The purpose of this study is to examine teachers’ experiences of power relations as psychological violence and the impact it has on their health. This study, using a qualitative approach, thus investigates the association between power relations and the dimensions thereof and how it manifests as psychological violence. In turn, it may have detrimental effects on the health of the teacher and the whole teaching-learning process. Based on the findings, recommendations for this - and future research - are proposed. Open-ended phenomenological interviews were used to collecct the qaulitative data. Eleven participants indicated their willingness to be individually interviewed for the study. The qualitative findings indicated that teachers experience power relations as psychological violence, it is experienced severely and emanates mostly from colleagues in management positions. The most prevalent and severe forms of power relations as psychological violence as experienced by teachers include being subjected to power abuse from principals; being subjected to autocratic management styles and management’s power abuse through the abdication of responsibility. The most severe physical health consequenses as experienced by teachers include feeling tired and experiencing physical ill health. It further emerged that the most severe phychological health consequenses were experienced in the form of feelings of helplessness and feeling emotional or wanting to cry. Teachers’ lack of work productivity and motivation were the most severe behavioural consequense because of the experience of power abuse as psychological violence. Teachers’ personal and family relations and teachers withdrawing socially were the most evident social consequense due to negative experiences. The findings from the study indicated that teachers experience power relations as psychological violence in various forms and that it is highly prevalent. The research results have shown that teachers identified many dimensions of power relations, such as management styles, the perception or experience of someone’s power or “weak point”, possessing no power or status, female teachers being treated in a subordinate manner and racial or cultural differences of others as a contributer to abuse power in relationships at school. This study contributes towards the power relations and psychological violence literature in general and in particular, teachers’ experiences in South Africa. In the light of the findings the study recommends that teacher support programmes should be put in place in order to address the experience of power relations as psychological violence. It further recommends that teachers and students studying to become teachers should be provided with information about power relations as psychological violence to create awareness. / Thesis (MEd (Educational Psychology))--North-West University, Potchefstroom Campus, 2013

The purpose of this study is to examine teachers’ experiences of power relations as psychological violence and the impact it has on their health. This study, using a qualitative approach, thus investigates the association between power relations and the dimensions thereof and how it manifests as psychological violence. In turn, it may have detrimental effects on the health of the teacher and the whole teaching-learning process. Based on the findings, recommendations for this - and future research - are proposed. Open-ended phenomenological interviews were used to collecct the qaulitative data. Eleven participants indicated their willingness to be individually interviewed for the study. The qualitative findings indicated that teachers experience power relations as psychological violence, it is experienced severely and emanates mostly from colleagues in management positions. The most prevalent and severe forms of power relations as psychological violence as experienced by teachers include being subjected to power abuse from principals; being subjected to autocratic management styles and management’s power abuse through the abdication of responsibility. The most severe physical health consequenses as experienced by teachers include feeling tired and experiencing physical ill health. It further emerged that the most severe phychological health consequenses were experienced in the form of feelings of helplessness and feeling emotional or wanting to cry. Teachers’ lack of work productivity and motivation were the most severe behavioural consequense because of the experience of power abuse as psychological violence. Teachers’ personal and family relations and teachers withdrawing socially were the most evident social consequense due to negative experiences. The findings from the study indicated that teachers experience power relations as psychological violence in various forms and that it is highly prevalent. The research results have shown that teachers identified many dimensions of power relations, such as management styles, the perception or experience of