CERPOP • The EQUITY team

EQUITY - Embodiment, social ineQualities, lifecoUrse epidemiology, cancer and chronIc diseases, intervenTions, methodologY
CERPOP, UMR 1295, Joint Research Unit: Inserm - University Toulouse III Paul Sabatier

Michelle KELLY-IRVING - Leader @ 0033 (0)5 61 14 56 32
Cyrille DELPIERRE - Leader @ 0033 (0)5 61 14 56 74   

• The Equity research team studies the construction of social inequalities in health across the life course in the general population and within health care trajectories. The originality of this approach lies in our comprehensive analysis of the construction of health inequalities combining the life course framework with health care research, through adapted analytical methods.

• Our research is not pathology or illness focused, rather, it centres on the study of the social determinants of health which affect health and many pathological processes. We explore mechanisms likely to affect or explain the social gradient in health by exploring chronic diseases, with a specific interest in cancers, which are a primary cause of death and ill health in France and elsewhere.

• Our work also contributes to social and health policies through the translation of our research findings into "interventional research" which focuses on reducing social inequalities in health using interdisciplinary approached

• To meet these objectives, our team is structured in three research axes:

(i) Within the "Lifecourse and embodiment axis" we analyse pathways between the social environment and health through biological mechanisms that may be influenced by "exogenous" exposures (material and behavioral factors), and "endogenous" exposures (psychosocial factors). To do this we carry out secondary data analysis of longitudinal datasets (cohort, panel data etc). The two priorities of this axis are, to identify, characterize and understand structural/ social exposures, as well as study the biological embodiment of social factors, notably through the analysis of biomarkers;

ii) The "Care pathways, chronic diseases and cancers axis" examines patient-related determinants (socioeconomic, territorial, comorbidity, literacy) and healthcare system-related determinants (characteristics of caregivers & of the organization of the healthcare offer) along health care pathways: from diagnosis, through all phases of treatment and follow-up, to death. We place a particular emphasis on technological and organizational developments (e-medicine, ambulatory shift), and also integrate the analysis of the efficiency of the care pathway, including economic and epidemiological evaluation with regard to the socioeconomic and geographical contexts. Primary access to care (general medicine, emergency medicine), secondary access to care, particularly the management of cancer but also other chronic pathologies (musculoskeletal disorders, HIV, cardiovascular pathologies, mental health outcomes), and the prescription and use of medication are the main themes explored in this axis, using hospital or population data, and French medico-administrative databases.

iii) The "Causal Chains and Methodology axis" is focused on examining and responding to methodological issues encountered in the two above research axes, and in developing methodological research questions relevant to the study of social inequalities in health through: the use of causal inference methods; methods for studying dynamic repeated exposures in relation to social determinants and access to care; by developing methodologies that allow the use of various data sources in order to reconstruct a history of exposures, particularly social exposures, of the populations studied.