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La santé ne passe pas par l’hôpital

Posted on | mars 31, 2011 | 21 Comments

C’est le lancement aujourd’hui d’un outil en ligne visant à permettre la comparaison de l’état de santé des Américains. Ces statistiques colligées et mise en forme par un groupe comprenant l’Université du Wisconsin associent à l’état de santé des Américains de nombreuses variables sociales, environnementales, économiques et démographiques.

On y apprend, non sans une certaine surprise, que l’environnement (naturel ou humain) n’est pas le plus important facteur faisant varier l’état de santé. L’offre de santé publique (dépistage, qualité et proximité des hôpitaux) non plus, même si ces derniers ont tout de même un effet.

Au contraire, la santé pas d’abord et avant tout par… l’éducation. Ainsi, la réussite des études secondaires, voir postsecondaire  est un facteur important. Dans le premier quartile (le plus en santé) 82% des habitants ont leur diplôme d’étude secondaire, comparativement à 75% dans le quatrième quartile. Le taux d’analphabétisme est en toute logique inversement proportionnel, passant de 11 à 15%. L’éducation comme facteur de revenu ne peut évidemment être mis de côté : le revenu familial passe de 52904$ au premier quartile à 37632$ au dernier.

Mais l’éducation sexuelle est également un critère primordial, et va de pair également avec l’éducation en général : dans le quartile où le taux de grossesse adolescente est le moins élevé, 82% de la population a obtenu son diplôme d’études secondaires, contre 74% dans le dernier quartile. Il apparait donc logique de favoriser le maintien aux études des mères en bas âge. Cela est d’autant plus crucial que le taux de mères monoparentales augmente également en fonction du taux de grossesse adolescente (de 26% au premier quartile jusqu’à 35% dans le dernier). La pauvreté infantile suit la même pente (de 16% à 27%) et aussi le taux d’infections transmises sexuellement (de 234 par 100,000 à 417 par 100,000). Le poids des bébés naissants est également inversement proportionnel au taux de grossesses adolescentes.

La présence d’assurance santé n’aurait par contre aucune incidence sur la santé réelle, tout comme la pollution atmosphérique. L’accès à des aliments sain joue surtout pour le premier quartile. Par contre, le mode de vie rural est plus nocif sur la santé globale que le mode de vie urbain. Étrangement, l’alcoolisme est inversement proportionnel à la santé globale (vos hypothèses sont les bienvenues). L’activité physique et l’obésité ont également les relations que l’on sait.

L’apport important de cette étude est de démontrer l’importance primordiale de la sensibilisation et de l’éducation sur la santé. Connaissant les coûts que génèrent notre système de santé, sans parler des coûts entraîner par l’absentéisme causé par la maladie, nous devrions songer non pas à investir nos milliards dans la construction d’hôpitaux qui ne verront jamais le  jour, mais plutôt pour régler le problème à la source par la prévention.

http://www.countyhealthrankings.org/ranking-methods

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