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Alsharif A, Al Habbal O, Gabadian A, El Maamoun R, Al Faraj A, Kamr Aldin T, Haitham Aldammad O, Alkayakhi A, Al Habbal A. Behavioral difficulties and associated factors among the 'lost generation' of Syrian children and adolescents. Sci Rep 2024; 14:9286. [PMID: 38654099 DOI: 10.1038/s41598-024-59784-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
Childhood and adolescence, vital in shaping adult life and society, are profoundly impacted during conflicts like Syria's devastating war. This study explores the prevalence of behavioral disorders in Syrian children and adolescents, examining the influence of war and family-related factors. This cross-sectional study was conducted on children aged 2-17 years at a children's outpatient clinic in Damascus, Syria. We assessed parents' quality of life, war and family-related factors, and behavioral difficulties through parental interviews using two questionnaires: the Arabic version of the Strengths & Difficulties Questionnaire (SDQ) and the brief Arabic version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). 74.67% of children aged 2-4 years and 61.29% of children aged 5-17 years were experiencing behavioral difficulties, with emotional difficulties being the most prevalent ones. Children exposed to kidnapping, family losses, lack of school enrollment, and those with parents having lower education, lower socioeconomic status, and poorer quality of life exhibited higher Total SDQ scores. The high prevalence of behavioral difficulties among children and adolescents in Syria is a major concern, with both direct and indirect war-related factors contributing to this issue.
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Affiliation(s)
- Aya Alsharif
- Faculty of Medicine, Damascus University, Damascus, Syria
| | | | - Aram Gabadian
- Faculty of Medicine, Damascus University, Damascus, Syria
- Eye Surgical Hospital, Damascus, Syria
| | | | - Alaa Al Faraj
- Faculty of Medicine, Damascus University, Damascus, Syria
| | | | | | | | - Aya Al Habbal
- Faculty of Medicine, Damascus University, Damascus, Syria.
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Descarpentrie A, Estevez M, Brabant G, Vandentorren S, Lioret S. Lifestyle Patterns of Children Experiencing Homelessness: Family Socio-Ecological Correlates and Links with Physical and Mental Health. Int J Environ Res Public Health 2022; 19:16276. [PMID: 36498355 PMCID: PMC9737210 DOI: 10.3390/ijerph192316276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Diet, screen time, physical activity, and sleep combine into lifestyle patterns with synergistic effects on health. This study aimed to identify lifestyle patterns in children without housing and assess their associations with physical and mental health and family socio-ecological factors. In the 2013 ENFAMS cross-sectional survey (children aged 6-12 experiencing homelessness, Greater Paris area, n = 235), parents reported socio-ecological factors, children's behaviours, and mental health (the latter was also child-reported). Nurses measured children's haemoglobin concentrations and body mass index. Principal component analysis was used to derive sex-specific lifestyle patterns. Hierarchical linear regressions and "outcome-wide" analyses assessed, respectively, these patterns' relations to health and family socio-ecological factors. A rather healthy lifestyle pattern-similarly characterized by diverse diet and high sleep time-was identified, with slight differences by sex. Scores for this pattern were higher for children in food-secure or higher-income households, whose parents were proficient in French, who slept longer, or who received more social support compared to their counterparts, with some nuances by sex. Higher scores for this pattern were associated with higher prosocial behaviour scores (girls) and lower anxiety and hyperactivity-inattention symptoms scores (boys), but not with physical health. For this underserved and understudied population, the results highlight the importance of family socio-ecological factors in shaping the lifestyles and mental health of children.
