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Since the beginning of the twenty-first century, Vietnam has been facing an imbalance in the sex ratio at birth: at the national level, because of the use of prenatal sex selection, 113 boys are currently being born for every 100 girls. This practice has only emerged recently due to the late advent of high quality ultrasounds, whose use has increased within the private health system, according to a market-based approach rather than one based on public health. The preference for sons is exploited by health practitioners for commercial purposes: ultrasounds are used as pre- and post-conception methods, in order to fulfill gendered reproductive objectives. It falls within a large spectrum of traditional techniques and practices aimed at conceiving boys, and reproductive strategies to ensure the birth of a son. In fact, the development of ultrasounds acts as a constraint because couples can no longer use the excuse of chance to justify why they do not have a son.

To date, only a few contributions have examined the impact of health care systems on social inequalities in health. While it is difficult to uncover and document the presence of inequalities within curative care, a converging amount of empirical evidence points to the role and importance of this issue, which is therefore not to be neglected. Drawing on observations of multidisciplinary oncology meetings, the purpose of this article is to discuss how the health care system contributes to the (re)production of health inequalities by exploring the decision-making system underlying the biomedical management of patients suffering from head and neck cancer. Its main goal is to contribute to the understanding of the social dimension of medical decision-making, focusing in particular on whether and to what extent extra-clinical criteria account for the prescription of different treatments.

This article offers a contribution to the diachronic analysis of the relationships between health and work, drawing upon a variety of research that differs in its disciplinary affiliation, its methodologies, and its interpretative models. A re-reading of this research enables us to highlight five types of “displacement” and leads us to requalify various “events” (accident, exposure, loss of employment, change in working conditions, occurrence of health disorders). We do so by examining how they “repeat” over the course of an individual's working life, “accumulate” according to the positions occupied by individuals on the labor market, and “interweave,” by taking on meaning within personal stories, as well as how they are “shaped” toward possible categorizations, and finally “integrated” into the combined history of men and women at work and systems of production. In this way, diachronic research on the relationships between health and work can inform new avenues for action, beyond the dominance of “presentist” policies.