Greater Paris Region Research Articles

Proof of concept of a sexual health outreach program led by community health workers in homeless hostels in the greater Paris region.

Homeless individuals face exacerbated risks of infectious diseases, including sexually transmitted infections (STIs). Programs led by Community Health Workers (CHWs) have demonstrated potential to enhance healthcare access for marginalized groups such as homeless families. This study aims to evaluate the feasibility and effectiveness of a novel CHW-based outreach program addressing sexual health issues among individuals residing in homeless hostels. Twelve social homeless hostels in the greater Paris region were selected as program implementation sites. An outreach program was developed consisting of two interventions: sexual health workshops and STI screening sessions (HIV and hepatitis B and C) accompanied by individual interviews, both conducted by CHWs within each hostel over an 8-week period and scheduled weekly. Feasibility, participation and engagement were evaluated using complementary methods including qualitative field observations, semi-structured interviews and focus groups with CHWs, satisfaction questionnaires for participants, and quantitative outcome data collection of each intervention. A total of 80 program activities (workshops and screening sessions) were conducted. Among the participants, 542 women and 30 men engaged in workshops. During the 30 Rapid Diagnostic Testing sessions, 150 individuals underwent testing for HIV, hepatitis B, and/or hepatitis C. Positivity rates were 6.7% for hepatitis B and 0.9% for hepatitis C. No HIV infections were detected. Participant satisfaction rates were consistently high (>76%) across workshops. Qualitative analysis unveiled two critical axes influencing program feasibility and effectiveness: program organization and CHW involvement. This assessment of the program highlights its feasibility among a population that is difficult to reach through conventional healthcare efforts. The intervention's potential effectiveness is suggested by self- and CHW-reported improvements in sexual health literacy and high rates of referral to the healthcare system, as well as holistic well-being considerations. CHW involvement is a vital determinant of program success, as are robust coordination among stakeholders, deep understanding of the target population, and strong partner engagement. This outreach program amplifies the voices of often-overlooked populations while empowering them to navigate health and social challenges. Although these workshops serve as lifelines for those frequently excluded from mainstream services, long-term improvements to the health and wellbeing of homeless populations will necessitate systemic governmental intervention.

Urbanization in France: An Overview of Transformations and Impacts

This paper explores the historical perspectives and contemporary trends of urbanization in France, shedding light on the transformations, challenges, and opportunities that have shaped the country's urban landscape over time. The article begins by tracing the roots of urbanization in the nineteenth century when industrialization spurred rapid urban growth in cities like Paris, Lyon, Marseille, and Bordeaux. The rise of urban infrastructure, including factories, transportation networks, and housing, accommodated the growing urban population.The twentieth century marked a transition in France's urbanization patterns, with post-war reconstruction, suburbanization, and changing societal dynamics playing significant roles. Efforts were made to rebuild and modernize cities after the World Wars, resulting in urban renewal projects and architectural changes. Suburbanization emerged as a trend driven by the desire for improved living conditions outside overcrowded city centers.In recent decades, globalization, technological advancements, and changing lifestyles have influenced urban development patterns in France. Metropolitan areas, particularly the Greater Paris Region, have experienced significant expansion, concentrating economic activities, cultural institutions, and population. However, smaller towns and rural areas have faced population decline and struggles to maintain services and infrastructure.The consequences of urbanization in France have been multifaceted. Cities have become centers of economic innovation, cultural vibrancy, and educational opportunities, attracting talent and fostering creativity. Additionally, urban areas have played a crucial role in France's tourism industry, with cities like Paris and Lyon being major global destinations. However, the rapid growth of cities has presented challenges related to housing affordability, transportation congestion, environmental sustainability, and social inequality.To effectively manage urbanization, policymakers, urban planners, and researchers must understand the driving factors, impacts on local communities, and strategies for sustainable urban development. The article emphasizes the importance of examining demographic shifts, urban planning initiatives, transportation systems, housing dynamics, cultural transformations, and the quest for sustainable development. By analyzing the historical trajectory and current trends of urbanization in France, valuable insights can be gained into the opportunities and challenges faced by the country as it navigates the complexities of a rapidly changing urban landscape.The article concludes by highlighting the need for comprehensive urban planning, sustainable development practices, and inclusive policies to address the challenges posed by urbanization in France. It emphasizes the importance of transportation systems, housing dynamics, affordability, and environmental considerations in creating resilient and livable cities. Additionally, the article suggests that examining specific case studies like Paris, Lyon, and Marseille can provide deeper insights into the unique challenges and successes of urbanization in different cities.

