Cancer, territoires et discrimination : des zones rurales aux quartiers prioritaires de la ville

Abstract

The article aims to characterize the social determinants that define the cancer experience in its plurality, making room for the consideration of socio-economic and ethno-racial inequalities, and discusses territorial entry as a marker of health inequalities. The analysis retains the qualitative and French aspect of two projects, including a European research project of mixed protocol, and relies on 60 interviews with patients and professionals involved in their care and 100H of in situ observation of care consultations. The results are structured around four axes. The first focuses on universal care and health coverage. The second focuses on 'visible minorities,' more present in the city priority neighborhoods (CPN) than in the rural areas, and their invisibilization in oncology. The third part shows that an analysis of the caregivers' interactions with patients must rely on the notion of trust and that they first and foremost come from the 'good reputation' of professionals and institutions. Finally, the fourth part puts into perspective the gendered contours of the trajectory of illness and social support. The article highlights the mechanisms of production of health inequalities in a context of desertification. It shows that these inequalities remain embedded in a system of territorial, socio-economic and racial segregation that reinforces the feelings of discrimination of cancer patients.