title: Inhabitants' and professionals' social representations of health determinants in a disadvantaged urban area in France: a qualitative analysis.
abstract: OBJECTIVE
  Access to care in French disadvantaged urban areas remains an issue despite the implementation of local healthcare structures. To understand this contradiction, we investigated social representations held by inhabitants of such areas, as well as those of social and healthcare professionals, regarding events or behaviours that can impact low-income individuals' health.
  
  
  METHODS
  In the context of a health diagnosis, 288 inhabitants living in five disadvantaged districts of Aix-les-Bains, as well as 28 professionals working in these districts, completed an open-ended questionnaire. The two groups of respondents were asked to describe what could have an impact on health status from the inhabitants' point of view. The textual responses were analyzed using the Alceste method.
  
  
  RESULTS
  We observed a number of differences in the way the inhabitants and professionals represented determinants of health in disadvantaged urban areas: the former proposed a representation mixing personal responsibility with physiological, social, familial, and professional aspects, whereas the latter associated health issues with marginalization (financial, drug, or alcohol problems) and personal responsibility. Both inhabitants and professionals mentioned control over events and lifestyle as determinants of health.
  
  
  CONCLUSIONS
  The results are discussed regarding the consequences of these different representations on the beneficiary - healthcare-provider relationship in terms of communication and trust.
authors.affiliation: Social science institute, university of Lausanne, bâtiment Geopolis, quartier Mouline, CH-1015 Lausanne, Switzerland. Electronic address: ingrid.gilles@unil.ch.
authors.forename: I
authors.initials: I
authors.lastname: Gilles
authors.affiliation: Community center for social action/Centre communal d'action sociale, 6, rue des Prés-Riants, 73100 Aix-les-Bains, France.
authors.forename: B
authors.initials: B
authors.lastname: Bejaoui
authors.affiliation: Social science institute, university of Lausanne, bâtiment Geopolis, quartier Mouline, CH-1015 Lausanne, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Courvoisier
authors.affiliation: Social science institute, university of Lausanne, bâtiment Geopolis, quartier Mouline, CH-1015 Lausanne, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Clémence
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D006282:Health Personnel / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008503:Medical Staff / Q000706:statistics & numerical data / Q000600:supply & distribution; D008875:Middle Aged; D064890:Social Determinants of Health / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D035862:Vulnerable Populations / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Bas revenus; Déterminants de santé; Health determinants; Low-income population; Professional-patient communication; Relation professionnels–patients; Représentation sociale; Social perception