Details

Autor(en) / Beteiligte

• Paquet, Ginette

Titel

Social inequalities in health, their origin and their reduction: The determining role of early childhood

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

2005

Link zum Volltext

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• In order to study the persistent links between social inequalities and the health status of people in rich societies, we have chosen the following approach: In the first chapter, we examine the availability of health care without financial barriers. The second chapter deals with the marked prevalence of life-style habits that are harmful to health among people from underprivileged social classes. The third examines the feeling of control over one's destiny. The fourth considers early childhood in relation to developing a feeling of control over one's life and to the expression of protective factors. Finally, the fifth chapter looks into the possibility, in an underprivileged environment, of overcoming the fatalism linked to early academic failure. The information gathered enabled us to reach the following conclusions: There exists a health and mortality social gradient in most modern societies. Causality mainly operates in the direction of social position toward health, inverse causality being a much less important phenomenon. Across Québec and Canada, the results are in line with international currents. For example, our analyses of the data from the Québec longitudinal study of child development show that the risks of experiencing precarious health are substantially higher for a small child who is born and raised in a family situated at the bottom of the social ladder. Furthermore, even if the life-style habits of individuals explain, to a large extent, their state of health, we show that those life-styles only very partially explain social differences with respect to the onset of illness. Next, we delineate the way in which the psychosocial environment brings together the possibilities offered by the social structure to respond to fundamental needs for personal efficiency and self-esteem. The feeling of control over one's destiny is shown to be a central factor associated with one's position in the social hierarchy, a sentiment which protects a person from illness. Our results furthermore indicate that the influence of social position on the health of preschool children diminishes in the presence of protection factors, such as breast feeding, support from grand-parents and a mother in very good health. We also establish that in an underprivileged environment it is possible to promote the development of a feeling of control over one's destiny right from early childhood and to decrease academic failure with high-quality preschool programs. Essentially, we submit that accessible medical services are not in themselves enough to create equal opportunities in the health. As well, the struggle against behaviour that is harmful to health will not ensure success in this respect. In order to counter the adversity linked to a disadvantaged social position, we must consider the explanatory potential of the feeling of control over one's destiny and recognize that early childhood is the most propitious period to develop this feeling. In addition, a childhood spent in an impoverished environment may in fact include factors that protect health. Scientific knowledge also indicates that the key element for reducing health-related social inequalities lies in early prevention of academic failure in underprivileged environments. Lastly, we express misgivings concerning the orientations being adopted by Québec in the area of childhood services designed to guarantee equal opportunities.