Skip to Main content Skip to Navigation
Theses

Déterminants sociaux et asthme : approche épidémiologique

Abstract : The general aim of the thesis was to study the role of social determinants in asthma with a particular focus on methodological aspects to characterize neighborhood social context.The first part of the thesis aimed to investigate the hypothesis of a differential exposure to air pollution, an important risk factor for asthma. Specifically, we studied the association between socioeconomic position (SEP) assessed at individual-level (educational level and occupational status) and neighborhood-level (unemployment rate) and exposure to nitrogen dioxide (NO2), a marker of traffic exhaust, in 16 western European cities. In stratified analyses, including 5692 participants from three European cohorts, association between individual SEP and NO2 were generally weak and inconsistent in direction. The neighborhood unemployment rate was positively and significantly associated with NO2 in most of the cities studied.The second part of the thesis aimed to better understand the association between socioeconomic position and asthma control, the main target of asthma management. We first focused on methodological aspects to characterize neighborhood social context in the E3N cohort. We compared three indices of deprivation and showed that the French Deprivation Index was the most appropriate to measure neighborhood social context in this specific cohort composed of elderly women with higher socioeconomic profile than the elderly women in the general French population. We then investigated the association between SEP, at individual- and area-level, and asthma control in Asthma-E3N, a case-control study on asthma nested in the E3N cohort. Including 2258 women with current asthma, the analysis showed that women with medium and low educational level had more often uncontrolled asthma than women with high educational level. Women living in deprived neighborhood had more often uncontrolled asthma independently of their educational level.
Document type :
Theses
Complete list of metadatas

https://tel.archives-ouvertes.fr/tel-01821462
Contributor : Abes Star :  Contact
Submitted on : Friday, June 22, 2018 - 2:49:06 PM
Last modification on : Monday, March 9, 2020 - 6:41:08 PM
Long-term archiving on: : Monday, September 24, 2018 - 6:57:44 PM

File

75324_TEMAM_2017_diffusion.pdf
Version validated by the jury (STAR)

Identifiers

  • HAL Id : tel-01821462, version 1

Collections

Citation

Sofia Temam. Déterminants sociaux et asthme : approche épidémiologique. Santé publique et épidémiologie. Université Paris-Saclay, 2017. Français. ⟨NNT : 2017SACLS110⟩. ⟨tel-01821462⟩

Share

Metrics

Record views

516

Files downloads

5067