Major depressive disorder in post-secondary students attending foodbanks in France.

Poor mental health among youth is a major public health issue that has risen to the forefront since the COVID-19 crisis, especially among post-secondary students and precarious populations. The objectives of this work were to evaluate the rate of major depressive disorder (MDD) among precarious post-secondary students in the greater Paris region, to describe its risk factors, and to identify determinants for not seeking care. We conducted a multi-site, cross-sectional survey of post-secondary students attending a selection of 13 student foodbanks in the greater Paris region (France) between 30 November 2021 and 27 January 2022. This study had two complementary epidemiological and sociological components: a quantitative description of MDD through completion of a questionnaire performed through face-to-face or telephone interviews, and a qualitative assessment of the factors underlying MDD through in-depth follow-up interviews conducted among a sub-selection of students who participated in the first phase. Among 456 students who participated in our survey, 35.7% presented with MDD. The risk of suffering from MDD was higher among women, students housed by third-parties, students reporting moderately to severely hungry and/or poor physical health. Students receiving material and/or social support were less likely to present with MDD. Among students who reported needing health care in the last year or since their arrival in France, 51.4% did not seek care. To address poor mental health among precarious students, policy action must jointly consider financial precarity, administrative barriers, housing, food security, physical health, and access to health services, especially mental health.

A French bazaar and a Mexican street market: an object-centered comparative analysis of interstitial spaces

A neighborhood bazaar run by a community organization in Saint-Denis in the Greater Paris region, an ‘informal’ cultural street market in downtown Mexico City run by the oldest members of the Punk-Rock community. . . Two spaces that have in common the circulation of objects and a dense web of affective interactions between people and commodities. This article shows how the circulation of objects creates interstitial spaces between the public and the domestic. But it goes further by demonstrating that these interstitial spaces also challenge market and gender norms. Through a participatory methodology involving photography and comparative dialog, the article analyzes the place of objects in the creation of interstitial spaces and their subversive potential.

Local multifractality in urban systems—the case study of housing prices in the greater Paris region

Even though the study of fractal and multifractal properties has now become an established approach for statistical urban data analysis, the accurate multifractal characterisation of smaller, district-scale spatial units is still a somewhat challenging task. The latter issue is key for understanding complex spatial correlations within urban regions while the methodological challenge can be mainly attributed to inhomogeneous data availability over their territories. We demonstrate how the approach proposed here for the multifractal analysis of irregular marked point processes is able to estimate local self-similarity and intermittency exponents in a satisfactory manner via combining methods from classical multifractal and geographical analysis. With the aim of emphasizing general applicability, we first introduce the procedure on synthetic data using a multifractal random field as mark superposed on two distinct spatial distributions. We go on to illustrate the methodology on the example of home prices in the greater Paris region, France. In the context of complex urban systems, our findings proclaim the need for separately tackling processes on the geolocation (support) and any attached value (mark, e.g. home prices) of geospatial data points in an attempt to fully describe the phenomenon under observation. In particular, the results are indicators of the strength of global and local spatial dependency in the housing price structure and how these build distinct layered patterns within and outside of the municipal boundary. The derived properties are of potential urban policy and strategic planning relevance for the timely identification of local vulnerabilities while they are also intended to be combinable with existing price indices in the regional economics context.

