The research work carried out at the EHESP fall within the following 5 fields of research and expertise:
- Social and health policies
- Organisation, steering, regulation and management of health services in their health, social and medico-social dimensions
- Environmental and occupational health
- Health promotion and disease prevention
- Health safety
3 levels of analysis and multiple actors (political, institutional and professional)
The analysis of social and public health policies carried out at the EHESP takes into account different levels and interconnections. These policies are analysed in detail at 3 levels because they a public policies, with a national framework and their implementation involves national and territorial agents:
- the design and decision as well as the reform process, with the role played by political agents, high level civil servants, experts in charge of these dossiers, but also the media which increasingly represent one of the components of a political agenda;
- the implementation, with the role played by professionals and field agents which give consistency to the regulatory frameworks, often with some integration and coordination difficulties; this phase can also be an adjustment and redefinition phase for the policy created;
- the users and their representatives, which can contribute to the reorientation, or even partly produce these devices and their evaluation.
The work of the research professors of the EHESP who work on these policies related to their research activity within ARENES (UMR CNRS 6051 ARENES) currently concern in particular the policies targeting the stages of life (childhood, youth and old age policies), or special forms of vulnerability (handicap, loss of autonomy, progressive chronic disease), or even policies targeting well-being in a health promotion and risk prevention perspective.
The work carried out within the EHESP on the analysis of social and public health policies are part of a European opening, through collaborations established with researchers in all European countries. They have resulted in numerous publications in national and international journals.
Organisation, steering, regulation and management of health services in their health, social and medico-social dimensions
A sector that is part of the health service and management research line
The development of the “Organisation and management of health services” at the EHESP corresponds to the “Health care Management and Policy” found in North American public health schools. It is therefore part of the “health service and management research” line common in the English speaking work, which has been the subject of numerous management or general medicine journals, but which is poorly developed in France.
The research developed in this subject matter should be useful and enlightening for health actors such as health establishment managers, doctors or policy makers. Their objective is also to feed management science debates beyond merely the medical and medico-social sector.
The training, research and expertise activities around this line of research are mainly carried out by the Institute of management, which does not prevent collaborations with other departments (Department of Quantitative Methods in Public Health, in particular, as well as the Department of Human and Social Sciences). The research activities are carried out by the Health organisations management (HOM) research team in collaboration with other teams at the national and international level. The HOM team was created within the EHESP in 2012 as a response to a priority need highlighted in the AERES assessment report in 2011. This research team works on different subjects involving management sciences: hospital performance, health safety, prevention and social health inequalities. It presents 2 lines of research: hospital performance and healthcare pathway, including prevention work under a management approach.
Health environment courses for all publics
All the publics trained at the EHESP benefits from health environment courses. The public that follows courses mainly concerning this field are the following:
- future professional agents working for the public or the private sector:
– for the evaluation of the impact of the environment on health via the characterisation of general and work environment-related exposure and risks,
– for risk management via preventive or corrective policies and actions.
- future researchers on living environment-related risks.
This training function benefits from applied research on the environment, exposure and associated risks carried out within the Institut de recherche sur la santé, l’environnement et le travail (IRSET – Health, environment and work research institute), UMR1085-Insem-Univ. Rennes1-EHESP. The training on risk management policies could be reinforced by the progressive strength of the research on this aspect (social, political and economic dimensions) especially through greater inter-school collaborations and with other UMR, in particular ARENES (UMR CNRS 6051 ARENES).
A broad view of health determinants
Health is influenced by social and environmental factors that interact throughout life with genetics and behaviour.
The objective of health promotion is to give individuals more control over their health in order to improve it. It is a positive concept that emphasises social and personal resources as well as institutional, political and environmental resources. Its ambition is individual well-being, therefore health promotion does not solely belong to the health sector. It also very broadly takes into account health determinants.
The aim of prevention is to prevent the appearance of diseases or to reduce their consequences by acting on their determinants. The health condition of the population also depends on measures taken in sectors other than the health sector. Therefore, the prevention policy should focus on the intervention of the health system (so-called medicalised prevention, carried out by health professionals in “preventive clinical practices”) and levers that are not in this system to act on the environment and behaviour.
The study subjects within a research perspective not only include lifestyle and behaviour, but also social, economic and environmental determinants. Health inequalities are at the centre of this approach and aim at the identification of inequalities as well as the exploration of the impact of interventions in all their complexity. A multi-disciplinary approach and the use of mixed methods provide a better understanding of this complexity.
Healthcare-related environmental risks, emergent risks
The risks associated with health products and medical practices as well as the threat of emergence of epidemic infectious diseases are sources of concern for the health authorities and the population. The optimal management of health crises requires fast intervention capacities on complex constantly evolving situations.
The research, expertise and training activities are essentially carried out by the Department of environmental and occupational health and sanitary engineering and by the Department of Quantitative Methods in Public Health. In addition to these 2 departments, collaborations with the Department of Human and Social Sciences concern risk perception. The subject is approached within the Institute of Management via the risk management angle and its impact on organisations.
The research in these units is carried out within entities with an EHESP label such as the UMR IRSET for the “environmental risks” part and the HOM team for the “healthcare-related risks“. The EHESP also has long term collaborations with the UMR 190 and the Institut Pasteur as part of the research on “emergent risks“, as well as with the InVS which organises with the EHESP the IDEA training and the CNAM which has integrated the latter training into one of its master degrees.
Furthermore, the EHESP is leading the research in this field with the University Paris Descartes and the Institut d’études politiques de Paris, within the framework of the Comue Sorbonne-Paris-Cité.