Comparaison du score individuel de précarité des Centres d'examens de santé, EPICES, à la définition socio-administrative de la précarité

Abstract

In French Health Examination Centres, populations in deprived situation were usually defined by administrative criteria The aim of the study was to investigate whether EPICES, a new individual index of deprivation, was more strongly related to health status than an administrative classification. The EPICES score was calculated on the basis of 11 weighted questions related to material and social deprivation. Participants were 197, 389 men and women, aged over 18, encountered in 2002 in French Health Examination Centres. Relationships between health status, health-related behaviours, access to health care, EPICES and the administrative classification of deprivation were analyzed by logistic regression. The associations between EPICES and the study variables were stronger than those observed for the administrative definition. The comparison also showed socially disadvantaged people with poor health identified by the EPICES score who were not by the administrative classification. These results showed that the EPICES score can be a useful tool to improve the identification of deprived people having health problems associated to deprivation.

Psychosocioeconomic Precariousness, Cognitive Decline and Risk of Developing Dementia: A 25-Year Study

“…Nonetheless, the results show that this ratio is associated with a higher risk of death (hazard ratio 1.34, 95% CI 1.25-1.44; p < 0.0001), which is an argument in favor of the reliability of this measure [29]. Several authors have underlined the importance of taking into account health insurance in psychosocioeconomic precariousness measure [19,30] as well as health behaviors [31]. Unfortunately, this information has not been collected in our study.…”

“…Among these studies, Lee et al [18] reported a cumulative socioeconomic risk for cognitive impairment in elderly. In line with this cumulative approach, we meant to focus on the association between multiple vulnerabilities (the concept of ‘psychosocioeconomic precariousness') and cognitive ageing, using psychosocial variables in addition to occupation, education and income, as it has been recently proposed [19,20]. Therefore, the novelty of this research is that we combined a cumulative approach of precariousness (each item is scored 1 point and considered as providing additional precariousness) with a multidimensionality definition of precariousness including indicators of poor socioeconomic status and psychosocial vulnerability.…”

“…Lee et al [18] measured socioeconomic status with four indicators, i.e., education, income, wealth and occupation in 4,155 subjects aged ≥65 years, and showed that the combined effect of such factors on cognitive decline was stronger than the effect of each factor considered separately. Moreover, the use of psychosocial variables in addition to occupation, education and income has been recently proposed [19,20]. Indeed, numerous authors have underlined the multidimensional nature of precariousness, and the necessity to consider not only markers of individual's economic resources but also markers of social support, such as ‘living with a partner' or ‘whether an individual goes on holiday' [19,20].…”

“…Moreover, the use of psychosocial variables in addition to occupation, education and income has been recently proposed [19,20]. Indeed, numerous authors have underlined the multidimensional nature of precariousness, and the necessity to consider not only markers of individual's economic resources but also markers of social support, such as ‘living with a partner' or ‘whether an individual goes on holiday' [19,20]. …”

Agir pour la santé des « travailleurs vulnérables » : expérimentation d’un partenariat entre services de santé au travail et centres d’examens de santé de l’assurance maladie (PREMTES)

“…Le score EPICES va de 0 (absence de précarité) à 100 (maximum de précarité), le seuil de précarité étant de 30 [30]. Plusieurs publications ont montré que ce score est significativement lié à de très nombreux indicateurs de santé avec « relations score dépendantes » : comportements à risque, non recours aux soins, mauvaise santé perçue et santé mesurée [30,[33][34][35]. Il est également lié au diabète et à ses complications [36], au syndrome métabolique [37] et aux indicateurs de santé mentale [38,39].…”