someone’s power or “weak point”, possessing no power or status, female teachers being treated in a subordinate manner and racial or cultural differences of others as a contributer to abuse power in relationships at school. This study contributes towards the power relations and psychological violence literature in general and in particular, teachers’ experiences in South Africa. In the light of the findings the study recommends that teacher support programmes should be put in place in order to address the experience of power relations as psychological violence. It further recommends that teachers and students studying to become teachers should be provided with information about power relations as psychological violence to create awareness. / Thesis (MEd (Educational Psychology))--North-West University, Potchefstroom Campus, 2013

Made available in DSpace on 2011-05-04T12:42:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2010 / Este trabalho foi concebido a partir da reflexão e discussão sobre as principais oportunidades para a abordagem integrada de Saúde Pública e Meio Ambiente, considerando o atual cenário energético mundial, a introdução de novas tecnologias de produção e a necessidade de construção de uma referência conceitual e prática que considere a interação entre Saúde, Meio Ambiente, Responsabilidade Social das Empresas e Desenvolvimento Sustentável. Considerando os inúmeros desafios para o controle dos impactos ambientais e de saúde, através da gestão efetiva de responsabilidade social de empresas potencialmente poluidores, particularmente da indústria de petróleo e energia, essa tese tem como principal objetivo discutir como os aspectos de saúde podem ser incorporados ao licenciamento ambiental do setor petróleo. Para isso foi utilizada uma abordagem metodológica exploratória, por meio de exaustivo levantamento bibliográfico na literatura científica e institucional deáreas empresariais e governamentais responsáveis pela obtenção e concessão de licenças ambientais. A partir da seleção e análise de documentação oficial, particularmente dos estudos e relatórios de impacto ambiental (EIA/RIMA) de empreendimentos nacionais de exploração, produção e refino do petróleo, avaliousea existência de evidências e oportunidades para a inserção de questões de saúde nos respectivos projetos de investimento desse setor. Como ferramenta de avaliação dessas questões nos EIA/RIMA dos empreendimentos selecionados, foi utilizada uma adaptação de uma matriz de análise validada para o setor hidrelétrico, cujas categorias analíticas foram baseadas nos parâmetros estabelecidos para os estudos de avaliação de impacto ambiental pela Resolução CONAMA 1/86 e nos principais aspectos da metodologia de Avaliação de Impactos à Saúde (AIS). Como resultado, a matriz empregada mostrou-se um instrumento metodológico com grande potencial para orientar a incorporação dos aspectos desaúde no processo de licenciamento ambiental, instrumentalizando a Avaliação de Impacto Ambiental (AIA) e subsidiando a tomada de decisão, contribuindo, portanto, para uma gestão socioambiental mais proativa do setor petróleo. / This work was conceived from the discussion about the main opportunities for the integrated approach of Public Health and Environment, considering the current world energy scenario, the introduction of new production technologies and the need for a more comprehensive conceptual reference among Health, Environment, Social Responsibility and Sustainable Development. Considering the several challenges for effective management of the environmental and health impacts, particularly caused by oil industry, strategic for the development and economical growth of our country, the main objective of this thesis is discuss how the health aspects could be incorporated to the environmental licensing of this sector. An exploratory methodological approach was used, starting from an exhausting bibliographical research in scientific and institutional literature, produced by companies and government areas related with the environmental licenses. The health evidences and opportunities in the main official documents, particularly studies and reports of the environmental impacts (EIA/RIMA, in portuguese) of national enterprises of oil exploration, production and refining, was evaluated. An adapted matrix, validated for the hydroelectric sector, was used like a tool for assessment of health subjects in the selected RIMA. The analytical categories of this matrix were based on the established parameters for the studies of environmental impact assessment of CONAMA Resolution 1/86, and on the main aspects of Health Impact Assessment (HIA) methodology. As result, this matrix was considered like an important instrument with great potential to guide the incorporation of the health aspects in the environmental licensing, supporting the Environmental Impact Assessment (EIA) and decision makers, contributing to a proactive social and environmental management of the petroleum industry.

