Geographical Locations - France

• (Statistical) Number of Inhabitants per Doctor: 350
• CIA World Factbook : France

Organisations and Networks

UN and Multinational

• WHO
  - WHO Country Profile - France
  - WHO - Tobacco control: country profile: France
  - WHO - Environmental Burden of Disease: Country Profile – France
• International Agency for Research on Cancer - The International Agency for Research on Cancer (IARC) is part of the World Health Organization. IARC's mission is to coordinate and conduct research on the causes of human cancer, the mechanisms of carcinogenesis, and to develop scientific strategies for cancer control. The organisation is located in Lyon, France.

Government

• Haut Conseil de la Santé Publique - The High Commission for Public Health was established in 1991 with the aim of providing advice and assisting decision making within the Department of Health in order to improve community health in France.
• Ministère de l'Emploi et la Solidarité
  Portail www.sante.fr - A meta-site offering access to public health organisations and institutes

Non-Government

• AdmiNet-France - Health & Welfare
• Société française de santé publique
• Sispo - Syndicats des Internes de Santé Publique de l'Ouest
• MSF - Médecins Sans Frontières / Doctors Without Borders

Academic Institutions

• Institut de Recherche d'Etude et de Documentation en Economie de la Santé -" IRDES's primary mission is to provide high quality research and information for those who interested in the future of health care systems. IRDES's multidisciplinary team monitors and analyses trends in the behaviour of consumers and health care professionals from a medical, economic, geographic and sociological perspective. In addition, IRDES provides access to health information for general public through its documentation center. "
• École de Santé Publique de Nancy
• École Nationale de la Santé Publique
• Institut de recherche pour le développement - The role of the IRD is to perform research and manage scientific programmes centred on the relationship between man and his environment in the tropics.
• EpiWeb - Epi Web : le site du Service d'Epidémiologie et de Santé Publique du Centre Hospitalier et Universitaire de Lille.