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Affiliation(s)
- Alexandra Descarpentrie
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
| | - Mégane Estevez
- Université de Bordeaux, Inserm, UMR1219, PHARes team, F-33000 Bordeaux, France
| | - Gilles Brabant
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France
| | - Stéphanie Vandentorren
- Université de Bordeaux, Inserm, UMR1219, PHARes team, F-33000 Bordeaux, France
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France
- Institut Convergences Migration/CNRS, F-93322 Aubervilliers, France
| | - Sandrine Lioret
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
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O' Brien N, Quinn N, Joyce B, Bedford H, Crushell E. Emergency department utilisation by homeless children in Dublin, Ireland: a retrospective review. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001368. [PMID: 36053629 PMCID: PMC8928284 DOI: 10.1136/bmjpo-2021-001368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/08/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Despite increasing prevalence, European family homelessness remains under-researched. METHODS A retrospective review was performed of homeless children attending a paediatric emergency department in Dublin, Ireland, from 1 January 2017 to 31 December 2020. Comparison was made with a random cohort of 1500 non-homeless paediatric attendances in 2019. Homelessness was defined using the European Typology of Homelessness and Housing Exclusion, including those with addresses of no fixed abode, government homeless accommodation and certain residential settings. The objectives were to compare presentations between homeless and non-homeless children. We were interested in determining differences regarding demographics, healthcare utilisation, clinical presentation and outcomes. RESULTS Of 197 437 attendances 3138 (1.59%) were homeless. Compared with the non homeless, homeless children were less likely to be ethnically Irish (37.4% vs 74.6%, p<0.001) or have been born in Ireland (82.3% vs 96.2%, p<0.001). Irish Travellers (3% vs 0.8%), Roma (22.5% vs 2.4%) and black (21.1% vs 4.2%) ethnicities were over-represented (p<0.001) in the homeless cohort.Homeless children were younger (age <12 months: 26% vs 16%; p<0.001), less likely to be fully vaccinated (73.6% vs 81.9%, p<0.001) and have registered general practitioners (89.7% vs 95.8%, p<0.001). They were more likely to represent within 2 weeks (15.9% vs 10.5%, p<0.001), and use ambulance transportation (13.2% vs 6.7%, p<0.001). Homeless children had lower acuity presentations (triage category 4-5: 47.2% vs 40.7%, p<0.001) and fewer admissions (5.9% vs 8.4%, p<0.001) than non-homeless children. DISCUSSION Infants, Irish Travellers, Roma and black ethnicities were over-represented in homeless presentations. Homeless children had increased reliance on emergency services for primary healthcare needs.
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Affiliation(s)
- Niamh O' Brien
- Paediatric Emergency Medicine, Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Nuala Quinn
- Paediatric Emergency Medicine, Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Birgitta Joyce
- Paediatric Emergency Medicine, Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Helen Bedford
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Ellen Crushell
- Metabolic Medicine, Children's Health Ireland at Temple Street, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
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Frenoy P, Vandentorren S, Arnaud A, Vuillermoz C, Rico Berrocal R, Martin-Fernandez J, Azria E, de Lauzon-Guillain B, Bernard JY, Lioret S. Demographic, socioeconomic, and sociocultural factors associated with any breastfeeding in homeless mothers. Matern Child Nutr 2021; 17:e13167. [PMID: 33780138 PMCID: PMC8189215 DOI: 10.1111/mcn.13167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/31/2021] [Accepted: 02/02/2021] [Indexed: 11/27/2022]
Abstract
In high-income countries, breastfeeding has been shown to be positively associated with socioeconomic position. However, less is known about breastfeeding practices and their associated factors among extremely disadvantaged populations. We aimed to assess the associations of cultural origins and socioeconomic factors with any breastfeeding initiation and duration in homeless families. We analyzed data from 456 children aged 6 months to 5 years from the cross-sectional ENFAMS survey, conducted in 2013 among a random sample of homeless families in shelters in the Greater Paris area. Data were collected by bilingual interviewers in 17 languages. Four nested multivariable robust Poisson regression models were run in a hierarchical framework to determine the factors associated with breastfeeding initiation and with any breastfeeding for 6 months or more. Most of the children (86.0%) had previously been or were currently being breastfed at the time of the survey; 58.9% were fed with breast milk ≥6 months. A higher maternal age and African origin were positively associated with breastfeeding ≥6 months, although the relation to the region of origin was moderated by education level. Migration to escape war, unrest or other violence and the child's birth in France were inversely associated with breastfeeding ≥6 months. Any breastfeeding by these homeless mothers seems influenced predominantly by their cultural origin and complicated by a difficult migration trajectory. The possible influence of poor material circumstances and cumulative hardship should encourage interventions targeted at homeless mothers that emphasize social/family support with a commitment to improving the family's living conditions.
