Contrasted life trajectories: reconstituting the main population exposomes in French Guiana

Abstract

In French Guiana, life expectancy is between 2 and 3 years below that of France, reflecting differences in mortality rates that are largely sensitive to primary healthcare and thus preventable. However, because poverty affects half of the population in French Guiana, global measurements of life expectancy presumably conflate at least two distinct situations: persons who have similar life expectancies as in mainland France and persons living in precariousness who have far greater mortality rates than their wealthier counterparts. We thus aimed to synthesize what is known about statistical regularities regarding exposures and sketch typical French Guiana exposomes in relation to health outcomes. We conducted a narrative review on common exposures in French Guiana and made comparisons between French Guiana and mainland France, between rich and poor in French Guiana, and between urban and rural areas within French Guiana. The most striking fact this panorama shows is that being a fetus or a young child in French Guiana is fraught with multiple threats. In French Guiana, poverty and poor pregnancy follow-up; renouncing healthcare; wide variety of infectious diseases; very high prevalence of food insecurity; psychosocial stress; micronutrient deficiencies; obesity and metabolic problems; and frequent exposure to lead and mercury in rural areas constitute a stunningly challenging exposome for a new human being to develop into. A substantial part of the population’s health is hence affected by poverty and its sources of nutrition.

The Epidemiological Particularities of Malignant Hemopathies in French Guiana: 2005–2014

“…However, adjusted mortality rates were not. This combination of high incidence but low mortality may have resulted from the high HIV prevalence in French Guiana (1.2% overall and 1.6% in the 15–49 years old [ 29 ]) combined with a well-funded universal health system [ 30 ] offering the latest oncological therapeutic advances to all patients, irrespective of their social condition.…”

Incidence of Pediatric Cancers in French Guiana: How Does It Compare to Global Estimates?

“…The exposome of persons living in French Guiana is quite different from that of mainland France [10]. The ecosystem of pathogens and environmental exposures-some of which may be carcinogenic [11,12]-are very different from those in mainland France.…”

Forty Years of HIV Research in French Guiana: Comprehend to Combat

“…Although it has featured a French administration akin to the rest of France since 1946 [ 1 ] and a universal health system, it is quite different from mainland France: it is a multicultural territory with ancestries from all continents; its history is marked by different waves of immigration, with populations trying to improve their economic conditions in this morsel of France—a third of the population and nearly half of adults are foreigners [ 2 ]; it is marked by widespread poverty with, still today, over half the population living under the French poverty threshold [ 3 ]; population growth is the highest in Latin America, driven by a high birth rate and immigration, increasing 5-fold from around 60,000 in the late 1970s to 300,000 today [ 4 ]. The exposome in French Guiana and the immunogenetic make-up of the population are also quite different from mainland France [ 5 ]. In this context, the epidemiologic transition is still incomplete, with a mix of causes of death before 65 years—notably AIDS deaths—that is more reminiscent of low- and middle-income countries than of mainland France [ 6 ].…”