeur(s) : Université des Antilles Études caribéennes
Résumé : Les îles sont devenues les principaux marchés mondiaux pour le tourisme balnéaire en profitant de leur richesse naturelle et culturelle. Dans le même temps, les îles sont des territoires fragiles avec des ressources limitées, raison pour laquelle un développement durable de l’activité touristique est une nécessité. L'étude de la consommation des ressources naturelles par le tourisme est une étape essentielle pour détecter les menaces que cette activité cause à l'environnement et donc la mise en œuvre de mesures plus durables. Dans cet article, nous analysons la consommation des ressources naturelles dans cinq régions touristiques de Minorque. Les données ont été recueillies auprès des fournisseurs, des établissements touristiques et au travail d’enquête terrain, ainsi cela nous a permis d'estimer la consommation d'eau et d'électricité, la production et la collecte des déchets pour les études de cas. Les consommations élevées d’eau et de déchets observés indiquent la nécessité d'entreprendre des actions. D'autre part, les résultats montrent que les coûts environnementaux les plus élevés proviennent des établissements touristiques fondés sur la faible densité de ménage.
Islands have become world’s leading markets for sun and sand tourism taking advantage of their natural and cultural richness. At the same time, islands are fragile territories with limited resources, reason why a sustainable development of tourism is a necessity. The study of natural resources consumption by tourism is an essential step to detect the threats that this activity is causing to the environment and thus implement measures to go towards a more sustainable direction. In this article we analyze the natural resources consumption in five tourist areas of Menorca. Data were gathered from supplier companies, tourist establishments and through fieldwork, and allowed us to estimate water and electricity consumption, generation and collection of waste for the case studies. The high observed ratios of water consumption as well as waste generation and collection ratios indicate the need to undertake actions. The results showed the higher environmental costs of tourism settlements based on low density of household.
Espagne
Minorque

Droits : info:eu-repo/semantics/openAccess
urn:doi:10.4000/etudescaribeennes.6267
http://journals.openedition.org/etudescaribeennes/6267

Éditeur(s) : HAL CCSD
Résumé : For a decade, distance-based methods have been largely employed and improved in the field of spatial economics. Such tools are very powerful to evaluate accurately the spatial distribution of plants or retail stores for example (Duranton and Overman, 2008; Jensen and Michel, 2011). In the present paper, we introduce a new statistic measure based on distances to evaluate the spatial concentration of economic activities. As far as we know, the m function is the first relative density function proposed in the economic literature. This tool completes the typology of distance-based methods recently drawn up by Marcon and Puech (2014). By working on several theoretical and empirical examples, we prove the advantages and the limits of the m function to gauge the spatial structures in spatial economics.
https://hal.archives-ouvertes.fr/hal-01082178

hal-01082178
https://hal.archives-ouvertes.fr/hal-01082178
https://hal.archives-ouvertes.fr/hal-01082178/document

Éditeur(s) : HAL CCSD
Résumé : Over the last decade, distance-based methods have been introduced and then improved in the field of spatial economics to gauge the geographic concentration of activities. There is a growing literature on this theme including new tools, discussions on their specific properties and various applications. However, there is currently no typology of distance-based methods. This paper fills that gap. The proposed classification helps understand all the properties of distance-based methods and proves that they are variations on the same framework.
https://halshs.archives-ouvertes.fr/halshs-00679993

halshs-00679993
https://halshs.archives-ouvertes.fr/halshs-00679993
https://halshs.archives-ouvertes.fr/halshs-00679993v3/document

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: An environmental health inequality is a major public health concern in Europe. However just few studies take into account a large set of characteristics to analyze this problematic. The aim of this study was to identify and describe how socioeconomic, health accessibility and exposure factors accumulate and interact in small areas in a French urban context, to assess environmental health inequalities related to infant and neonatal mortality.Methods: Environmental indicators on deprivation index, proximity to high-traffic roads, green space, and healthcare accessibility were created using the Geographical Information System. Cases were collected from death certificates in the city hall of each municipality in the Nice metropolitan area. Using the parental addresses, cases were geocoded to their census block of residence. A classification using a Multiple Component Analysis following by a Hierarchical Clustering allow us to characterize the census blocks in terms of level of socioeconomic, environmental and accessibility to healthcare, which are very diverse definition by nature. Relation between infant and neonatal mortality rate and the three environmental patterns which categorize the census blocks after the classification was performed using a standard Poisson regression model for count data after checking the assumption of dispersion.Results: Based on geographic indicators, three environmental patterns were identified. We found environmental inequalities and social health inequalities in Nice metropolitan area. Moreover these inequalities are counterbalance by the close proximity of deprived census blocks to healthcare facilities related to mother and newborn. So therefore we demonstrate no environmental health inequalities related to infant and neonatal mortality.Conclusion: Examination of patterns of social, environmental and in relation with healthcare access is useful to identify census blocks with needs and their effects on health. Similar analyzes could be implemented and considered in other cities or related to other birth outcomes.
ISSN: 1476-069X

halshs-01366285
https://halshs.archives-ouvertes.fr/halshs-01366285
https://halshs.archives-ouvertes.fr/halshs-01366285/document
https://halshs.archives-ouvertes.fr/halshs-01366285/file/art_10.1186_s12940-016-0163-7.pdf
PUBMED : 27449640