Made available in DSpace on 2011-05-04T12:42:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / A proposta aqui apresentada considera a informação gerada pelo setor saúde como resultante da relação entre os processos de destruição e desgaste a que está submetida a população, em seus diferentes estratos, e os processos de resistência e recuperação desenvolvidos pelas mesmas. Dessa forma, a informação gerada, particularmente pelos serviços de saúde, reflete tanto as condições de vida da população como a capacidade de respostas desenvolvidas pela sociedade, naquele momento do seu processo histórico. Para tanto, procura-se descrever a evolução desta informação no tempo e no espaço, procurando identificar os problemas decorrentes de acesso, cobertura e complexidade dos serviços, além de falhas e desvios introduzidos no próprio processo de produção, disseminação e utilização da informação. Este trabalho se organiza em um estudo em três estágios que contribuem para um resultado final com a proposição de uma metodologia ou estratégia de ação. Pretende-se, dessa forma, lançar um debate e contribuir para que os dados do setor saúde possam vir a ser utilizados mais amplamente na construção de indicadores para a gestão do território, tanto por gestores como pela população em geral. O trabalho aqui apresentado envolve o levantamento dos indicadores da relação saúde e ambiente que estão sendo mais utilizados na literatura científica e na definição de prioridades para a gestão do território. Para esse levantamento procurou-se concentrar nas questões que se referem ao saneamento, como sendo as questões mais antigas e gerais da relação saúde-ambiente enfrentadas pela humanidade. Em continuidade, procura-se aplicar uma metodologia, em desenvolvimento, que resgate as informações existentes nos bancos de dados da saúde, buscando identificar situações concretas na população que reside em numa área selecionada, entorno de um ponto, possível foco de contaminação. Esse estudo, realizado em uma cidade do interior do Rio Grande do Norte, onde existe uma planta industrial da PETROBRÁS, inserido em uma pesquisa mais abrangente, funciona como um estudo de caso, onde os dados gerados pelos serviços de saúde puderam ser comparados com outras metodologias de investigação em saúde e ambiente procurando subsidiar a construção de indicadores. Em um segundo estudo de caso, procurou-se aplicar esta mesma estratégia na avaliação de impactos a serem gerados por um projeto de desenvolvimento, na saúde da população, em uma região da Amazônia. Neste estudo também se procurou avaliar o potencial da utilização das informações geradas pelo setor saúde no monitoramento de impactos ambientais, porém em uma região bem mais ampla e de maior diversidade de situações e de estrutura de serviços de saúde. A metodologia empregada parte de um reconhecimento de campo e se utiliza dos dados secundários de saúde disponíveis, que, associados a uma série de entrevistas com informantes-chave e oficinas com gestores, profissionais de saúde e representantes da comunidade, procura traçar os perfis de saúde-doença das localidades, identificando padrões e processos, particularmente, aqueles que poderiam sofrer influência do empreendimento ou processo em questão. Deste estudo, além do perfil de saúde da população, abrangendo a infraestrutura de serviços, acesso e utilização, procurou-se traçar o perfil da própria informação de saúde e seu processo de implantação, desenvolvimento e manutenção dos diferentes bancos de dados. Ao se analisar a informação em saúde num contexto de rápidas transformações e baixa cobertura de serviços, utiliza-se a própria falta do dado, ou baixa qualidade do mesmo, como informação, que, no contexto das formações econômico sociais existentes e no seu processo de desenvolvimento, podem constituir importantes indicadores. Como conclusão, observa-se o potencial da utilização das informações de saúde para o monitoramento e avaliação de impactos de projetos de desenvolvimento e alterações do ambiente. Destaca-se a não utilização das informações, tanto por parte dos setores de planejamento e gestão do território, quanto pelo próprio setor saúde, que se utiliza delas de modo administrativo e burocrático, sem um cuidado com sua qualidade e adequação a usos que, em muito, poderiam auxiliar o planejamento e as ações de saúde, assim como fortalecer o papel da saúde na gestão do território. O adequado tratamento e utilização da informação gerada pelo setor saúde pode promover, a melhoria da qualidade da mesma e o melhor planejamento e utilização dos recursos para a saúde, além de fornecer uma ferramenta de avaliação do processo de desenvolvimento para a sociedade. Esta ferramenta, de baixo custo operacional, permite a introdução de variáveis sobre as condições de vida de diferentes estratos da população na formulação de respostas da sociedade para indagações como: desenvolvimento para que e para quem? / The proposal presented here considers the information generated to the health system as a resultant of the deprived processes to which the population is submitted, in different groups, and the strategies of resistance and recovery developed by them. The generated information, particularly for the health services, reflects the life conditions of the population and the response capacity developed by the society, at that moment of the historical process. The study aims to describe the evolution of the health information over time and space, identifying problems of access, covering and complexity of the services, besides the imperfections and deviation introduced in the own process of production, dissemination and information use. This study is organized in three steps, each of them contributing for a final result proposing a methodology or a strategy of action. There is an intention to launch a debate and to contribute to a widely use of the system health data in the construction of indicators for the management of the territory, touching managers and the population in general as well. The work presented here