Assessing the Effectiveness of an Urban CO2 Monitoring Network over the Paris Region through the COVID-19 Lockdown Natural Experiment.

The Paris metropolitan area, the largest urban region in the European Union, has experienced two national COVID-19 confinements in 2020 with different levels of restrictions on mobility and economic activity, which caused reductions in CO2 emissions. To quantify the timing and magnitude of daily emission reductions during the two lockdowns, we used continuous atmospheric CO2 monitoring, a new high-resolution near-real-time emission inventory, and an atmospheric Bayesian inverse model. The atmospheric inversion estimated the changes in fossil fuel CO2 emissions over the Greater Paris region during the two lockdowns, in comparison with the same periods in 2018 and 2019. It shows decreases by 42-53% during the first lockdown with stringent measures and by only 20% during the second lockdown when traffic reduction was weaker. Both lockdown emission reductions are mainly due to decreases in traffic. These results are consistent with independent estimates based on activity data made by the city environmental agency. We also show that unusual persistent anticyclonic weather patterns with north-easterly winds that prevailed at the start of the first lockdown period contributed a substantial drop in measured CO2 concentration enhancements over Paris, superimposed on the reduction of urban CO2 emissions. We conclude that atmospheric CO2 monitoring makes it possible to identify significant emission changes (>20%) at subannual time scales over an urban region.

Outer-suburban politics and the financialisation of the logistics real estate industry: The emergence of financialised coalitions in the Paris region

Logistics real estate is a type of property rarely covered in the existing literature on the financialisation of property markets. The emergence of specialised international real estate firms, which act as developers, investors and property fund managers, means that the logistics real estate industry has taken a unique financialisation path. The present article explains the specific features of the financialisation of the logistics real estate industry and contributes to the understanding of the financialisation of outer-suburban governance. Based on a qualitative analysis of the European logistics real estate market and case studies conducted in the Greater Paris region, the article combines an analysis of the sociotechnical mediations of financial circuits in the logistics built environment with the study of emerging local public–private coalitions formed to develop logistics zones. As such, it will be seen that the domination of integrated global firms in logistics real estate depends on their capacity to form local coalitions.

COVID-19 and homelessness: when crises intersect

COVID-19 and homelessness: when crises intersect

Breaking healthcare coordination boundaries in response to migrants precariousness: the case study of a healthcare network in the Parisian suburbs

Although the mechanisms underpinning health inequalities associated with migration are increasingly well described by social epidemiology and health sociology, the operations of health care systems involved in the assistance of migrant populations in precarious situations remain largely unexplored. Based on the study of a precariousness and healthcare network and its two main partner institutions located within the greater Paris region, this article exposes the coordination ch...

The elusive quest for social diversity: Public housing, diversity, and politics in France

This paper shows that social housing supply affects population diversity and that electoral incentives matter for the provision of social rental units at the local level. Using a nationwide policy reform imposing on French municipalities to increase their stocks of social dwellings, I find that there is a positive causal relationship between policy implementation, affordable housing supply and social diversity in the Greater Paris region. The impact of the policy is heterogeneous across municipality characteristics. Richer and more politically right-wing oriented municipalities build fewer new social housing units. I provide evidence that electoral incentives can explain part of the impact heterogeneity found. Conservative mayor re-election is threatened by the arrival of new public housing residents with different political preferences as well as by dissatisfaction with housing policy implementation among incumbent conservative voters. The findings imply that local government incentives might affect the implementation of affordable housing policies. This paper contributes to the limited body of evidence on the political economy of social housing provision.

Integrated Smart Water Management of the sanitation system of the Greater Paris region

ABSTRACT This case study details the development of a real-time control system (MAGES) in the Paris region designed to better control stormwater pollution caused by combined sewer overflows and to optimize the need for additional storage or treatment facilities. It is structured to outline the challenges facing the Greater Paris region water and sanitation networks, and the solutions provided by SIAAP, the public utility in charge of the treatment and transport of wastewater, over the past 20 years.

Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 mimicking Kawasaki disease (Kawa-COVID-19): a multicentre cohort

BackgroundCurrent data suggest that COVID-19 is less frequent in children, with a milder course. However, over the past weeks, an increase in the number of children presenting to hospitals in...

Clinical features of 1487 COVID-19 patients with outpatient management in the Greater Paris: the COVID-call study.

Clinical features of COVID-19 have been mostly described in hospitalized patients with and without ICU admission. Yet, up to 80% of patients are managed in an outpatient setting. This population is poorly documented. In France, health authorities recommend outpatient management of patients presenting mild-to-moderate COVID-19 symptoms. The aim of this study was to describe their clinical characteristics. The study took place in an emergency medical dispatching center located in the Greater Paris region. Patients included in this survey met confirmed COVID-19 infection criteria according to the WHO definition. We investigated clinical features and classified symptoms as general, digestive, ear–nose–throat, thoracic symptoms, and eye disease. Patients were included between March 24 and April 6 2020. 1487 patients included: 700 (47%) males and 752 (51%) females, with a median age of 44 (32–57) years. In addition to dry cough and fever reported in more than 90% of cases, the most common symptoms were general symptoms: body aches/myalgia (N = 845; 57%), headache (N = 824; 55%), and asthenia (N = 886; 60%); shortness of breath (N = 479; 32%) and ear–nose–throat symptoms such as anosmia (N = 415; 28%) and ageusia (N = 422; 28%). Chest pain was reported in 320 (21%) cases and hemoptysis in 41 (3%) cases. The main difference between male and female patients was an increased prevalence of ear–nose–throat symptoms as well as diarrhea, chest pains, and headaches in female patients. General symptoms and ear–nose–throat symptoms were predominant in COVID-19 patients presenting mild-to-moderate symptoms. Shortness of breath and chest pain were remarkably frequent.Electronic supplementary materialThe online version of this article (10.1007/s11739-020-02379-z) contains supplementary material, which is available to authorized users.

EXPLUME v1.0: a model for personal exposure to ambient O<sub>3</sub> and PM<sub>2.5</sub>

Abstract. This paper presents the first version of the regional-scale personal exposure model EXPLUME (EXposure to atmospheric PolLUtion ModEling). The model uses simulated gridded data of outdoor O3 and PM2.5 concentrations and several population and building-related datasets to simulate (1) space–time activity event sequences, (2) the infiltration of atmospheric contaminants indoors, and (3) daily aggregated personal exposure. The model is applied over the greater Paris region at 2 km×2 km resolution for the entire year of 2017. Annual averaged population exposure is discussed. We show that population mobility within the region, disregarding pollutant concentrations indoors, has only a small effect on average daily exposure. By contrast, considering the infiltration of PM2.5 in buildings decreases annual average exposure by 11 % (population average). Moreover, accounting for PM2.5 exposure during transportation (in vehicle, while waiting on subway platforms, and while crossing on-road tunnels) increases average population exposure by 5 %. We show that the spatial distribution of PM2.5 and O3 exposure is similar to the concentration maps over the region, but the exposure scale is very different when accounting for indoor exposure. We model large intra-population variability in PM2.5 exposure as a function of the transportation mode, especially for the upper percentiles of the distribution. Overall, 20 % of the population using bicycles or motorcycles is exposed to annual average PM2.5 concentrations above the EU target value (25 µg m−3), compared to 0 % for people travelling by car. Finally, we develop a 2050 horizon projection of the building stock to study how changes in the buildings' characteristics to comply with the thermal regulations will affect personal exposure. We show that exposure to ozone will decrease by as much as 14 % as a result of this projection, whereas there is no significant impact on exposure to PM2.5.

