The French Republic is a unitary semi-presidential republic in Western Europe with a population of over 65 million inhabitants. France is one of the world’s most developed countries and the world’s sixth largest economy measured by GDP. It is Europe’s third largest economy by nominal GDP in 2017. France enjoys a high standard of living as well as a high public education level, and has also one of the world’s highest life expectancies. France has been listed as the world’s “best overall health care” provider by the World Health Organization whilst average life expectancy at birth is 77 years for men and 84 years for women, one of the highest of the European Union.
The French welfare state is based on the principle of “national solidarity” – this commitment is declared in the first article of the French Code of Social Security. It is understood as sharing responsibility and pooling risk overall in society. Recently, additional attention has been given to the most vulnerable groups by introducing a guaranteed minimum income. However, as with other EU countries, the distribution of many behavioural risk factors to health follows a social gradient: smoking rates and obesity are more then twice higher with those that have the least level of education compared with the highest level of education.
The public and political debate on the subject of health inequalities in France tends to focus on social exclusion and accessibility to health care services, rather than on the mechanisms involved in the creation of socioeconomic inequalities. Linguistically, these two terms (health inequalities and social exclusion) are often interchanged in both public debate and political thought.
The issue of health inequalities has only really appeared on the political agenda in recent years, however it is being afforded increasing attention in debates around the issue.
Policy responses are devised at a national level with priorities and frameworks being established. It is then the responsibility of the Regional Health Agencies to create specific plans within these frameworks that are tailored to their own needs and that explicitly address health inequalities. The cancer plan (2014) aims to tackle inequalities in cancer incidence and outcomes. The plan includes early diagnosis, access to quality care, and innovations. Strengthening public health and prevention policies may reduce the pressure on the health system and reduce social inequalities in health.
An overview of policy responses addressing health inequalities in can be found in our Policy Database.
An overview of projects and initiatives that are currently taking place or that have successfully been finalized, and that are addressing health inequality issues, can be found in our Project Database.
Please find below an overview of key actors in France working on health inequality issues:
- Agence Nationale pour la cohésion sociale et l’égalité des chances (ACSE) – National Agency for Social Cohesion and the Equality of Opportunities. The ACSE contributes to actions for people facing difficulties of social or professional integration
- Comité national de santé publique (CNSP) – National Committee for Public Health. The CNSP was created in 2004 to function as a cross government group to improve coordination and information among the main ministries whose policies may have a health impact.
- Conférence nationale de santé – National Health Conference. Acting as a forum for dialogue on health issues, the national conference of health is an advisory authority to the Minister of Health. It allows the actors of the health system to express their points of view on health policies and to communicate requests and expectations of the population. It fosters dialogue between health system users and professionals, other actors and policy makers. The work program of the conference for the period 2011-2014 addresses health inequalities as an overall orientation.
- Institut national de prévention et d’éducation pour la santé (INPES) – National Institute for Health Prevention and Education
- Société française de santé publique (SFSP) – French Association of Public Health. The SFSP provides various actors within the health system a frame and means for collective reflection based upon the critical analysis of scientific evidence and professional practices. It formulates propositions to assist decision-makers and to inform public opinion regarding the strengths and weaknesses of public health policies. It is strongly involved in addressing social determinants of health and health inequalities.
Are you aware of any other key actors that should be added to this list?
Please let us know!
Please find below an overview of relevant documents addressing health inequality issues in France. Further publications can be found in our Publications Database.
- Éléments de réflexion pour une politique de santé 2011 – 2025 (2011). Position Paper for a health politics 2011 – 2025
- Réduire les inégalités sociales de santé (2010) – Reducing social inequalities of health.
- National Strategy Report on Social Protection and Social Inclusion 2008-2011 (2008)
- “Cancer Plan 2014–2019, Objective 10, National Smoking Reduction Programme 2014–2019”
Are you aware of any other key resources that should be added to this list?
Please let us know!