Critical urban areas, deprived areas and neighbourhood effects on health in France

Since the 1980s. different French governments have formulated public policies aimed at taking into account the specific problems of deprived neighbourhoods. The aim of this paper is to determinate the existence of a neighbourhood effect on health and to discuss the implementation of a geographical index of deprived areas in France. Using the National Health Survey of 2002-2003 and 1999 French census data, we attempt to measure the individual and collective determinants of Self-Reported Health Status (SRH). By using a principal component analysis of aggregated census data, we obtain three synthetic factors: "economic and social condition", "residential stability" and "generational", and show that these contextual factors are correlated with individual SRH. Our research shows that health inequalities cannot be tackled by using only the Critical Urban Area criterion (the fact of living in a CUA or not) because some inequalities remain ignored and thus, hidden. We suggest a methodology to build a new health deprivation index allowing to better target health inequalities. (C) 2012 Elsevier Ireland Ltd. All rights reserved.