Santé mentale des mères et des enfants de familles sans logement en Île-de-France. Résultats de l’enquête ENFAMS

IntroductionThe number of homeless families in the Greater Paris region has increased over time and given their vulnerability, it is necessary to better know their characteristics, especially in terms of mental health. Our objective was to study the prevalence of mental health difficulties among homeless women and their children and associated factors. MethodsThis study was based on the ENFAMS survey, conducted during the winter of 2012–2013 among 801 homeless families in the Greater Paris region, by trained interviewers and psychologists. Mothers’ depression was assessed by the Composite International Diagnostic Interview (CIDI) and their Post Traumatique Stress Disorders was assessed by the Mini International Neuropsychiatric Interview (MINI). Depression and PTSD of the mothers were studied in weighted Poisson regression models with robust error variance. The emotional and behavioural difficulties of children were assessed by the Strengths and Difficulties Questionnaire (SDQ) and studied by linear regression. ResultsHomeless women have a high prevalence of depression (28.8 %) and Post Traumatic Stress Disorder (PTSD) (18.9 %); their children have high levels of emotional and behavioral difficulties (20.8 %). Factors associated with maternal depression include fluency in French, suicidal risk, PTSD, and unmet medical needs. The risk of PTSD in mothers was associated with departure from the country of origin for a violent cause, depression and residential instability. Children's emotional and behavioral difficulties were associated with parents’ birth region, residential mobility, children's health and overweight, children's sleep patterns, mother's suicidal risk, the fact that children do not like their housing or are victim of school bullying. ConclusionThe standard health care system and primary care professionals must take advantage of the opportunity offered by each contact with homeless families to detect mental health disorders, which have a high prevalence in both mothers and their children, and refer them to existing structures to facilitate their access to health care.

Impact of on-site clinical genetics consultations on diagnostic rate in children and young adults with autism spectrum disorder

BackgroundNeurogenetics investigations and diagnostic yield in patients with autism spectrum disorder (ASD) have significantly improved over the last few years. Yet, many patients still fail to be systematically investigated.MethodsTo improve access to services, an ambulatory team has been established since 1998, delivering on-site clinical genetics consultations and gradually upgrading services to 502 children and young adults with ASD in their standard environment across 26 day-care hospitals and specialized institutions within the Greater Paris region. The evaluation included a clinical genetics consultation, screening for fragile X syndrome, metabolic workup, chromosomal microarray analysis, and, in a proportion of patients, next-generation sequencing of genes reported in ASD and other neurodevelopmental disorders.ResultsFragile X syndrome and pathogenic copy number variants (CNVs) accounted for the disease in 10% of cases, including 4/312 (1.3%) with fragile X syndrome and 34/388 (8.8%) with pathogenic CNVs (19 de novo and 4 inherited). Importantly, adding high-throughput resequencing of reported intellectual disability/ASD genes to the screening procedure had a major impact on diagnostic yield in the 141 patients examined most recently. Pathogenic or likely pathogenic sequence variants in 27 disease genes were identified in 33/141 patients (23.4%; 23 were de novo and 10 inherited, including five X-linked and five recessive compound heterozygous variants). Diagnosed cases presented atypical and/or syndromic ASD with moderate to severe intellectual disability. The diagnostic yield of fragile X syndrome and array CGH testing combined with next-generation sequencing was significantly higher than fragile X syndrome and array CGH alone (p value 0.009). No inborn errors of metabolism were detected with the metabolic screening.ConclusionBased on the diagnostic rate observed in this cohort, we suggest that a stepwise procedure be considered, first screening pathogenic CNVs and a limited number of disease genes in a much larger number of patients, especially those with syndromic ASD and intellectual disability.

Who sells to whom in the suburbs? Home price inflation and the dynamics of sellers and buyers in the metropolitan region of Paris, 1996-2012.