National Policy and Related Documents

• Code de la santé publique [Public health code]
• Guide des vaccinations

Reports, Guidelines, and Projects

• Health care systems in transition: France, 2004
  "An important reform recently took place in the form of the Universal Health Coverage Act (CMU), which was passed in June 1999 and came into force on 1 January 2000. This act, as its name suggests, establishes universal health coverage, opening up the right to statutory health insurance coverage on the basis of residence in France. Furthermore, those whose income is below a certain level (currently 1.8% of the population) are entitled to free coverage. The old system of individual insurance, with contributions that could be financed by the general councils (according to income scales that varied from one department to another), has now been replaced by a system based on the right to health insurance and the logic of social protection through insurance rather than state aid. The CMU Act has further shifted the balance of the health insurance system away from a work-based system towards a system of universal health coverage." [WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies, 2004]
• Health needs and public health functions addressed in French public health journals
  Background: Our aim, as part of the collaborative study SPHERE (Strengthening Public Health Research in Europe), was to describe public health publications in the French language according to health needs and public health functions. Method: All articles published in six French public health journals, and one French/English language Canadian journal, over the period 1995–2004, were retrieved from three electronic databases. Original research articles were indexed by hand according to one main domain of health need, based on Global Burden of Disease categories, and into one of four public health functions. Results: After removing duplicates, 3984 original research articles were identified. Only 51% could be allocated to a health needs code. Of these, 71% were about non-communicable diseases, 25% communicable, maternal and perinatal conditions and 5% injuries. This compared only moderately with the global burden of disease for France (84, 5 and 11%, respectively). The other articles addressed health determinants, such as behavioural or environmental exposures, or a methodological issue. Ninety-two percent of the articles could be assigned a public health function code. Health monitoring and health services research accounted for 80% of references from French journals. Only 9% of articles from French journals were related to prevention, which was lower than that in the Canadian journal (17%). Only 1% of articles dealt with legislation. Conclusion: The distribution of articles in French public health journals broadly follows the distribution of health needs. History and data availability may explain the extra research focus on communicable diseases and maternal and child health research. Injuries, and prevention, are topics which appear to be under-represented in French language journals. [author abstract] [European Journal of Public Health, Vol. 17, Supplement 1, pp.38-42, 2007]
• Highlights on health in France, 2004
  "Highlights on health give an overview of a country’s health status, describing recent data on mortality, morbidity and exposure to key risk factors along with trends over time. The reports link country findings to public health policy considerations developed by the WHO Regional Office for Europe and by other relevant agencies." [WHO Regional Office for Europe, 2006]
• Influence of socio-economic and lifestyle factors on overweight and nutrition-related diseases among Tunisian migrants versus non-migrant Tunisians and French
  Background: Migrant studies in France revealed that Mediterranean migrant men have lower mortality and morbidity than local-born populations for non-communicable diseases (NCDs). We studied overweight and NCDs among Tunisian migrants compared to the population of the host country and to the population of their country of origin. We also studied the potential influence of socio-economic and lifestyle factors on differential health status. Methods: A retrospective cohort study was conducted to compare Tunisian migrant men with two non-migrant male groups: local-born French and Tunisians living in Tunisia, using frequency matching. We performed quota sampling (n = 147) based on age and place of residence. We used embedded logistic regression models to test socio-economic and lifestyle factors as potential mediators for the effect of migration on overweight, hypertension and reported morbidity (hypercholesterolemia, type-2 diabetes, cardiovascular diseases (CVD)). Results: Migrants were less overweight than French (OR = 0.53 [0.33–0.84]) and had less diabetes and CVD than Tunisians (0.18 [0.06–0.54] and 0.25 [0.07–0.88]). Prevalence of hypertension (grade-1 and -2) and prevalence of hypercholesterolemia were significantly lower among migrants than among French (respectively 0.06 [0.03–0.14]; 0.04 [0.01–0.15]; 0.11 [0.04–0.34]) and Tunisians (respectively OR = 0.07 [0.03–0.18]; OR = 0.06 [0.02–0.20]; OR = 0.23 [0.08–0.63]). The effect of migration on overweight was mediated by alcohol consumption. Healthcare utilisation, smoking and physical activity were mediators for the effect of migration on diabetes. The effect of migration on CVD was mediated by healthcare utilisation and energy intake. No obvious mediating effect was found for hypertension and hypercholesterolemia. Conclusion: Our study clearly shows that lifestyle (smoking) and cultural background (alcohol) are involved in the observed protective effect of migration. [author abstract] [BMC Public Health 2007, 7: 265]
• Non-profit health care hospitals in France
  Private for-profit clinics are one of the pillars of the French hospital care system. Alongside public hospitals, they provide French patients with additional choice. Greater competitiveness has given rise to a greater abundance of care and to much shorter waiting lists than those found elsewhere. A third category of establishments – private but operating on a non-profit basis – is also involved in this competition. Penalised by various regulatory obstacles, they play only a limited role. With the government seeking to reform the hospital system in France, priority should go toward removing these obstacles. A large portion of public health care budgets is devoted to financing hospital care. In public debate surrounding provision of this care, private for-profit clinics generally go up against public hospitals, which are supposedly the sole providers of so-called “public hospital service.” Private non-profit hospitals are usually ignored, even though most of them also provide this “public service.” With obligations identical to those of public hospitals, they are nonetheless managed in a less rigid way. They are also more likely to adapt to society’s future health care needs. They are a major pillar in the provision of hospital care in Alsace and account for the great majority of establishments in the Netherlands. If the government really wants to reform the French health care system, it should examine the alternative they provide. [author abstract] [Institut économique Molinari (IEM) – IEM’s Economic Note, July 2010]
• Prevention and control of viral hepatitis in France – a VHPB symposium report – Veyrier-du-Lac, France, November 18-19, 2004
  Contents: The healthcare system in France; National strategy for prevention and control of viral hepatitis infection in France; Hepatitis A in France; Hepatitis B in France [including Epidemiology of hepatitis B in France; Hepatitis B surveillance; Hepatitis B immunisation policy; Prevention and residual risk of HBV infection following blood transfusions; Preventive measures against HBV infection in healthcare workers; and Preventive measures for prisoners]; Hepatitis C in France [including Epidemiology of hepatitis C in France; Hepatitis C surveillance; Screening; Preventive measures for injecting drug users (IDUs); Nosocomial HCV infections; Prevention and residual risk of HCV infection following blood transfusions; Preventive measures for prisoners; and Prediction of HCV-related morbidity and mortality burden in France]; Hepatitis B and C ; Hepatitis E in France; Viral hepatitis research in France; Hepatitis B vaccine safety issues; and What still needs to be done [Viral Hepatitis, Volume 13 - Number 2, March 2005]
• Private health insurance in France
  "While France has a universal public health insurance system, the coverage it provides is incomplete and the vast majority the French population has private complementary health insurance. Among OECD countries, the share of health care financed by private insurance is third highest behind the US and the Netherlands, two countries where private coverage is the primary source of payment for a large percentage of the population. France’s high rate of private insurance coverage is partly explained by historical factors and partly by the preferential tax treatment of employer-sponsored coverage. Because of the high rate of employer provision – roughly half of all contracts are obtained through the workplace – coverage tends to vary with activity and industry classification. Historically, coverage was also positively related with income. In 2000, the French government introduced a new program, the Couverture Maladie Universelle (CMU), which extended eligibility for publicly funded complementary coverage to low income individuals. Since then, the percentage of the population with complementary coverage has increased from 86% to roughly 92%." [Organisation for Economic Co-operation and Development, OECD Health Working Papers 12, March 2004]
• Psychosocial resources and social health inequalities in France: Exploratory findings from a general population survey
  "We use a unique general population survey to assess the respective impact on self-assessed health status of subjective perceptions of social capital controlling for standard sociodemographic factors (occupation, income, education, age and gender). The survey is unique for two reasons: First, we use a variety of measures to describe self-perceived social capital (trust and civic engagement, social support, sense of control, and self-esteem). Second, we can link these measures of social capital to a wealth of descriptors of health status and behaviours. We find empirical support for the link between the subjective perception of social capital and health. Sense of control at work is the most important determinant of health status. Other important ones are civic engagement and social support. To a lesser extent, sense of being lower in the social hierarchy is associated with poorer health status. On the contrary, relative deprivation does not affect health in our survey. Since access to social capital is not equally distributed in the population, these findings suggest that psychosocial factors can explain a substantial part of social inequalities in health in France." (au)
• Public health and prevention in France
  "Health equality for French citizens is based on equal access to healthcare and prevention. Prevention consists as much of promoting early access to care as curbing destructive behaviour and exposure to toxic agents… Only prevention can protect against diseases for which there is no effective treatment. This is why France has stepped up its prevention policy in recent years to improve the French population’s health, reduce premature death (before 65 years old) and combat health inequalities between regions, genders and socio-economic groups. This prevention action has been the main thrust of the government’s health policy." [Ministère des Affaires étrangères / French Ministry of Foreign Affairs, 2007]

Educational Resources

• CDC - Travel Information : Western Europe
• EpiConcept - Systèmes d'Information en Santé Publique (in French)
• Institut Pasteur - Institut Pasteur is a non-profit private foundation which contributes to the prevention and treatment of disease, primarily infectious diseases, through research, education, and public health activities.