Sciences Po CSO/CNRS CNRS

Health

Michel Crozier led the charge at the CSO, beginning in the mid-1980s, for a sociological analysis of public health problems.

Initially focused on an organizational approach to hospitals, research on healthcare broadened in the 1990s to include public policy, the organization of care outside the hospital setting, clinical and pharmaceutical research, prevention (cancer and AIDS), and medications. A veritable research program on healthcare was thus created.
These researchers all collaborate regularly with major institutions in the healthcare sector, such as the IRESP, the CNAMTS, the HAS, and the EHESP, for research, consulting, and teaching missions.

In the wake of previous research on the question of rationalization in healthcare systems and the political dynamics of the health orientation of social problems, the “Healthcare” research program at the CSO aims to broaden and deepen this research to include the relations between public and private actors in the (re)configuration of the health field.

Two research areas have been identified:

Knowledge, tools, and practices: rationalization and standardization dynamics of healthcare practices

The research conducted in this program has shown the importance of knowledge and norms in the creation of healthcare policy and in the regulation of healthcare systems. At different levels of the healthcare system, information and knowledge are used in assessment processes.
This includes:
- data formalization methods, which are specific to expert communities (biologists, pharmacologists, toxicologists, doctors from different fields, epidemiologists, healthcare economists, etc.);
-judgment methods and references (cost/benefit analyses or cost effectiveness analyses, “risk against risk” approach, etc.);
-action norms and principles (precautionary principle, proximity principle, fairness, personal autonomy and dignity, etc.);
-cognitive devices (best practice guides, medical and health recommendations, indicators, rankings, etc.).
We have thus observed that reforms in the healthcare sector since the 1980s focus on rationalization and entail a series of economic and management devices and logic.
Several studies will pursue this line of thought in the coming years, by looking at the production of knowledge in bio-clinical and economic research, as well as its use in regulating markets.

Health, the State, and the Market: new types of public-private partnerships

Public action in the healthcare domain is a fruitful terrain for research, due to the various actors involved and the subsequent conflicts of interest, knowledge, and values that can be observed. Recent decades have been marked by the diversification of actors involved in regulating healthcare activities. Alongside traditional actors, whether they be professional, institutional, or industrial, we can now find the preoccupations of new actors involved in defining public problems and determining what constitutes the common good: associations, experts, agencies, high authorities, observatories, and international organizations. As healthcare issues are eminently political, they call into question the legitimacy and identity of groups mobilized in this domain. These issues consecrate and reveal situations of interdependence between different worlds which must find common ground and redefine their respective positions.
Research on the creation and organization of French and European healthcare agencies (regarding medications, foodstuffs, drugs, and addiction) aims to reveal the logics behind the emergence of a third-party actor between the public and private sectors (professionals and industrial actors). Healthcare policy walks a fine line between denouncing conflicts of interest and showcasing the virtues of Public-Private Partnerships; the orientation chosen is at the root of bitter conflicts between the actors previously mentioned. Thus, by studying the regulation of the European functional foods market, CSO researchers aim to trace the links between the European Commission, the European Food Safety Authority, industrialists, national governments, and healthcare professionals regarding recognizing health claims for functional foods and the way the market is organized for these products.


The researchers involved in the Healthcare program are:
Daniel Benamouzig
Henri Bergeron
Patrick Castel
Etienne Nouguez
Olivier Pilmis

And also:
Olivier Borraz
Jean-Noël Jouzel
Renaud Crespin


Research Programs