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Inégalités sociales de santé et expositions environnementales. Une analyse spatio-temporelle du risque de mortalité infantile et néonatale dans quatre agglomérations françaises

Abstract : In France, existence of social health inequalities (SHI) has well established. Infant and neonatal mortality are recognized as indicators of the health status of a population. In spite of numerous risk factors already identified, a part of these inequalities remain unexplained, environmental nuisances are suspected. The thesis objectives were to analyze by a spatial and temporal approach, the contribution of exposure to nitrogen dioxide to social inequalities in infant and neonatal mortality in France between 2000 and 2009. We conducted an ecological type epidemiological study using the French census block as the geographical unit in the metropolitan areas of Lille, Paris, Lyon, and Marseille. All cases collected in the cities hall were geocoded using address of parent's residence. Socioeconomic data estimated from the 1999, 2006 national census were used in a composite index which encompasses multiple dimensions to analyze global deprivation. Average nitrogen dioxide concentrations were modeled by the air quality monitoring networks. Generalized additive models allowed to take into account spatial autocorrelation and generate maps using smoothing on longitude and latitude while adjusting for covariates of interest. Using an innovative approach, results highlight the existence of socio-spatial, environmental or cumulate inequalities in infant and neonatal mortality. These results are city-specific, they vary according to the period and the health event demonstrating the difficulty to generalize these observations at the national level
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Submitted on : Thursday, March 29, 2018 - 12:46:24 PM
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  • HAL Id : tel-01750446, version 1

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Cindy Padilla. Inégalités sociales de santé et expositions environnementales. Une analyse spatio-temporelle du risque de mortalité infantile et néonatale dans quatre agglomérations françaises. Médecine humaine et pathologie. Université de Lorraine, 2013. Français. ⟨NNT : 2013LORR0192⟩. ⟨tel-01750446⟩

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