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Affiliation(s)
- Pauline Frenoy
- Université de Paris, CRESS, INSERM, INRAE, Paris, France
| | - Stéphanie Vandentorren
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France.,Institut Pierre Louis d'Épidémiologie et de Santé Publique, Department of Social Epidemiology, INSERM, Sorbonne Université, Paris, France
| | | | - Cécile Vuillermoz
- Institut Pierre Louis d'Épidémiologie et de Santé Publique, Department of Social Epidemiology, INSERM, Sorbonne Université, Paris, France
| | | | - Judith Martin-Fernandez
- INSERM, Bordeaux Population Health Research Center, UMR 1219, CIC1401-EC, University of Bordeaux, ISPED, Bordeaux, France
| | - Elie Azria
- Université de Paris, CRESS, INSERM, INRAE, Paris, France.,Maternité Notre Dame de Bon Secours, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | | | - Jonathan Y Bernard
- Université de Paris, CRESS, INSERM, INRAE, Paris, France.,Agency for Science, Technology and Research (A*STAR), Singapore Institute for Clinical Sciences (SICS), Singapore
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Tortelli A, Perquier F, Melchior M, Lair F, Encatassamy F, Masson C, K’ourio H, Gourevitch R, Mercuel A. Mental Health and Service Use of Migrants in Contact with the Public Psychiatry System in Paris. Int J Environ Res Public Health 2020; 17:ijerph17249397. [PMID: 33333905 PMCID: PMC7765309 DOI: 10.3390/ijerph17249397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND Migrants, and particularly asylum seekers, are at increased risk of psychiatric disorders in comparison with natives. At the same time, inequalities in access to mental health care are observed. METHODS In order to evaluate whether the Parisian public psychiatric system is optimally structured to meet the needs of this population, we examined data on mental health and service use considering three different levels: the global system treatment level, a psychiatric reception center, and mobile teams specializing in access to psychiatric care for asylum seekers. RESULTS We found higher treatment rates among migrants than among natives (p < 0.001) but inequalities in pathways to care: more mandatory admissions (OR = 1.36, 95% CI: 1.02-1.80) and fewer specialized consultations (OR = 0.56, 95% CI: 0.38-0.81). We observed a mismatch between increased need and provision of care among migrants without stable housing or seeking asylum. CONCLUSIONS Inequalities in the provision of care for migrants are observed in the Parisian public psychiatric system, particularly for those experiencing poor social and economic conditions. There is a need to facilitate access to mental health care and develop more tailored interventions to reduce discontinuity of care.
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Affiliation(s)
- Andrea Tortelli
- Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France; (F.L.); (C.M.); (A.M.)
- Pierre Louis Institute for Epidemiology and Public Health (IPLESP/INSERM UMR_S 1136), 75012 Paris, France;
- Institut des Migrations, 75013 Paris, France
- Correspondence:
| | - Florence Perquier
- Departement d’Epidémiologie, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France;
| | - Maria Melchior
- Pierre Louis Institute for Epidemiology and Public Health (IPLESP/INSERM UMR_S 1136), 75012 Paris, France;
- Institut des Migrations, 75013 Paris, France
| | - François Lair
- Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France; (F.L.); (C.M.); (A.M.)
| | - Fabien Encatassamy
- CPOA: Centre Psychiatrique d’Orientation et d’Accueil, Hôpital Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences-1, rue Cabanis, F-75014 Paris, France; (F.E.); (H.K.); (R.G.)
| | - Chloé Masson
- Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France; (F.L.); (C.M.); (A.M.)
| | - Hélène K’ourio
- CPOA: Centre Psychiatrique d’Orientation et d’Accueil, Hôpital Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences-1, rue Cabanis, F-75014 Paris, France; (F.E.); (H.K.); (R.G.)
| | - Raphaël Gourevitch
- CPOA: Centre Psychiatrique d’Orientation et d’Accueil, Hôpital Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences-1, rue Cabanis, F-75014 Paris, France; (F.E.); (H.K.); (R.G.)
| | - Alain Mercuel
- Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France; (F.L.); (C.M.); (A.M.)