Price inflation has outbalanced the income of residents and buyers in major post-industrial city-regions, and real estate has become an important driver of these inequalities. In a context of a resilient inflation of home values during the last two decades in the greater Paris Region, it is critical to examine housing price dynamics to get a better understanding of socioeconomic segregation. This paper aims at presenting spatial analysis of the dynamics of segregation pertaining to inflation, analyzing price and sellers and buyers data. Using interpolation techniques and multivariate analysis, the paper presents a spatial analysis of property-level data from the Paris Chamber of Notaries (1996-2012) in a GIS (159,000 transactions in suburban areas, single family homes only). Multivariate analysis capture price change and local trajectories of occupational status, i.e. changes in balance between inward and outward flows of sellers and buyers. We adopt a method that fits the fragmented spatial patterns of suburbanization. To do so, we remove the spatial bias by means of a regular 1-km spatial grid, interpolating the variables within it, using a time-distance matrix. The main results are threefold. We document the spatial patterns of professionalization (a rise of executives, intermediate occupation and employees) to describe the main trends of inward mobility in property ownership in suburbs, offsetting the outward mobility of retired persons. Second, neighborhood trajectories are related the diverging patterns of appreciation, between local contexts of accumulation with a growth of residential prices, and suburbs with declining trends. The maturity of suburbanization yields a diversified structure of segregation between the social groups, that do not simply oppose executives vs. blue collar suburbs. A follow-up research agenda is finally outlined.

Reasserting state power by remaking markets? The introduction of real estate investment trusts in France and its implications for state-finance relations in the Greater Paris region

Taking as its focus the growth of Real Estate Investment Trusts (REITs) in France, this paper explores the remaking of the French property market in both conceptual and concrete terms. In doing so, it reconstructs how public bodies of the national state, in interaction with domestic property companies, have reconfigured the French urban property sector by (i) introducing new market regulations and tax decrees; (ii) enabling French REITs to engage in property development; (iii) creating a REIT within the state; and by (iv) initiating the large-scale urban redevelopment project of Grand Paris in which French REITs manifest themselves as urban partners. By paying attention to the relative importance of national regulatory state power within, what is after all, a multi-scalar state system, the paper unravels how the introduction of REITs has shaped and reshaped (i) finance and property markets; (ii) the urban built environment; and (iii) the state apparatus itself. The paper concludes that the French state has created a financialized urban governance regime in which REITs, of which one is publicly owned, exercise considerable autonomy. As such, it makes a historical-analytical contribution to the debate on the financialization of urban development, and the role of the state in this process.

Negative Binomial Autoregressive Process with Stochastic Intensity

We introduce negative binomial‐60 autoregressive (NBAR) processes with stochastic intensity for (univariate and bivariate) count processes. The univariate NBAR process is defined jointly with an underlying intensity process, which is autoregressive gamma. The resulting count process is Markov, with negative binomial conditional and marginal distributions. The process is then extended to the bivariate case with a Wishart autoregressive matrix intensity process. The NBAR processes are compound autoregressive, which allows for simple stationarity condition and quasi‐closed form nonlinear forecasting formulae at any horizon, as well as a computationally tractable generalized method of moment estimator. The model is applied to a pairwise analysis of weekly occurrence counts of a contagious disease between the greater Paris region and other French regions.

Negative Binomial Autoregressive Process

We introduce negative binomial‐60 autoregressive (NBAR) processes with stochastic intensity for (univariate and bivariate) count processes. The univariate NBAR process is defined jointly with an underlying intensity process, which is autoregressive gamma. The resulting count process is Markov, with negative binomial conditional and marginal distributions. The process is then extended to the bivariate case with a Wishart autoregressive matrix intensity process. The NBAR processes are compound autoregressive, which allows for simple stationarity condition and quasi‐closed form nonlinear forecasting formulae at any horizon, as well as a computationally tractable generalized method of moment estimator. The model is applied to a pairwise analysis of weekly occurrence counts of a contagious disease between the greater Paris region and other French regions.