some progress and still strong social and territorial inequalities

Risk behaviors, eating habits, physical activity, life expectancy, chronic diseases, use of and access to care…: on all fronts, health inequalities persist in France. In this sense, the report on the state of health of the population in France, published on Wednesday, September 21 by the Directorate of Research, Studies, Evaluation and Statistics (Drees), will hardly surprise. It is but a reminder of the main drivers of these inequities: socioeconomic level and region of residence, two partially linked determinants. “The first murderer in the world is misery and poverty, and France is no exception”says Mahmoud Zureik, professor of epidemiology and public health at the University of Versailles-Saint-Quentin (Yvelines).

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To compile these figures, the DREES has compiled, in addition to its own data, the results of numerous studies by Public Health France, Health Insurance, Inserm, the National Institute of Statistics and Economic Studies (Insee), Epi-Phare…

This report recalls first of all a demographic perspective: if today 9% of people are 75 years old, in thirty years it should be 16%. Life expectancy at birth continues to grow despite a Covid-19 related drop in 2020 (minus seven months for men and minus six months for women). In 2021, it was 85.4 years for women and 79.3 years for men. But profits decrease over time. Between 2014 and 2019, it increased 0.2 years among women, compared to a one-year increase between 2009 and 2014; and in men 0.5 years versus 1.5 years.

Territorial disparities

One positive point, however: disability-free life expectancy (without loss of autonomy linked to disability, illness, etc.) at age 65 is progressing faster than life expectancy at age 65. Between 2009 and 2019, the former increased by 2.1 years and the latter by 0.8 years for women, and by 1.4 years and 1.2 years for men. “This is a sign that France has made progress in terms of prevention”observes Antoine Flahault, director of the Geneva Institute for Global Health. “Our country had to catch up, especially compared to Sweden or Spain”adds Philippe Amouyel, professor of public health at the University of Lille and at the University Hospital of Lille.

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But this progress is still marked by strong inequalities. The disparities are territorial, first of all. Thus, life expectancy remains lowest in the north and east of metropolitan France and in the five overseas departments and regions (DROM). In Maine-et-Loire, it reaches a maximum of 86.3 years at birth for women and 80.3 years for men. In Mayotte, it does not exceed 73.6 years for women and 72.3 years for men. The rest, “The north and northeast of France are distinguished by higher mortality from all types of cancer, diseases of the respiratory system and cardiovascular and neurovascular diseases”notes Drs.

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