involves the survey of the indicators related to health and environment that are being used in the scientific literature and in the definition of priorities for the management of the territory. To do this research it was necessary to concentrate on questions related to the sanitation condition, defined as the oldest general questions of the relation health/ environment faced by the humanity. A methodology has been developed, which rescued the existing information in health databases, searching to identify concrete situations in the population living in selected areas that could be a possible focus of contamination. This study, carried through in a city of the interior of the Rio Grande do Norte, where there is a PETROBRAS industrial unity, is part of a larger research and works as a case study, where data generated for the health services could have been compared with other methodologies of inquiry in health and environment, intending to contribute to the construction of indicators. In a second study of case, the same strategy of ―evaluation of impacts in the population health‖ was used in a development project in the Amazon Region. In this study we also intended to evaluate the potential use of the information generated by the system health in monitoring ambient impacts, however in a bigger region with more diversity of situations and structure of health services. The employed methodology starts from a field recognition and uses available secondary data of health that, associated to many key informants interviews and workshops with managers, professionals of health and representatives of the community, showed the local health-illness profiles, identifying standards and processes, particularly those that could have influence the enterprise or the process in question. This study, besides the population health profile, enclosing the infrastructure of services, access and use, aims to trace the profile of the health information itself and the process of implantation, development and maintenance of different data bases. When analyzing the health information in a context of rapid transformations and low covering of services, the lack of information, or its low quality, could be used as an information itself that, in a context of existing socio-economic formations and in its process of development, might constitute important indicators. The conclusion shows the potential of the health information use for monitoring and evaluating impacts in development projects and environment transformation. It is highlighted that the information is not being used in the best way, neither by the part of the planning systems and management of the territory, nor by the health system, which are using them in administrative and bureaucratic way, without taking care to the quality and the adequacy of this utilization that, if used as it should be, could assist the planning and the actions of health, as well as fortifying the role of the health in the management of the territory. The adequate treatment and use of the information generated by the health system might provide, besides the improvement of the quality and the consequent better planning and use of the resources to the population health, an evaluation tool for the society development process. This tool, of low operational cost, allows the introduction of variables on the conditions of different population groups, formulating answers to the society questions as: ―development‖ to what and to whom?

No description available.

Cette thèse répond à un double objectif, elle s’est concentrée d’une part sur le rôle joué par l’énergie dans le développement industrielle et économique des pays et d’autres parts sur les retombées de son usage sur l’environnement et l’état de santé des individus. Nous avons élaboré et exploité une base de données relative à la région de Sfax, qui a été utilisée pour l’analyse empirique adaptée à chaque axe de recherche. Le cheminement suivi pour argumenter cette thèse nous a amené à constituer trois chapitres. Au niveau du premier chapitre, nous avons particulièrement apprécié le rôle que l’énergie a préoccupé dans le développement économique des nations. Suite à notre analyse empirique, deux résultats principaux sont annoncés, d’abord, la présence d’un effet de long terme entre la consommation de l’énergie et le développement économique dans la région de Sfax impliquant ainsi sa dépendance économique à l’énergie, ensuite, l’existence d’une relation de causalité unidirectionnelle partant de la consommation de l’énergie vers la croissance économique. Dans un deuxième chapitre, nous nous sommes intéressés à étudier l’impact de la consommation de l’énergie sur la détérioration de la qualité de l’environnement. Deux points sont mis en valeur. Premièrement, une corrélation est détectée entre la consommation de l’énergie et les polluants suivants : PM10, SO2 et NO2. Deuxièmement, la présence de l’O3 troposphérique dans l’air n’est pas subordonnée à la consommation de l’énergie mais plutôt aux réactions photochimiques impliquant le NO2 et l’oxygène sous l’effet des rayons solaires ultra-violets. Finalement, les facteurs météorologiques et surtout la température (T) et l’humidité relative (HR) agissent sur la dispersion des polluants et leur accumulation autour de leurs sources d’émissions. Le dernier chapitre s’est focalisé sur l’analyse de l’impact sanitaire de la pollution atmosphérique. Adapté au contexte de la région de Sfax, trois constats principaux sont détectés. Tout d’abord, les maladies cardiovasculaires sont affectées par les émissions de S02 tandis que les maladies respiratoires sont influencées par les émissions de SO2 et O3. Ensuite, une corrélation est justifiée entre l’O3 te le NO2 qui confirme la réaction chimique de piégeage de l’ozone déjà indiquée. Enfin, nous avons déduit que la vitesse de vent (VV) impacte la distribution des polluants principalement le NO2, le SO2 et les PM10. La température (T) affecte à son tour les admissions hospitalières pour motif cardiovasculaire. / This thesis has a dual