title: Toward a Socio-Territorial Approach to Health: Health Equity in West Africa.
abstract: This study contributes to the literature about the effects of space and place on health by introducing a socio-territorial approach to urban health disparities in West Africa. It explores how urban spaces, specifically neighbourhoods, are shaped by social and economic relations and strategies of territorial control. We examine the potential influence of socio-territorial processes on vulnerability to disease, access to medical care, healthscapes, and illness experiences. Our research was conducted in Senegal and relied on a mixed methods design. We identified four neighbourhoods that represent the socio-spatial heterogeneity of the city of Saint-Louis and utilized the following methods: geographic and anthropological field research, household surveys, health knowledge and behaviour surveys, clinical exams, and illness interviews. Our results highlight the socio-territorial processes at work in each neighbourhood, clinical findings on three health measures (overweight, high blood pressure, and hyperglycaemia) and health experiences of individuals with hypertension or type II diabetes. We found significant differences in the prevalence of the three health measures in the study sites, while experiences managing hypertension and diabetes were similar. We conclude that a socio-territorial approach offers insight into the complex constellation of forces that produce health disparities in urban settings.
authors.affiliation: Laboratoire Dynamiques Sociales et Recomposition des Espaces (LADYSS), Université Paris Ouest Nanterre, Nanterre 92000, France. lucie.vialard@gmail.com.
authors.forename: Lucie
authors.initials: L
authors.lastname: Vialard
authors.affiliation: Laboratoire Dynamiques Sociales et Recomposition des Espaces (LADYSS), Université Paris Ouest Nanterre, Nanterre 92000, France. clara.squiban@gmail.com.
authors.forename: Clara
authors.initials: C
authors.lastname: Squiban
authors.forename: Gilles
authors.initials: G
authors.lastname: Riveau
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Hermann
authors.forename: Doudou
authors.lastname: Diop
authors.affiliation: Unité Mixte de Recherche Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche pour le Développement, Montpellier 34394, France. florence.fournet@ird.fr.
authors.forename: Florence
authors.initials: F
authors.lastname: Fournet
authors.affiliation: Laboratoire Dynamiques Sociales et Recomposition des Espaces (LADYSS), Université Paris Ouest Nanterre, Nanterre 92000, France. salem.gerard@gmail.com.|Centre Population et Développement (CEPED), Université Paris Descartes-Institut de Recherche pour le Développement, Paris 75006, France. salem.gerard@gmail.com.
authors.forename: Gérard
authors.initials: G
authors.lastname: Salem
authors.affiliation: International Development and Social Change, IDCE, Clark University, Worcester, MA 01610, USA. efoley@clarku.edu.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Foley
mesh_terms: D000328:Adult; D000354:Africa, Western; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000628:therapy; D011057:Politics; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012675:Senegal / Q000453:epidemiology; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: West Africa; diabetes; health disparities; hypertension; socio-territorial approach; urban health