rubrica

Disuguaglianze

  • Chiara Marinacci1

  1. S.C. a D.U. Scuola di Sanità Pubblica, ASL TO3
Chiara Marinacci -

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Ricerca bibliografica periodo 02 aprile 2011 – 2 giugno 2011

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Database: Pubmed/MEDline
Stringa: ("socioeconomic factors"[MeSH Terms] OR "social class"[MeSH Terms] or "educational status"[MESH terms] OR inequalities[Title/Abstract] OR inequities[Title/Abstract] OR socioeconomic[Title/Abstract]) AND ("italy"[MeSH Terms] OR "italy"[All Fields]) AND ("2011/04/02"[PDAT]: "2011/06/02"[PDAT])

Di ogni articolo è disponibile l'abstract. Per visualizzarlo basta cliccare sul titolo.

1. Luy M, Di Giulio P, Caselli G. Differences in life expectancy by education and occupation in Italy, 1980-94: Indirect estimates from maternal and paternal orphanhood. Popul Stud (Camb). 2011 May 20:1-19. [Epub ahead of print]
Vienna Institute of Demography of the Austrian Academy of Sciences.
Abstract
In the present study, we use the modified orphanhood method to analyse mortality differences by socio-economic status in Italy. This technique permits the indirect estimation of adult mortality from survey-based information on parents' survival in developed populations and helps to overcome several limitations of conventional studies on mortality differences by social class. We estimate a time series of life tables by education and occupation and analyse the differences in life expectancy by socio-economic status along with their changes between 1980-84, 1985-89, and 1990-94. Whereas mortality differences between the highest social class and the other socio-economic status groups increased among men, they decreased among women. We speculate about the reasons for these sex-specific trends and evaluate the application of indirect estimation techniques to the populations of developed countries.
2. Breslau J, Miller E, Jin R, Sampson NA, Alonso J, Andrade LH, Bromet EJ, de Girolamo G, Demyttenaere K, Fayyad J, Fukao A, Gălăon M, Gureje O, He Y, Hinkov HR, Hu C, Kovess-Masfety V, Matschinger H, Medina-Mora ME, Ormel J, Posada-Villa J, Sagar R, Scott KM, Kessler RC. A multinational study of mental disorders, marriage, and divorce. Acta Psychiatr Scand. 2011 Apr 30. doi: 10.1111/j.1600-0447.2011.01712.x. [Epub ahead of print]
Department of Internal Medicine, University of California Department of Pediatrics, University of California, Davis, CA Department of Health Care Policy, Harvard Medical School, Boston, MA, USA Health Services Research Unit, Institut Municipal d'Investigació Mèdica (IMIM-Hospital del Mar); CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Catalonia, Spain Department & Institute of Psychiatry, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Bologna, Italy Department of Psychiatry, University Hospital Gasthuisberg, Leuven, Belgium Department of Psychiatry and Clinical Psychology, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St. George Hospital University Medical Center and Faculty of Medicine, Balamand University, Beirut, Lebanon Department of Public Health, Yamagata University Graduate School of Medicine, Yamagata, Japan Scoala Nationala de Sanatate Publica, Management si Perfectionare in Domeniul Sanitar Bucharest, (SNSPMPDSB), Romania Department of Psychiatry, University College Hospital, Ibadan, Nigeria Shanghai Mental Health Center, Shanghai, China Department of Global Mental Health, National Center for Public Health Protection, Sofia, Bulgaria Shenzhen Institute of Mental Health, Shenzhen, Guangdong, China EA4069 Université Paris Descartes, Paris, France Clinic of Psychiatry, University of Leipzig, Leipzig, Germany National Institute of Psychiatry, Mexico City, Mexico Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center, Groningen, the Netherlands Instituto Colombiano del Sistema Nervioso, Bogota D.C. Colombia All India Institute of Medical Sciences (AIIMS), New Delhi, India Department of Psychological Medicine, Wellington School of Medicine and Health Sciences, Dunedin, New Zealand. .
Abstract
A  multinational study of mental disorders, marriage, and divorce. Objective: Estimate predictive associations of mental disorders with marriage and divorce  in a cross-national sample. Method: Population surveys of mental disorders included assessment of age at first marriage in 19 128) and age at first divorce in a subset of 12 countries 46 = countries (n 729). Associations between mental disorders and subsequent marriage and 30 = (n Fourteen of divorce were estimated in discrete time survival models. Results: 18 premarital mental disorders are associated with lower likelihood of ever marrying (odds ratios ranging from 0.6 to 0.9), but these associations vary across ages of marriage. Associations between premarital mental disorders and marriage are generally null for early marriage (age 17 or younger), but negative associations come to predominate at later ages. All 18 mental disorders are positively associated with divorce (odds ratios ranging from 1.2 to 1.8). Three disorders, specific phobia, major depression, and alcohol abuse, are associated with the largest population attributable risk proportions for both marriage and This evidence adds to research demonstrating adverse divorce. Conclusion: effects of mental disorders on life course altering events across a diverse range of socioeconomic and cultural settings. These effects should be included in considerations of public health investments in preventing and treating mental disorders.
3. Puliti D, Miccinesi G, Manneschi G, Buzzoni C, Crocetti E, Paci E, Zappa M. Does an organised screening programme reduce the inequalities in breast cancer survival? Ann Oncol. 2011 Apr 22. [Epub ahead of print]
Clinical and Descriptive Epidemiology Unit, ISPO-Cancer Prevention and Research Institute, Florence, Italy.
Abstract
BACKGROUND:
The aim of the present study was to examine whether the implementation of an organised mammographic screening programme in Florence has been successful in reducing socioeconomic inequalities in breast cancer survival.
PATIENTS AND METHODS: All invasive breast cancer cases diagnosed in women resident in the city of Florence in a prescreening period and in the first 10 years of the screening programme were selected. Their socioeconomic status (SES) was determined by using the national census 2001 data. All breast cancers were followed up to 10 years after the diagnosis.
RESULTS: In the prescreening period, the survival of deprived women was 12 percentage points lower than the reference class, both in the younger age class (<50 years old) and in the age class target of the screening programme (50-69 years old). This difference progressively decreases until disappearing completely during the first 10 years of the screening programme for the age class invited to screening, whereas it remains stable in the younger age class. Participation in breast cancer screening and diagnostic accuracy were similar by SES.
CONCLUSION: The organised breast cancer screening implemented in the Florentine area achieved the goal of reducing inequalities in breast cancer survival.

