Background of the project and study objectives

Societal background

In terms of social disparities assessed from income inequalities, France has an intermdiate position between Japan and North European countries on the one hand and the United States of America on the other hand.

Certain reports have indicated that social disparities in France have moderately increased since the 1980s. On the contrary, income disparities between municipalities in French regions have increased in a dramatic way over the last two decades, indicating that social segregation in space has markedly strengthened.

A particularly strong increase in socio-environmental disparities has been observed over the past decades in the Ile-de-France region, which is the richest region but also the one in which social disparities are the strongest.

It seems therefore important - and urgent - to evaluate the repercussions that these increasing disparities in wealth over the Paris metropolitan area may have on health.

Scientific context

A large number of researchers in North America and North Europe have focused on the influences that geographic life environments (particularly the residential environment) may have on health. The goal of these studies was to examine whether unfavorable neighborhood characteristics - a low socioeconomic status, an unhealthy food environment, a lack of environmental opportunities for active living, etc. - increase the risk of poor health outcomes, including obesity, hypertension, and coronary heart disease.

However, very few studies on these issues have been conducted in France. In order to address this gap, the aim of the RECORD Cohort Study is to develop comprehensive investigations related to territorial disparities in health and environmental effects on health.

Objectives of the study

The main objective of the RECORD project is to investigate health disparities in the Ile-de-France region, with a particular interest for the differences observed between advantaged and disadvantaged neighborhoods. The RECORD Study is mainly interested in coronary heart disease and its behavioral, clinical, and biological risk factors (physical activity, smoking, obesity, hypertension, cholesterol, etc.). It is also interested in preventive and curative healthcare utilization behavior related to cardiovascular risk factors.

Beyond description of health disparities that exist between neighborhoods, the objective of the study is to understand the mechanisms through which geographic life environments affect health. To achieve this aim, we propose to take into account the characteristics of the physical environment, the services that are available or not in the vicinity, and the social interactions that take place in the neighborhoods. Moreover, we assume that it is important to pay attention to the experiences (either affective, cognitive, or relational) that individuals have in their neighborhood to understand how geographic life environments affect health.

This study is of interest for the community for different reasons. First, our work will provide relevant information for the public debate on social inequalities in health and on the deteriorating life conditions that prevail in the socially disadvantaged neighborhoods of the country. Second, our investigations will allow us to identify relevant intervention strategies aimed at removing environmental barriers or creating environmental opportunities for healthy lifestyles. Recent developments in the public health literature suggest that it is relevant to implement "multilevel" interventions aimed at both modifying geographic environments and encourage residents through education and counseling programs to have healthy lifestyles in these modified environment. Finally, studies such as the RECORD project are able to provide scientific arguments and quantitative evidence that allow one to argue in favor of health friendly environments in large scale urban planning projects.

The "Ongoing studies" section of the website describes some of the analyses we are currently conduting based on the RECORD Cohort Study.