purpose; it focused on the one hand on the role of energy in the industrial and economic development of the country and on the other hand on the impact of its use on the environment and health status of individuals. We developed and operated a database on the Sfax region, which has been used for empirical analysis suited to each area of ​​research. The path followed to argue this thesis has led us to establish three chapters.At the first chapter, we particularly appreciated the role of energy in economic development of nations. Following our empirical analysis, two main results are announced, first, the presence of a long-term effect between energy consumption and economic development in the region of Sfax implying its economic dependence on energy. Then the existence of unidirectional causal relationship starting from energy consumption to economic growth. In the second chapter, we are interested in studying the impact of energy consumption on the deterioration of the environment quality. Two points are emphasized, first, a correlation is found between energy consumption and the following pollutants: PM10, SO2 and NO2. Secondly, the presence of tropospheric ozone (O3) in the air is not conditional on the energy consumption but rather to photochemical reactions involving NO2 and oxygen under the influence of solar ultraviolet radiation. Finally, weather factors, especially temperature (T) and relative humidity (RH) affect the dispersion of pollutants and their accumulation around their emission sources. The last chapter is focused on the analysis of the health impact of air pollution. Adapted to the region of Sfax, three main findings are detected. First, cardiovascular diseases are affected by S02 emissions and while respiratory diseases are influenced by emissions of SO2 and O3. Then, a correlation is justified between O3 NO2, confirming the chemical reaction of ozone scavenging already indicated. Finally, we concluded that the wind speed (VV) affects the distribution of pollutants mainly NO2, SO2 and PM10. Temperature (T) in turn affects hospital admissions for cardiovascular reasons.

Cette thèse a été réalisée en cotutelle Université de Montréal (UdeM) - Université Libre de Bruxelles (ULB). L'auteur a bénéficié de bourses doctorales provenant du Fonds national de la recherche scientifique (FNRS-Belgique), du Fonds de recherche du Québec-Société culture (FRQSC), et du Centre de recherche Léa-Roback sur les inégalités de santé de Montréal. / Les politiques de soutien au revenu des ménages se déclinent sous formes de mesures variées mises en place dans le cadre du système de protection sociale. Ces politiques influencent considérablement le revenu et les conditions de vie des ménages les plus vulnérables. Elles constituent un levier majeur pour réduire la pauvreté et les inégalités de revenu entre ménages. De ce fait, elles contribuent à améliorer la santé des populations et à réduire les inégalités sociales de santé (ISS) dès la naissance. L’évaluation de l’impact des politiques sociales sur les ISS dans différents contextes constitue une tâche complexe, du fait notamment de la difficulté, voire l’impossibilité, de mettre en place des études randomisées à grande échelle. Les variations des politiques sociales selon les pays constituent des opportunités pour mener des études comparatives sur base d’expériences naturelles. En partant d’un constat sur les limites des études comparatives habituelles, nous avons proposé une démarche de recherche visant à mieux étudier les spécificités des contextes afin d’expliquer les mécanismes par lesquels la combinaison des politiques de soutien au revenu influence la pauvreté des ménages et contribue aux ISS à la naissance à Bruxelles et à Montréal. Ce protocole de recherche a fait l’objet d’un 1er article. Le cœur de la thèse comprend trois parties. La première partie porte sur la comparaison des politiques d’aide sociale et d’allocations familiales en Belgique et au Québec et analyse les impacts sur l’intensité de la pauvreté des ménages à l’aide sociale dans les deux contextes. L’analyse se base sur la méthode des familles-types. Cette méthode consiste à calculer et comparer le revenu disponible de différents types de ménages. L’intensité de la pauvreté des ménages a été estimée selon le nombre d’enfants et la situation de couple. Pour chaque type de ménage, elle correspond à la différence relative entre le revenu disponible du ménage et le seuil de pauvreté relative. Les résultats montrent une intensité de la pauvreté plus marquée au Québec qu’en Belgique. Dans chaque contexte, on constate également que l’intensité de la pauvreté des ménages varie considérablement selon le nombre d’enfants et la situation de couple. Ce travail a fait l’objet d’un 2ème article. La deuxième partie porte sur la description des inégalités de santé à la naissance à Bruxelles et à Montréal. Les hypothèses de travail découlent des résultats obtenus à l’étape précédente. Deux études de cas ont été réalisées et analysées dans une perspective comparative. Les bases de données utilisées proviennent du couplage de données administratives issues des registres de naissance et des données de sécurité sociale. Les résultats ont donné lieu aux 3ème et 4ème articles. Le 3ème article concerne la population générale. Dans chaque région, des modèles de régression logistique ont été élaborés afin d’étudier l’association entre les issues défavorables de la grossesse (faible poids à la naissance, prématurité) et le statut socioéconomique (éducation de la mère et revenu). L’ampleur des inégalités de santé est plus marquée à Montréal qu’à Bruxelles et celles-ci diffèrent également selon l’origine de la mère. Le 4ème article porte spécifiquement sur la population bénéficiaire de l’aide sociale. Il compare l’association entre le faible poids à la naissance et la composition de ménage dans chaque région. On constate que les inégalités face au FPN varient selon le nombre d’enfants et la situation de couple entre les deux contextes, dans le même sens que les différences