Self-esteem, social fragility, precariousness and cancer

The lack or loss of self-esteem directs some subjects to errors of unconscious strategic choices that can weaken them socially and increase the factors of health inequalities (in the WHO term sense) by a deficiency of health supportive care. The consequences can be a latent depression, frequent relapses and addictions. Denial of depression leads to a lack of care which are considered as unnecessary. People takes refuge in addictive conducts, substitute of anxiolytic and antidepressant treatments. The social consequences are inevitable: school failure, difficulty of developing links with sentimental difficulties and breakdown of family ties, suicidal behavior, addictions, mental and social instability. In a socially and financially protected environment, lack of self-esteem can be hidden and precarious considerably reduced with the involvement of the entourage. For people who do not benefit of this protection, the social casualisation is inevitable. The health consequences are significant and these people are forgotten by public health plans. They do not agree with the prevention and screening messages and their treatment compliance is low. In oncology it means loss of chance and increase of health inequalities. One of the goal of the French cancer plan 2009-2013 is the reduction of these health inequalities and measures to achieve this objective will be recalled. But they will be realy efficient for populations in precarious situation only if they find again "their self esteem.". To cite this journal: Psycho-Oncol. 5 (2011).