Breve commento a cura di Chiara Marinacci
Oltre alla riduzione delle differenze di sopravvivenza per deprivazione socioeconomica, nel periodo post-screening tra le donne di età 50-69 anni, dallo studio emerge anche un marcato incremento, soprattutto nella seconda metà degli anni novanta, del rischio relativo di mortalità a carico delle donne deprivate con meno di 50 anni, rispetto alle coetanee più benestanti: ciò non sembrerebbe spiegato da differenze negli indicatori di prognosi utilizzati nello studio.

4. Merletti F, Galassi C, Spadea T. The socioeconomic determinants of cancer. Environ Health. 2011 Apr 5;10 Suppl 1:S7.
Center for Cancer Prevention, University of Turin, San Giovanni Battista University Hospital, Italy. franco.merletti@unito.it.
Abstract
This paper provides a synthesis on socioeconomic inequalities in cancer incidence, mortality and survival across countries and within countries, with particular focus on the Italian context; the paper also describes the underlying mechanisms documented for cancer incidence, and reports some remarks on policies to tackle inequalities.From a worldwide perspective, the burden of cancer appears to be particularly increasing in developing countries, where many cancers with a poor prognosis (liver, stomach and oesophagus) are much more common than in richer countries. As in the case of incidence and mortality, also in cancer survival we observe a great variability across countries. Different studies have suggested a possible impact of health care on the social gradients in cancer survival, even in countries with a National Health System providing equitable access to care.In developed countries, there is increasing awareness of social inequalities as an important public health issue; as a consequence, there is a variety of strategies and policies being implemented throughout Europe. However, recent reviews emphasize that present knowledge on effectiveness of policies and interventions on health inequalities is not sufficient to offer a robust and evidence-based guide to the choice and design of interventions, and that more evaluation studies are needed.The large disparities in health that we can measure within and between countries represent a challenge to the world; social health inequalities are avoidable, and their reduction therefore represents an achievable goal and an ethical imperative.

Breve commento a cura di Chiara Marinacci
Sintesi delle conoscenze sulle diseguaglianze socioeconomiche nella mortalità, nell’incidenza e nella sopravvivenza per tumori, con particolare attenzione anche al ruolo di differenti indicatori di posizione sociale sull’insorgenza di specifici tumori, mettendo così a fuoco diversi meccanismi di generazione delle diseguaglianze in differenti fasi dei percorsi di vita.

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