observées au niveau de la pauvreté. La troisième partie explore davantage les différences constatées à l'étape précédente selon l’immigration. Dans chaque région, elle compare l’impact du SES sur la santé périnatale chez différents groupes d’immigrés et les chez les mères nées en Belgique ou au Canada. Les résultats ont donné lieu aux 5ème et 6ème article de la thèse. L’analyse souligne l’importance de tenir compte des enjeux liés à l’immigration pour mieux expliquer la contribution des politiques de soutien au revenu aux ISS à la naissance. Cette thèse constitue une contribution unique. Dans deux régions où les taux de pauvreté et les prévalences des issues de la grossesse sont comparables dans la population générale, on constate des différences notables quant aux inégalités de santé à la naissance. Les politiques de soutien au revenu dans les deux contextes contribuent à expliquer ces différences. L’analyse démontre la nécessité de remédier aux insuffisances de ces politiques dans les deux contextes. Finalement, elle souligne les défis de la réduction de la pauvreté. Ces défis touchent à différents domaines, notamment la conciliation travail-famille, le marché du travail, l’immigration et les inégalités économiques. Mots-clés : Pauvreté, Inégalités sociales de santé, Politiques sociales, Etat-Providence, Evaluation d’impact en santé, Expériences naturelles, Inégalités de revenu, Faible poids à la naissance, Santé périnatale, Politiques de soutien au revenu. / Income support policies significantly influence the income and living conditions of the most vulnerable households. They constitute a major lever for reducing poverty and income inequalities between households. As a result, they contribute to improving the health of populations and reducing social inequalities in health (SIH) starting from birth. Assessing the impact of social policies on SIH in different contexts is a complex task, due in particular to the difficulty, if not impossibility, of setting up large-scale randomised studies. Varying social policies in different countries provide opportunities for comparative studies on the issue, based on natural experiments. Starting from an observation on the limitations of the usual comparative studies, we have proposed a research approach aiming to better study the specificities of contexts, which would allow us to explain the mechanisms by which the combination of income support policies influences household poverty and contributes to SIH at birth in Brussels and Montreal. This research protocol was the subject of a first article. This core of this thesis consists of three parts. The first deals with the comparison of welfare and family allowance policies in Belgium and Quebec and analyses their impact on the intensity of poverty of welfare households in both contexts. The analysis is based on the model family method, which consists of calculating and comparing the disposable income of different types of households. The intensity of household poverty was estimated according to the number of children and marital status. For each household type, the intensity of poverty corresponds to the relative difference between the household's disposable income and the relative poverty threshold. The results show a higher intensity of poverty in Quebec than in Belgium. It is also found that, in each context, the intensity of household poverty varies considerably depending on the number of children and marital status. This work was the subject of a second article. The second part of this thesis focuses on the description of health inequalities at birth in Brussels and Montreal. The working hypotheses are derived from the results obtained in the previous stage. Two case studies were carried out and analysed in a comparative perspective. The databases used come from a combination of administrative data from birth records and social security data. The results led to the third and fourth articles. The third article concerns itself with the general population. Logistic regression models were developed for each region to study the association between adverse pregnancy outcomes (low birth weight, prematurity) and socioeconomic status (mother's education and income levels). The magnitude of health inequalities is greater in Montreal than in Brussels and also differs according to the mother's origin. The fourth article focuses specifically on welfare recipients. It compares the association between low birth weight and household composition in each region. We can see that inequalities in LBW vary according to the number of children and marital status in both contexts, much like the differences observed in terms of poverty. The third part further explores the differences observed in the previous stage according to immigration. It compares the impact of SES on perinatal health among different immigrant groups and among mothers born in Belgium or Canada. The results led to the fifth and sixth papers of the thesis. The analysis underlines the importance of taking the specific issues linked to immigration into account to better explain the role that income support policies play in SIH at birth. This thesis is a unique contribution. There are notable differences in health inequalities at birth between two regions with similar poverty rates and levels of prevalence of unfavourable pregnancy outcomes among the general population. The impact of income support policies in Belgium and Quebec on the intensity of household poverty helps explain these differences. Our analysis demonstrates the need for public policies that address the inadequacy of the current income support measures in both regions. Lastly, it emphasises that the causes of poverty are interdependent and touch on various issues, including work-family balance, job insecurity, immigration and economic inequalities. Keywords: Poverty, Social inequalities in health, Social policies, Welfare state, Health impact assessment, Natural experiments, Income inequalities, Low birth weight, Perinatal health, Income support policies.

