Health and social challenges

Within the European Union, France enjoys a rather enviable situation regarding the health of its population.

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Inserm Unit 149 "Epidemiological research in perinatal health and women’s health". Tenon Hospital, Paris. Les films unité, production Inserm/La Prod. 2008. Lasts: 3 min 36.

It is in fourth place in terms of life expectancy at birth (78 years on average) and first place for life expectancy at 65 (16 years for men and 20 for women). France has the lowest rates of cardiovascular deaths. The death rate in the under 15s is also very low, and infant mortality in particular has been cut in half over the last seven years.

Over the long term, positive trends are observed: steady decline in deaths from cardiovascular diseases, falls in elderly people, AIDS (thanks to tritherapies) and cot deaths. The quality of life among the elderly has improved with certain operations becoming more widespread, such as cataract surgery or fitting of hearing aids. This progress is not surprising since significant funding is devoted to health (10% of the GDP).

Evident weaknesses are appearing in our health situation alongside these positive results, however. The number of avoidable premature deaths (in the under 65s) is high compared with our neighbours, particularly because of the smoking and alcohol consumption levels in the general population. This premature death rate reduces the overall life expectancy and highlights the issue of inadequate primary prevention in our country. Despite social and political choices focusing on equal access to health care, health inequalities within the population are still evident between sexes, regions and professions. Accordingly, the life expectancy for women (82.7 years) is still higher than for men (75.2), even though trends are evening out this difference. Socioeconomic inequalities are considerable: at 35, an unqualified worker has an average of thirty-eight years left to live compared with forty-four for an executive. Regional disparities are also marked, with an inhabitant in the Midi-Pyrénées having a life expectancy of 76 against 71 for an inhabitant in the Nord-Pas-de-Calais.

These phenomena can be explained by various factors, some of which have been taken on board in the strategies of the public health policy. Since World War II, treatment has been viewed as the almost exclusive pillar of our healthcare system. And yet, it seems that prevention initiatives – accounting for a mere 7% of our healthcare expenditure – could play a key role in improving our health indicators, along with traditional treatment approaches. Moreover, the health inequalities observed concern unequal access to prevention more than unequal access to treatment.

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