Carde Estelle
Sante Publique. 2020 September-December;32(5):461-471. doi: 10.3917/spub.205.0461.
This article proposes to clarify the concept of social inequality in health: theoretically first, then by mobilizing it on a specific study field, the Covid-19 pandemic in Quebec during the spring of 2020.It begins with a discussion of various definitions of social inequalities in health and then proposes the following one: these are differences in health observed between several social groups and which result from the power relation(s) between these groups.Applying this definition to the Covid-19 pandemic occurs in two stages. First, power relations that differentiate exposure to the various risks caused by the pandemic are identified: being infected, dying of it, but also seeing one's health affected by the pandemic without necessarily being infected with the new coronavirus. The study of this latter risk requires monitoring exposure to social determinants of health that is unbalanced by the context of the pandemic: income, social network, care and social services, education, stigma.This first step of the analysis considers power relations taken in isolation from each other. The second explores their articulation. Its common thread is the ethno-racial relation, of which are analyzed the links with socio-economic relation. Finally, a systemic perspective of inequalities is drawn, essential for identifying actions to be taken to fight against social inequalities in health.
首先从理论层面入手，然后通过在一个特定研究领域——2020年春季魁北克省的新冠疫情——中运用这一概念来进行阐述。文章开篇讨论了健康领域社会不平等的各种定义，随后提出如下定义：健康领域的社会不平等是指在几个社会群体之间观察到的健康差异，这些差异源于这些群体之间的权力关系。将这一定义应用于新冠疫情可分为两个阶段。首先，确定区分接触疫情所带来的各种风险的权力关系：感染新冠病毒、死于新冠病毒，以及自身健康受到疫情影响但不一定感染新冠病毒。对后一种风险的研究需要监测在疫情背景下失衡的健康社会决定因素的接触情况：收入、社会网络、医疗和社会服务、教育、污名化。分析的第一步孤立地考虑权力关系。第二步则探讨它们之间的相互联系。其主线是种族关系，并分析了种族关系与社会经济关系之间的联系。最后，得出了不平等的系统视角，这对于确定为消除健康领域社会不平等而应采取的行动至关重要。