Contexte : Cette étude vise à investiguer l'association du diabète gestationnel (DG) sur la qualité de vie liée à la santé bucco-dentaire (QVLSBD) et la prévalence des caries dentaires. Méthodes : Dans cette étude cas-témoin, des femmes diagnostiquées avec le DG ainsi que celles ayant une grossesse sans complication ont été recrutées au Département d'Obstétrique et Gynécologie de l'Hôpital Sainte-Justine à Montréal, Canada. Tout d'abord, les participantes ont complété six questionnaires en ligne, fournissant des données sur leur historique médical, leur statut socio-économique, leurs habitudes de vie et leur QVLSBD. Ensuite, les femmes ayant dûment complété la première partie ont été invitées à participer à un examen oral. Des analyses bivariées ont été menées pour enquêter sur l'association entre le DG et les différents paramètres. Résultats : Cent trente-six (136) femmes enceintes ont participé à la première partie de l'étude, dont 13 avaient le DG et 123 étaient dans le groupe témoin. Parmi elles, quatre femmes avec le DG et 18 du groupe témoin ont procédé à la deuxième partie. Les données sociodémographiques ont montré que les femmes avec le DG allaient moins chez le dentiste (p=0,005), participaient moins à des activités sportives (p=0,003), avaient des revenus plus faibles (p<0,001) et travaillaient davantage à temps partiel (p=0,019). Les femmes avec le DG ont rapporté des effets négatifs sur leur QVLSBD, particulièrement au niveau psychologique (p=0,033) et social (p=0,014), bien que la différence ne soit pas significative dans l'ensemble (p=0,066). Les facteurs ayant un impact négatif sur la QVLSBD étaient la multiparité, le revenu, l'usage du tabac, la douleur et la gingivite, sans disparités significatives dans les caries ou la salive entre les groupes. Conclusions : Le DG semble détériorer la QVLSBD, surtout psychologiquement et socialement, soulignant le besoin d'une meilleure prise en charge dentaire pendant la grossesse. Des études additionnelles sont nécessaires pour approfondir les connaissances sur les impacts du DG. / Background: This study aims to investigate the association of gestational diabetes mellitus (GDM) on oral health-related quality of life (OHRQoL) and prevalence of dental caries. Methods: In this case-control study, women diagnosed with GDM as well as those with uncomplicated pregnancies were recruited from the Department of Obstetrics and Gynecology at the Hôpital Sainte-Justine in Montreal, Canada. First, participants completed six online questionnaires, providing self-reported data on their medical history, socio-economic status, lifestyle habits, and OHRQoL. Subsequently, women who duly completed the first part were invited to undergo an oral examination. Bivariate analyses were conducted to investigate the association between GDM, and the different data parameters. Results: One hundred and thirty-six (136) pregnant women participated in the first part of the study, of which 13 had GDM and 123 were in the control group. Among them, four women with GDM and 18 from the control group proceeded to the second part. Sociodemographic data showed women with GDM had less frequent dental appointments (p=0.005), engaged less in physical activity (p=0.003), earned lower incomes (p<0.001) and worked part-time (p=0.019). Women with GDM experienced adverse effects on their OHRQoL, particularly in psychological (p=0.033) and social (p=0.014) aspects, although not statistically significant overall (p=0.066). Factors negatively impacting OHRQoL were multiparity, income, tobacco use, pain and gingivitis, with no significant discrepancies in caries or saliva between the groups. Conclusions: GDM appears to impair OHRQoL, especially psychologically and socially, emphasizing the need for better dental care during pregnancy. Further studies are needed on GDM's long-term impacts.