Amat-Roze Jeanne-Marie
PU, Département de Géographie, Université Paris Est Créteil (UPEC), Lab'URBA EA 34 82.
Rech Soins Infirm. 2011 Sep(106):5-15.
It is common to confuse health and medicine, but this comparison is far too limited to promote health. Health is related to the living conditions of the individual, from all points of view: food, education, housing, work, travels, health care. Obviously the latter is part of it but is just one link in a long chain. A health condition is the result of a system of multiple interactive components at a given time and in a given place: endogenous factors (physical, biological, genetic) and exogenous ones (political, economic, social and cultural environments, features of the living conditions). The discrepancies are the results of the differentiated combinations of these factors. Some contexts associate a series of health protecting factors whereas others associate factors of vulnerability. There has always been a dialogue between, on the one hand, medicine and, on the other hand, sociology, anthropology and economy. It dates back to antiquity for geography (cf: Hippocrates treatise: on air, water and places) but it disappeared at the time of Pasteur revolution. The 20th century marks the return of geography and in 2009 a French law takes hold of one of its key words "territory". Why? What are the contributions of this discipline? Maps are a strong image of this discipline, which cannot be limited to this production. Geography also contributes to the laws of distance, polarity and flows and to the notions of scale, accessibility, network, basin, space for living, territorial dynamics.... We have here a very good opportunity to establish a dialogue between health and geography. Indeed, the perception of the territorial dimension of health issues is being reinforced both through the reading of epidemics such as SARS and flues and through the discrepancies in the health conditions. This reinforcement is related to the territorialization procedures. In the field of health care planning this discipline provides us, thanks to its tools, with decision-making diagnoses necessary for the promotion of a greater territorial equity. At the time of the implementation of the HPST (Law on Hospital - Patient - Health - Territory) and ARS (Regional Agency for Health) laws and of the debates on the health territories, the emphasis will be put on the French health care system.