Collection Of Mechanisms Conducive To Reducing Social Health Inequalities In France

摘要

Health promotion is struggling to prove its ability to reduce social health inequalities. This exploratory research uses a 'realistic evaluation' approach to identify mechanisms conducive to reducing social health inequalities in France in five action areas. Case studies from five health promotion actions in three regions were conducted. Data resulted from 41 individual interviews and documentation of the health promotion actions. Interviews were conducted to explore a list of 51 candidate mechanisms, selected from three tools identified in the literature. Data analysis was carried out through interview content analysis. The following mechanisms were corroborated by this empirical study: engagement of all key partners, significant participation, giving value to the different types of inputs and knowledge, common vision, shared leadership, continuous critical reflection on processes and outcomes, and resource mobilization. This exploratory research enabled us to confirm, through empirical data, the existence of mechanisms specific to actions aimed at reducing social inequalities in health from the point of view of stakeholders. At the same time, it has revealed new candidate mechanisms which should be explored through further research. The analysis shows that focus should not solely be on mechanisms but should also largely take into consideration the role of policymakers in ensuring success of actions. This exploratory research demonstrates that a realistic evaluation approach is doable. However, it should be replicated at a larger scale to access all knowledge necessary for a comprehensive understanding of mechanisms conducive to reducing social health inequalities in France. (Global Health Promotion, 2011; 18(3): 47-60)