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Roze M, Melchior M, Vuillermoz C, Rezzoug D, Baubet T, Vandentorren S. Post-Traumatic Stress Disorder in Homeless Migrant Mothers of the Paris Region Shelters. Int J Environ Res Public Health 2020; 17:ijerph17134908. [PMID: 32646029 PMCID: PMC7370032 DOI: 10.3390/ijerph17134908] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 11/17/2022]
Abstract
Migrant women are disproportionately more likely to experience traumatic events in their country of origin, during migration and after arriving in the host country. Homeless women are more likely to be exposed to multiple victimizations in childhood (emotional or physical maltreatment) and in adulthood (sexual abuse, street victimization). This study’s objective was to describe the factors associated with the likelihood of post-traumatic stress disorder (PTSD) among homeless migrant mothers in the Paris region. Face-to-face interviews were conducted by bilingual psychologists and interviewers in a representative sample of homeless families in the Paris region. PTSD was ascertained using the Mini International Neuropsychiatric Interview (MINI) (n = 691 mothers). We studied PTSD in mothers using weighted Poisson regression. Homeless migrant mothers had high levels of PTSD (18.9%) in the 12 months preceding the study. In multivariate analysis, PTSD was associated with departure from the country of origin because of violence (PR = 1.45 95% CI 1.03; 2.04), depression in the preceding 12 months (PR = 1.82 95% CI 1.20; 2.76), and residential instability (PR = 1.93 95% CI 1.27; 2.93). Homeless migrant mothers have high levels of traumatic events and PTSD. Improvements in screening for depression and PTSD and access to appropriate medical care are essential for this vulnerable group.
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Affiliation(s)
- Mathilde Roze
- INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, F75012 Paris, France; (M.R.); (M.M.); (C.V.)
| | - Maria Melchior
- INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, F75012 Paris, France; (M.R.); (M.M.); (C.V.)
| | - Cécile Vuillermoz
- INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, F75012 Paris, France; (M.R.); (M.M.); (C.V.)
| | - Dalila Rezzoug
- CESP Inserm 1178, Université Paris 13, APHP Hôpital Avicenne, 93000 Bobigny, France; (D.R.); (T.B.)
- Centre National de Ressources et Résilience, 59800 Lille, France
| | - Thierry Baubet
- CESP Inserm 1178, Université Paris 13, APHP Hôpital Avicenne, 93000 Bobigny, France; (D.R.); (T.B.)
- Centre National de Ressources et Résilience, 59800 Lille, France
| | - Stéphanie Vandentorren
- INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, F75012 Paris, France; (M.R.); (M.M.); (C.V.)
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France
- Correspondence:
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D'Sa S, Foley D, Hannon J, Strashun S, Murphy AM, O'Gorman C. The psychological impact of childhood homelessness-a literature review. Ir J Med Sci 2020; 190:411-417. [PMID: 32488463 DOI: 10.1007/s11845-020-02256-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 05/09/2020] [Indexed: 11/26/2022]
Abstract
In August 2019, 3848 children in Ireland were faced with emergency homelessness [1]. In recent years, lack of affordable housing, unemployment and shortage of rental properties have been the primary driving factors for the potentially devastating impact of familial homelessness in our society [1]. Our aim was to evaluate current knowledge on the psychological impact of homelessness in children. Using the PRISMA model, we performed a review of the currently available literature on the psychological impact of homelessness on children. This concept was explored under two different categories-'transgenerational' and 'new-onset homelessness'. Hidden homelessness was also explored. Our literature review revealed several psychological morbidities which were unique to children. This includes developmental and learning delays, behavioural difficulties and increased levels of anxiety and depression [66, 77, 40, 81, 42]. This has been demonstrated by poorer performance in school testing and increased levels of aggression. Anxiety in children within this cohort has been shown to peak at time of dispersion from their stable home environment [67]. Our study highlights violence, aggression and poor academic learning outcomes to be just some of the key findings in our review of homelessness in childhood, worldwide. Unfortunately, there has been minimum research to date on paediatric homelessness within the context of the Irish population. We anticipate this review to be the first chapter in a multipart series investigation to evaluate the psychological morbidity of paediatric homelessness within the Irish Society.
