In February 2010, the French National Observatory on Poverty and Social Exclusion launched its sixth report. Ten years after the founding of the Observatory, this edition has a special character as it integrates the impact of the economic downturn. EPHA summarises the part of the report dealing with health issues.
In February 2010, the National Observatory on Poverty and Social Exclusion (Observatoire national de la pauvreté et de l’exclusion sociale – ONPES) launched its sixth report on the impact of 10 years of poverty and social exclusion observation in times of crisis.
The report is divided into three chapters. Chapter 1 highlights the current economic crisis and its effects on poverty and social exclusion. It analyses the measures taken by the government to counter the effects of the crisis and tries to find exit solutions or follow-up solutions. Chapter 2 attempts to find a trend explaining the evolution of poverty. It particularly analyses the situation of the most vulnerable and rights’ inequalities, e.g. the right to health, that will be further developed below. Finally, Chapter 3 presents a new approach in collecting data. Indeed, the ONPES worked on the association of people directly affected by poverty and social exclusion to the data gathering process.
The report illustrates the fact that health inequalities have been accentuated by the economic downturn. A number of observations are made:
Studies have shown that diseases and health problems are often the cause of poverty rather than its consequence. However, the available data show that health problems are very present amongst the most vulnerable groups, thus highlighting the social inequalities of health: while the average population facing bad health represents 9.6% of the population, 15.3% of the most vulnerable declared living in bad or very bad health. The report underlines that health varies considerably depending on socioeconomic status. However, it would be wrong to only consider the financial aspect of health without taking into account health determinants.
Health coverage increases: this chapter highlights a number of measures undertaken to offer universal minimum coverage. Targeted assistance has been created for the most vulnerable, and for undocumented migrants.
Healthcare renouncement: while the lowest level of healthcare renouncement was reached in 2002 (11.2% of the population), in 2006 14% of the population renounced healthcare for financial reasons. Lack of complementary coverage was the main reason for relinquishment, with dental care (63%), optical care (25%) and specialist care (16%) topping the list of reasons cited.
Several barriers remain in accessing healthcare. Households still have to pay part of health expenditures. Even if there is no clear delimitation from the social security system, data suggests health expenditures represent 50% of household expenditures compared to 40% in 2001. Surcharges are one major reason for the increase given that only one third of complementary insurance schemes reimburse them. Health inequalities therefore rise in parallel with the renouncement of healthcare for financial reasons. The lack of reimbursement for certain medicines also threatens household budgets.
Other reasons for renouncing healthcare are also illuminated, such as the complexity of obtaining healthcare following recent reforms, and the growing feeling of disaffiliation - from the system in general and from a personal point of view.
For further information:
Read the full report (in French): Sixième rapport de l’Observatoire national de la pauvreté et de l’exclusion sociale : « Bilan de 10 ans d’observation de la pauvreté et de l’exclusion sociale à l’heure de la crise »
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