—The protection of health is progressively imposed as an individual approach and as a collective necessity, health policy is one of the elements of national solidarity. But the dark reality is that inequalities belie the universalist promise of our social security system, which was supposed to guarantee care to “everyone according to their needs”.
—Public health policy was established in the 19th century, well before the establishment of the contemporary welfare state. The establishment of the health system progressed in fits and starts: the cholera epidemic in 1850 led to the regulation of unhealthy housing, the Spanish flu epidemic led to the creation of the first ministry of “hygiene, emergency and social welfare” in 1920.
3.1.1. A continuous improvement of the sanitary state in France in the 20th century
—French life expectancy at birth has improved considerably since the beginning of the 20th century. Infant mortality has fallen by more than 80% since the 1950s.
—Causes of this improvement: reinforcement of the health care offer on the territory. In 40 years, the number of doctors has tripled + progress in hygiene and medicine thanks to vaccination and antibiotics > fight against infectious and parasitic diseases (smallpox, typhoid, measles, diphtheria, tuberculosis) + technological progress and modernization of hospitals with very sophisticated equipment (scanner, MRI).
—The universalization of social protection allowed for wider access to the health care system and to treatments that were previously too costly. The economic growth of the “Trente Glorieuses” contributed to the increase in the standard of living of the French and to the improvement of their food and housing conditions. French people whose standard of living increased spent more on the maintenance of their bodies and their health.
3.1.2. Persistent multiform inequalities
—Inequalities according to gender, place of residence, standard of living or education. Social gaps seem to be widening between socio-professional categories: in the 1960s, the difference in life expectancy of the least favored categories was lower than that of the most affluent. These inequalities are visible from birth: