Orientador: Maria da Luz Rosario de Sousa / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-19T03:02:10Z (GMT). No. of bitstreams: 1 Ferrer_AnayGomes_M.pdf: 1246713 bytes, checksum: 36e4cf2e8aa1197c5a39ba4688b2f95d (MD5) Previous issue date: 2011 / Resumo: No trabalho diário dentro das Unidades de Saúde da Família (USF) podem-se observar diferenças sistemáticas na situação de saúde de grupos populacionais vulneráveis (desigualdades em saúde). Estas desigualdades de saúde são evitáveis, injustas e desnecessárias caracterizando, assim, as iniquidades em saúde. Através da integralidade busca-se superar a visão isolada e fragmentada na formulação e implementação de políticas saudáveis. A integralidade é uma ferramenta fundamental dentro da Estratégia de Saúde da Família (ESF) na consolidação do Sistema Único de Saúde (SUS) e ela não tem condições de ser desenvolvida por um único setor isoladamente. Um modo de trabalhar a intersetorialidade é se organizar em redes sociais de apoio de trabalhadores. Esta forma de organização é facultativa. Assim, o objetivo do presente estudo, apresentado no capítulo 1 é apresentar a experiência em rede social de apoio de trabalhadores do bairro do IAA, situado no município de Piracicaba, estado de São Paulo, Brasil. Metodologia: pesquisa de ata das reuniões da rede social de apoio de trabalhadores do IAA do período de agosto de 2006 a dezembro de 2010. Resultados: dos impactos positivos já alcançados, observaram-se redução de registros lançados no livro de ocorrências do percentual de violência dentro da escola, de alunos retidos, evadidos e com baixo rendimento; o não relato ou observação de gravidez na adolescência nos que fizeram parte das atividades desenvolvidas, relatos de abusos e violência são trazidos a tona e tratados adequadamente, foram avaliadas e encaminhadas 28 crianças com distúrbio de aprendizado, a orientação da formação profissional de alguns dos integrantes da rede passa a ser voltada para as necessidades desta comunidade, maior aproximação entre os setores. Conclusão: o trabalho descrito apresenta uma articulação intersetorial com ações conjuntas e sistemáticas de planejamento, que resultaram em impactos positivos. O trabalho em rede não resolveu todos os determinantes sociais do local, mas suas ações foram capazes de minimizar algumas iniquidades. / Abstract: In daily work within the Family Health Units (FHU) can be observed systematic differences in health status of vulnerable populations. These health inequalities are avoidable, unfair and unnecessary, featuring well, inequities in health. By integrity we seek to overcome any isolated and fragmented in the formulation and implementation of healthy political. Integrity is a key tool within the Family Health Strategy (FHS) in the consolidation of Unified Health System (SUS), and she is unable to be developed by a single sector alone. One way of working the intersectional is to organize themselves into social networks to support workers. This form of organization is optional. So the objective of this study, shown in Chapter 1 is present the experience in social support network for workers in the neighborhood of the IAA, located in Piracicaba, São Paulo, Brazil. Methodology: Survey of the records of meetings of the social support network for employees of the IAA for the period August 2006 to December 2010. Results: From positive impacts already achieved, there was a decrease in the number of reports of violence inside the school, the child's risk group ceased to exist, not reporting or observation of teenage pregnancy in who are part of the activities, a situation of abuse and violence are brought to light and treated appropriately, the school dropout rate was zero in the municipal school, the orientation of vocational training of some members of the network becomes focusing on the needs of the community's area of operations, closer ties between the sectors, assessment and referral of 28 children with learning disorders. Conclusion: The type of work proposed and described features a breakthrough in the evolution of the social support networks as there is a joint intersectoral action with systematic planning, which result in positive impact for the community. Networking has not solved all the social determinants of the place, but their actions were able to minimize some inequities / Mestrado / Odontologia em Saude Coletiva / Mestre em Odontologia em Saúde Coletiva

Master of Public Health - MPH / This research aimed to explore why the Imbizo Men's Health Project is successful in encouraging men to participate in an HIV focused intervention by exploring what the respondents perceived to be the essential elements required for the constructive involvement of men in health related HIV prevention programmes. It used the qualitative research method of six focus group discussions to gather data. The study population was participants from the Imbizo Men's Health Project. A purposive sample of 40 men aged 18- 35 years old living in Soweto were selected from this study population. The content of the focus group discussions was analysed to identify recurring themes and perceptions, and the key suggestions made by the respondents. / South Africa

This dissertation is about Indigenous and settler health, wellbeing and health policy in rural Manitoba. Across Canada, both sweeping and incremental provincial health system changes have profound effects on marginalized communities facing existing health inequities, including rural settler and Indigenous peoples. Increasingly, the centralization of provincial health care systems has led to the elimination of health services within rural settings. The research I present in this dissertation arose from advocacy efforts in a rural community in southwest Manitoba. The community sought representation and recognition in health decision-making in the midst of the largest health care system transformation in provincial history and called for local research production. The community-led study grew to the larger inquiry and analysis presented here, including a First Nation and Métis community, which were both affected by the transformation. The objectives of this dissertation were to analyze the ideas and structures used to inform provincial decisions, and to understand community experiences of rural health care before and during system transformation. As a settler researcher, I undertake an anti-colonial, strengths-based, community-engaged approach to research, developed through ongoing relationship with the community. In addition to a critical thematic analysis of key policy documents, semi-structured interviews were conducted with settler, First Nations, and Métis community members and service providers regarding their experiences within the health care system, their perceptions of change and the impacts of transformation on health and wellbeing. Arising themes include the importance of relational health care relationships in determining wellbeing, and the sense that the government undertook dehumanized decision-making in developing and implementing health system change. This dissertation concludes with policy recommendations for provincial governments, including the prioritization of community voices, and the visibility and involvement of rural and Indigenous peoples in health system decision-making. / Thesis / Doctor of Philosophy (PhD)

Equitable healthcare is a prerequisite for good living conditions and good health in the population. The Health Care Act states that healthcare in Sweden must be provided on equitable terms, however, inequities in Swedish healthcare are continuously reported. The aim of this thesis was to investigate barriers and facilitators to equitable care from the perspective of healthcare professionals with coordination responsibility. A qualitative study design with an abductive approach was used. Data were collected through semi-structured interviews with six healthcare professionals with coordination responsibility in Region Gävleborg, all of whom are connected to the local knowledge management group within the lifestyle focus area. Analysis of the collected material was performed using thematic analysis. The results show that healthcare professionals with coordination responsibility view politics and management, work cultures, and staffing as important barriers that exist in working with equitable care. Furthermore, the results show that cooperation within the healthcare organization, patient involvement, and knowledge are considered to facilitate the achievement of equitable care. The conclusion is that more knowledge and clearer guidelines are needed in order for healthcare professionals to be able to work more effectively to counter inequities in care.

With over 6 million children receiving some form of special education in the United States, and federal legislation mandating that all disabled students be provided with a free and appropriate education (FAPE) in the least restrictive environment (LRE), school districts are facing the daunting task of providing individualized services for a growing percentage of special education students. Unfortunately, it is well established in the research literature that special needs students who "belong" to racial and ethnic minority groups and/or are from low Socioeconomic Status classes have traditionally been over-represented in special education. Disturbingly, not only are minorities over-represented in special education classification, they are also under-funded. While research contends that the actual level and quality of service received by members of the above groups tend to be sub-standard to those of their white and/or higher income counterparts, parent perceptions regarding this may or may not align with this fact. This leaves the potential for a gap to exist between what objective measurements and observations uncover and what the parent holds to be true. This also raises the question of ethics in equity of information access for those with limited cultural or social capital. This qualitative study examines the perceptions parents from various demographic groups have regarding the special education services their children receive. Interviews with parents of special needs children who are from the Philadelphia and surrounding areas serve as the primary data source. Additionally, information gathered while assuming the role of observer participant in a local support group serve as a support source of data for my study. A variety of sources were used to gather data on parent perceptions for this study. The parents of twelve special needs children were interviewed for this study. Each parent was asked a series of questions regarding their experiences with their child(ren)'s special education including, but not limited to, identification of the disability; ease/difficulty of obtaining services; design of education program offering; initiation of services; IEP implementation; and goal attainment. Several characteristics of the participants were focused on to identify commonalities among participants that determine likenesses in perceptions of various aspects of interest relating to special education services. Participation/observation in a support group for parents of special needs children, in addition to the literature distributed at that session also served as data sources for this study and that led to the study findings. Survey quantitative data, and information from limited IEP review, were also contributors to the pool of data that ultimately led to the study findings and recommendations. The conduction of a focus group was planned and attempted on more than one occasion during the study period, however, the recruitment of an acceptable number of willing participants proved to be an insurmountable challenge. One major area of interest in the study included determining if the participants believed there were differences in the special education services received by different students and if so, why. Interestingly, all of the respondents answered yes and identified eleven "major contributors" to the differences. The four considered most significant by a majority of the participants include Parental Persistence, Time Availability of the parents, the Connectedness/Access to Information maintained by the parents, and belonging to a high SES. After studying the content of all of the interviews, noticeable likenesses in the characterizations of the mindset of the participants regarding special education emerged. This commonality was so strong that it led me to give this phenomenon or theoretical concept a name - Framing Mindset. Each participant, as a result of her experiences over an extended period of time with the "universe of special education" develops a certain "casting point" where the parent's attitude becomes "set" and future decisions regarding special education programming for that child follow similar thought patterns. Thus, the parent has adopted one of three "mindsets" that serve as the "framework" from which all of their educational choices are built. Finally the study looked at the question: "How does a special needs parent's current stage of grief (Denial, Anger, Bargaining, Depression, and Acceptance) relating to having a son or daughter with a long term, often lifelong disability, influence the perception of the variables (quality, appropriateness, timeliness, comprehensiveness) comprising his or her child's educational programming?" According to the responses given by the study participants, the majority of the respondents had a connection between the stage on the Kubler-Ross' Grief Cycle and their satisfaction level with special education services; a small number of respondents did not have a connection between the stage on the Kubler-Ross' Grief Cycle and their satisfaction level with special education services; and for less than one quarter of the respondents it was not possible to determine if there was a connection between the stage on the Kubler-Ross' Grief Cycle and their satisfaction level with special education services. The results of this study have implications for advocacy/parent education, professional support group/facilitator training, and education policy. First, the results of this study, tell us that a large majority of the participants believe that access to information is key to determining the composition of the special education program received by their child. Knowing this, the role of the advocate can become much more critical to both newly diagnosed parents and parents who are not well connected. Second, the literature, interview participants, and support group participants affirm that seeking out and attending support groups is often one of the first things the parent of a newly diagnosed disabled child does to both obtain information and relieve stress. Unfortunately, the participants also indicated their frustrations with the formats and content of the groups - enough so that most did not return. Therefore, it is recommended to be the most helpful to parents of special needs children through the support group venue, training for the potential facilitator and a quick survey to potential attendees to assess their interest, preferred format, and needs should occur first. Finally, the implications of information from the study for education policy relate to the both the implementation of special education law and the oversight of the implementation of special education law. All of the interviewees asserted that there are differences in special education services among special needs. As a result of this remarkable finding, I recommend that changes to education policy include a provision for local oversight or "watchdogging" of the process of special education service provision; tougher sanctions be developed for districts and private schools who fail to provide appropriate services to a disabled child or are found guilty of providing inequitable services; and that parent surveys about their home district be distributed annually with the district and private school's scorecard partially based on the survey scores. / Educational Administration

Submitted by Isaac Francisco de Souza Dias (isaac.souzadias@ufpe.br) on 2016-03-02T18:03:41Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO Juliana Rodrigues de Souza Araújo.pdf: 8181871 bytes, checksum: 171f80b0cab70ae59e2d92c740512d02 (MD5) / Made available in DSpace on 2016-03-02T18:03:41Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO Juliana Rodrigues de Souza Araújo.pdf: 8181871 bytes, checksum: 171f80b0cab70ae59e2d92c740512d02 (MD5) Previous issue date: 2015-02-12 / O Sistema Único de Saúde surgiu no Brasil sob a perspectiva de direito social irrevogável, tendo a equidade como princípio doutrinário. Neste país de dimensões continentais, permeado por diversidades que fomentam o processo das iniquidades sociais em saúde, a equidade passa a ser um grande desafio. Para transpor esses problemas é necessário que a saúde busque parceiras intersetoriais e transdisciplinares, como a Saúde Pública faz com a Geografia, apropriando-se de temas como o território, numa perspectiva de atender a etiologia múltipla que o conceito ampliado de saúde estabelece. Dessa forma, foi selecionado o serviço da Estratégia de Saúde da Família – ESF, numa abordagem fenomenológica através da análise quali-quantitativa de suas práticas; cujo objetivo é correlacionar o mapeamento da cobertura da ESF, da área da Regional de Saúde 4, em Olinda – PE, com as áreas de maior risco para o desenvolvimento das iniquidades, considerando o conceito ampliado em saúde e os determinantes sociais de saúde. Os resultados apontam para um déficit na distribuição de cobertura de ESF na localidade e para a necessidade de reestruturação do trabalho em saúde a partir da organização e da apropriação do território adscrito pelas referidas equipes. Numa perspectiva mais abrangente, pode-se concluir que a participação social efetiva diante das variadas demandas que condicionam a saúde mostra-se como alternativa à minimização das iniquidades sociais, devendo, portanto, ser objeto permanente de trabalho dos profissionais de saúde. / The Health System in Brazil emerged from the perspective of social irrevocable law, with equity as doctrinal principle. In this country of continental dimensions, permeated by diversity that foster the process of social inequities in health, equity becomes a major challenge. To overcome these problems it is necessary that health seeks intersectoral and transdisciplinary partners, such as the Public Health makes geography, appropriating issues such as territory, with a view to cater to multiple etiologies that expanded health concept down. Thus, we selected the service of the Family Health Strategy - ESF, a phenomenological approach through qualitative and quantitative analysis of their practices; whose goal is to correlate the mapping of ESF coverage, the area of Regional Health 4 in Olinda - PE, with the areas of greatest risk for the development of iniquities, considering the concept expanded in health and social determinants of health. The results point to a deficit in the ESF cover distribution in the locality and the need for restructuring the health work from the organization and ownership of the territory ascribed by those teams. In a broader perspective, it can be concluded that effective social participation on the varied demands that affect health is shown as an alternative to minimizing social inequalities, and should therefore be permanent object of work of health professionals.

Le nombre de personnes ayant eu un cancer, dans le monde, n’a jamais était aussi élevé. Même si le bénéfice de l’adoption de comportements favorables à la santé, notamment en termes d’alimentation, suite à un diagnostic de cancer a été suggéré, peu d’études se sont spécifiquement intéressées à l’influence d’un diagnostic de cancer sur l’évolution à long terme de l’alimentation, ainsi qu’à l’impact de l’environnement socio-économique et du type de cancer (localisation et stade au diagnostic) dans cette relation. Par ailleurs, l’alimentation étant un des déterminants majeurs de la santé, de nombreuses études épidémiologiques ou cliniques souhaitent recueillir de plus en plus fréquemment les habitudes alimentaires de leurs sujets mais redoutent la durée de recueil avec les outils existants. L’objectif de ce travail doctoral était de 1) mieux caractériser les relations entre alimentation, environnement socio-économique et survenue de cancer, notamment chez les patients ayant eu un cancer, et 2) de créer et valider un outil de recueil alimentaire court, adapté au régime français, afin d’harmoniser le recueil des données alimentaires sur le plan national. À partir des données de plus de 50 000 femmes de la cohorte E3N, une augmentation de la consommation de fruits et légumes, utilisés ici comme marqueur de la qualité de l’alimentation, a été observée uniquement chez les femmes ayant eu un cancer du sein de stade avancé (II-III-IV). Cette augmentation était davantage prononcée dans certaines strates socio-économiques (chez les femmes à niveau d’éducation élevée et chez celles vivant dans le Sud, par exemple). En parallèle, un questionnaire de fréquence alimentaire court, capable d’évaluer rapidement l’alimentation des individus, a été développé en format papier et en ligne. La version papier de ce questionnaire a été validée dans une population de 127 patients atteints de maladie rénale chronique et la version numérique sur 92 adultes issus de la population générale. Ce travail précise l’influence complexe de l’environnement socio-économique sur l’évolution de l’alimentation chez les patients ayant eu un cancer. Des études complémentaires seront nécessaires pour comprendre les freins à l’adoption de comportements alimentaires favorables à la santé. Les recommandations nécessiteraient d’être modulées en fonction du niveau socio-économique des individus afin de réduire les inégalités socio-économiques en lien avec l’alimentation et la survenue de cancer. Finalement, ce travail doctoral va permettre de mettre à disposition de la communauté scientifique un outil de recueil alimentaire court, fiable et actualisé, qui sera commun à l’ensemble des groupes de population française. / The number of cancer survivors is increasing worldwide. Several studies have demonstrated a potential beneficial impact of healthy lifestyle factors, including the diet, on cancer survival, but only a few studies have evaluated the influence of a cancer diagnosis on the long-term evolution of the diet, taking into account the socioeconomic environment of individuals as well as cancer characteristics such as the site and stage at diagnosis. Moreover, considering that the diet is one of the main determinants of health, an increasing number of epidemiological studies aim to collect dietary data but are limited by the fact that dietary data collection is very time-consuming for participants as well as for researchers. The objective of this project was 1) to better characterize the complex relations between diet and socio-economic environment among women who had cancer and 2) to develop and validate a short tool able to quickly assess the diet in several French population subgroups, and standardize dietary data collection at a national level. We used data from over 50 000 women in the prospective E3N-EPIC cohort study and considered fruit and vegetable consumption as a proxy for overall diet quality. Compared with healthy and non-cancer women, an increase in fruit and vegetable consumption was only observed in women who had an advanced stage of breast cancer (stages II-III-IV). This increase was also only observed in certain socioeconomic groups (e.g. women with high level of education and women living in the South of France). A short food frequency questionnaire (SFFQ) was also developed, both a paper and online version, to easily and quickly assess diet. Both versions were validated in a sample of 127 patients with chronic kidney disease and a sample of 92 adults selected among the general population, respectively. Our results help to understand the complex influence of the socioeconomic environment on the evolution of the diet among patients who had cancer. Further studies are required to better understand the factors that prevent cancer survivors from the adoption of healthy dietary patterns. Dietary guidelines should adapt to the socioeconomic environment of individuals, in order to reduce socioeconomic inequities in diet and cancer. Finally, within the framework of the present study, a standardized, validated, short and modern tool has been developed to quickly assess diet in French clinical and epidemiological studies. Diet and dietary patterns will therefore be comparable between several French population subgroups.

Introduktion: Den digitala klyftan syftar på ojämlik tillgång till teknologi och försämrade hälsoskillnader, särskilt bland grupper med låg socioekonomisk status. Den digitala klyftan har en komplex påverkan på individers hälsa och välbefinnande, vilket medför ojämlikheter i tillgång till vård och hälsoutfall. Syfte: Denna litteraturstudie granskade den digitala klyftans inflytande på hälsoutfall inom grupper med låg socioekonomi Metoder: En litteraturstudie genomfördes med 12 vetenskapliga artiklar inom studiens syfte, genom sökningar i databaserna PubMed och CINAHL. Ramverket Digitala Regnbågen vägledde den tematiska analysen för att identifiera mönster och teman inom data i denna studie. Resultat: Studiens teman är: Effekten av den digitala klyftan på hälsa, inflytandet av socioekonomisk status på internetanvändning, inflytandet av socioekonomisk status på digital hälsolitteracitet och fördelar med internetanvändning. Resultaten avslöjar ojämlikheter i hälsoutfall, särskilt bland individer från grupper med låg socioekonomisk status. Skillnader i digital tillgång och användning förvärrar ojämlikheter i vårdtillgång, vilket påverkar livskvalitet, psykisk hälsa och välbefinnande. Socioekonomisk status påverkar internetåtkomst och användningsmönster. Dessutom påverkar socioekonomisk status förhållandet mellan digital litteracitet, internetanvändning och hälsoresultat. Internetåtkomst erbjuder fördelar som tillgång till hälsoinformation, telemedicinska plattformar och onlineresurser för förebyggande hälsa, särskilt under kriser som covid-19-pandemin. Slutsats: Kopplingen mellan den digitala klyftan, socioekonomiska skillnader och hälsoutfall visar hur begränsad digital tillgång förvärrar hälsoskillnader, särskilt bland grupper med låg socioekonomisk status. / Introduction: The digital divide refers to unequal access to technology and exacerbates health disparities, especially among low socioeconomic groups. The complex impact of the digital divide on people's health and well-being shows inequalities in healthcare access and outcomes. Aim: This literature study examined the impact of the digital divide on health outcomes among low-socioeconomic groups. Methods: A literature study was conducted with 12 scientific articles within the study aim, through searches in the databases PubMed and CINAHL. The Digital Rainbow Framework guided the thematic analysis to identify patterns and themes across the dataset in this study. Results: The study's themes are: The impact of the digital divide on health, the influence of socioeconomic status on internet use, the influence of socioeconomic status on digital health literacy, and internet usage benefits. Findings reveal disparities in health outcomes, particularly among low socioeconomic status groups. Disparities in digital access and utilization exacerbate inequalities in healthcare access influencing- quality of life, mental health, and well-being. Socioeconomic status significantly influences internet access and utilization patterns. Socioeconomic status influences the relationship between digital health literacy, internet utilization, and health outcomes. Internet access offers benefits such as health information, telemedicine platforms, and online resources for preventive health, particularly during crises like the COVID-19 pandemic. Conclusion: The connection between the digital divide, socioeconomic disparities, and health outcomes shows how limited digital access worsens health inequalities, especially among low-socioeconomic groups.

The political history of South Africa, especially that of the apartheid years, has affected the structuring and functioning of business in the country profoundly. In general, White business is highly developed and formal, with access to financial and infrastructural support. Black business is often subsistence-based, informal and struggles for access to support mechanisms. These structural inequities have had a depressing impact on the economy that will continue if they are not resolved. Following the 1994 elections, policies and legislation have been introduced aimed at redressing structural imbalances. There is thus both a political and an economic imperative to bridge the gaps that have arisen between Black and White business. The study proposes Black/White joint ventures as a mechanism to this end. The history of Black/White relationships means that these enterprises are likely to face many problems. A model has been developed through the study for the formulation, structuring and operation of Black/White joint ventures that takes into account the factors that are likely to impact on these ventures and affect their success potential. The process of applying the model in practice is directed towards results that are not prejudiced by the background of the parties to the venture. The study expands the concept of joint ventures within the South African context to incorporate initiatives along a continuum ranging from extensions to employment to full joint ventures. Depending on its nature and objectives, a venture may be placed and remain at any stage along the continuum, or may progress along it. Case studies of Black/White joint ventures were investigated in depth and analysed in terms of the application of the model, in order to determine the relevance of the model. In all cases, the success or failure of the venture under scrutiny could be ascribed to the way in which the presence of various elements identified as being components of the model had been accommodated in practice within the venture. The use of the model when applied to formulating, structuring and operating a Black/White joint venture can contribute to its success potential. / Business Management / DBL

La littératie en santé (LS) désigne les connaissances, la motivation et les compétences permettant d’accéder, comprendre, évaluer et appliquer l’information dans le domaine de la santé. C’est un déterminant majeur de santé qui est fréquemment considéré comme un mécanisme des inégalités sociales de santé. Ce travail de thèse a comme objectif fondamental d’évaluer l’association entre la LS, les inégalités d’information et l’état de santé des personnes atteintes de cancers. Toutefois, devant le manque d’instruments de mesure de la LS, nos premiers travaux ont consisté en la validation d’outils de mesure en France. Nos travaux empiriques se sont appuyés sur les analyses de trois enquêtes.Ces analyses ont permis d’obtenir des éléments de validation de plusieurs échelles subjectives en version française évaluant la LS, la numératie et la décision partagée.Un niveau limité de LS a été montré associé à une moindre participation au processus de décision partagée, des comportements de recherche d’information et un état de santé mentale et physique altéré. De plus, les patients avec un niveau limité de LS sollicitent davantage le médecin généraliste et les services sociaux.La prise en compte du niveau de LS des patients pendant tout le parcours de soins nous parait indispensable. Cela pourrait permettre d’adapter l’information au niveau de LS afin de réduire les inégalités d’information et augmenter la participation des patients à la prise de décision. En outre, cela pourrait également permettre aux professionnels de santé de proposer un accompagnement particulier pour les personnes à faible niveau de LS afin d’améliorer leur état de santé et leur qualité de vie. / Health Literacy (HL) refers to the knowledge, motivation, and skills to access, understand, evaluate, and apply information in the health field. It is a major determinant of health that is frequently considered as a mechanism of the social inequities of health. The main objective of this thesis is to evaluate the association between HL, information inequities and the health status of people with cancer. However, given the lack of HL measuring instruments in France, we started with the psychometric validation of measurement tools.Our empirical work is based on analyzes of three surveys.These analyses allowed having valid French version of subjective scales measuring HL, numeracy and shared decision-making process. Our analyzes have shown that a limited level of HL is associated with less involvement in the shared decision process, more information seeking and impaired mental and physical health status. In addition, patients with limited level of HL consulted more often the general practitioner and the social worker. Considering the patients’ HL level during all the course of their care seems mandatory. This would allow information to be tailored to patients’ HL level, to reduce information inequities and increase patient participation in decision-making. In addition, this would also allow health professionals to propose special care for people with low levels of HL to improve their health and quality of life.