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Affiliation(s)
- Saskia D'Sa
- Department of Paediatrics and Neonatology, University Hospital Limerick (UHL), Limerick, Ireland.
- Department of Paediatrics and Neonatology, University Maternity Hospital Limerick (UHML), Limerick, Ireland.
| | - Deirdre Foley
- Department of Paediatrics and Neonatology, University Hospital Limerick (UHL), Limerick, Ireland
- Department of Paediatrics and Neonatology, University Maternity Hospital Limerick (UHML), Limerick, Ireland
| | - Jessica Hannon
- Department of Paediatrics and Neonatology, University Hospital Limerick (UHL), Limerick, Ireland
- Department of Paediatrics and Neonatology, University Maternity Hospital Limerick (UHML), Limerick, Ireland
| | - Sabina Strashun
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
| | - Anne-Marie Murphy
- Department of Paediatrics and Neonatology, University Hospital Limerick (UHL), Limerick, Ireland
- Department of Paediatrics and Neonatology, University Maternity Hospital Limerick (UHML), Limerick, Ireland
| | - Clodagh O'Gorman
- Department of Paediatrics and Neonatology, University Hospital Limerick (UHL), Limerick, Ireland
- Department of Paediatrics and Neonatology, University Maternity Hospital Limerick (UHML), Limerick, Ireland
- Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland
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8
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Simbar S, Hosseinkhanzadeh AA, Abolghasemi A. Hope for the Future, Attachment Relationships, and Emotional-Behavioral Problems in Child Labor. ACTA ACUST UNITED AC 2019. [DOI: 10.29252/jcmh.6.3.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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9
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Darbeda S, Falissard B, Orri M, Barry C, Melchior M, Chauvin P, Vandentorren S. Adaptive Behavior of Sheltered Homeless Children in the French ENFAMS Survey. Am J Public Health 2018; 108:503-510. [PMID: 29470117 DOI: 10.2105/ajph.2017.304255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To describe the adaptive behaviors in a large sample of homeless children and identify factors associated with developmental delay. METHODS Data were from a cross-sectional survey of 557 children younger than 6 years randomly sampled among homeless sheltered families in the Paris region, France (January-May 2013). An interviewer and a psychologist conducted face-to-face interviews to collect information on sociodemographic and health characteristics. We assessed adaptive behaviors using the Vineland Adaptive Behavior Scales, second edition (VABS-II). RESULTS The mean VABS-II composite score (SD) was 75.4 (12.0), and most participating children (80.9%) were considered developmentally delayed. Characteristics negatively associated with children's developmental score were age, birth in a country other than France, low birth weight, and past-year hospitalization. CONCLUSIONS There is a high prevalence of developmental delays among children growing up homeless. Public Health Implications. Long-term integrated programs improving parenting and children's opportunities for stimulation and socialization should be developed in daycare centers, schools, shelters, and medical practices to minimize negative effects of early living conditions on children's development.
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Affiliation(s)
- Stéphane Darbeda
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Bruno Falissard
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Massimiliano Orri
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Caroline Barry
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Maria Melchior
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Pierre Chauvin
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
| | - Stéphanie Vandentorren
- Stéphane Darbeda, Bruno Falissard, Massimiliano Orri, and Caroline Barry are with Institut national de la santé et de la recherche médicale (INSERM), unit 1178, Centre de recherche en épidémiologie et santé des populations, University Paris Sud, Paris, France. Maria Melchior and Stéphanie Vandentorren are with INSERM, unit 136, Institut Pierre Louis d'épidémiologie et de santé publique, Department of Social Epidemiology, Sorbonne Universités, Pierre and Marie Curie University, Paris. Pierre Chauvin is with INSERM, Research Team on Social Determinants of Health and Use of Care, unit 707, Pierre and Marie Curie University, Paris
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10
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Affiliation(s)
- Maria Melchior
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France.
| | - Judith van der Waerden
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France
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