As we endure the second wave of the coronavirus epidemic, how to avoid the excess mortality observed in the poor areas of the region? Studies by the regional health observatory launched in March, establish the link between excess mortality and poverty. The problem of health inequalities is not new, but “it’s a slap in the face” admits Luc Ginot, director of public health at the regional health agency in Ile-de-France, which speaks of a phenomenon “much larger than one might expect given the profile of the epidemic.”
This virus mainly affects fragile audiences, starting with the oldest, but these poor areas are rather young. “It’s counterintuitive, what surprised us is the extent of the gaps, and the violence with which it appeared.” In Seine Saint-Denis, excess mortality is 118%, the differences in mortality vary from 1 to 3 between poor cities and rich cities.
According to these studies, the most affected areas in the region are concentrated in Seine-Saint-Denis, around the Plaine-Commune (Aubervilliers, La Courneuve, Épinay-sur-Seine, L’Île-Saint-Denis, Pierrefitte-sur-Seine, Saint-Denis, Saint-Ouen-sur-Seine, Stains and Villetaneuse), and Is together (Bagnolet, Bobigny, Bondy, Le Pré-Saint-Gervais, Les Lilas, Montreuil, Noisy-le-Sec, Pantin, Romainville). Also Sarcelles, Villiers-le-Bel in the Val d’Oise and Valenton in the Val-de-Marne.
More targeted prevention actions
Two mechanisms explain this excess mortality according to Luc Ginot. First it’s “there that remain the key workers, the most exposed, in contact with the public, cleaning staff, shops, cleaning the public road …”. They are also territories with habitat conditions “more degraded than elsewhere” with overcrowding in housing. In addition, the poorest people have more “risk factors” in terms of health, “with diabetes, obesity, hypertension or pulmonary pathologies.”
In these territories, the inhabitants also suffered more “the seriousness of the consequences of the virus which explains the higher excess mortality at the end of the chain”, notes Luc Ginot.
How do you prevent this from happening again? “We are working hard so that the phenomenon does not happen again with the same violence”, assures the director of public health at the ARS, with “more targeted prevention actions aimed at these populations, and work with field workers and neighborhood associations”.
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