• Chiara Marinacci1

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

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Ricerca bibliografica periodo dal 1 giugno 2012 al 15 agosto

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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]) OR socio-economic[Title/Abstract]) OR disparities[Title/Abstract]) AND ("italy"[MeSH Terms] OR "italy"[All Fields]) AND ("2012/06/1"[PDAT] : "2012/08/15PDAT])
1. Bammann K, Gwozdz W, Lanfer A, Barba G, De Henauw S, Eiben G, Fernandez-Alvira JM, Kovács E, Lissner L, Moreno LA, Tornaritis M, Veidebaum T, Pigeot I; the IDEFICS Consortium. Socioeconomic factors and childhood overweight in Europe: results from the multi-centre IDEFICS study. Pediatr Obes. 2012 Aug 8. doi: 10.1111/j.2047-6310.2012.00075.x. [Epub ahead of print]
Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany; BIPS Institute for Epidemiology and Prevention Research, Bremen, Germany

OBJECTIVE: To assess the association between different macro- and micro-level socioeconomic factors and childhood overweight. METHODS: Data from the IDEFICS baseline survey is used to investigate the cross-sectional association between socioeconomic factors, like socioeconomic status (SES), and the prevalence of childhood overweight. Differences and similarities regarding this relationship in eight European regions (located in Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden) are explored. 11 994 children (50.9% boys, 49.1% girls) and their parents were included in the analyses. RESULTS: In five of the eight investigated regions (in Belgium, Estonia, Germany, Spain and Sweden), the prevalence of childhood overweight followed an inverse SES gradient. In the other three regions (in Cyprus, Hungary and Italy), no association between SES and childhood overweight was found. The SES-overweight association in a region was best explained by the country-specific human development index and the centre-specific mean income. For the investigated association between other socioeconomic factors and overweight, no clear pattern could be found in the different regions. CONCLUSION: The association between socioeconomic factors and childhood overweight was shown to be heterogeneous across different European regions. Further research on nationwide European data is needed to confirm the results and to identify target groups for prevention.

2. Salvatore D, Buzzetti R, Baldo E, Furnari ML, Lucidi V, Manunza D, Marinelli I, Messore B, Neri AS, Raia V, Mastella G. An overview of international literature from cystic fibrosis registries. Part 4: Update 2011. J Cyst Fibros. 2012 Aug 7. [Epub ahead of print]
Cystic Fibrosis Centre, AOR Ospedale San Carlo, Potenza, Italy.

A total of 53 national cystic fibrosis (CF) patient registry studies published between July 2008 and November 2011 have been reviewed, focusing on the following topics: CF epidemiology, nutrition, microbiology, clinical complications, factors influencing diagnosis and lung disease, effects of socioeconomic status, therapeutic strategy evaluation, clinical trial methodology. The studies describe the clinical characteristics of CF patients, the incidence and prevalence of disease and role of gender gap, as well as the influence of socioeconomic status and environmental factors on clinical outcomes, covering a variety of countries and ethnic groups. Original observations describe patients as they get older, with special reference to the adult presentation of CF and long-term survival. Methodological aspects are discussed, covering the design of clinical trials, survival analysis, auxometry, measures of quality of life, follow up of lung disease, predictability of disease progression and life expectancy. Microbiology studies have investigated the role of selected pathogens, such as Burkholderia species and MRSA. Pulmonary exacerbations are discussed both as a factor influencing morbidity and an endpoint in clinical trials. Finally, some studies give insights on complications, such as CF-related diabetes and hemoptysis, and emerging problems, such as chronic nephropathy.

3. Leone L, Scatigna M, Donati A, Pesce C. Bridging supply and demand: Relationship between cocaine seizures and prevalence estimates of consumption. Public Health. 2012 Jul 5. [Epub ahead of print]
CEVAS, Counselling and Evaluation of Social and Health Policies, Rome, Italy. Abstract
OBJECTIVES: Drug supply and demand indicators have mainly been analysed without triangulating information on environmental drug availability and consumption. This study proposes an approach to analyse the prevalence of illicit drug consumption together with indirect indicators of drug supply. STUDY DESIGN: Ecological study correlating cocaine seizure data and consumption prevalence estimates at local level, using Italian provinces as the unit of analysis. METHODS: The amount of cocaine seized in proportion to the number of potential consumers was computed at Italian provincial level from the 2005 database of the Italian Central Directorate for Anti-Drug Services. Indicators of consumption prevalence, at provincial level, in 15-16-year-old students from the 2005 European School Survey Project on Alcohol and Other Drugs (ESPAD) and 15-54-year-old respondents from the 2005 Italian Population Survey on Alcohol and Drugs (IPSAD) were correlated with the population-adjusted amount of total seizures and seizures of different sizes. ESPAD data were also regressed on seizure data after controlling for the prediction accrued by socio-economic variables that might cause covariation of seizure and consumption prevalence data. Regression-predicted prevalence values were computed and correlated with the ESPAD prevalence data for the following year. RESULTS: There was a weak general correlation between the population-adjusted total seizure and IPSAD prevalence indicators, but not ESPAD prevalence indicators. In contrast, ESPAD data were more strongly correlated with small seizures. The regression model yielded significant variance in prevalence data (18% and 23% in small and large provinces, respectively) explained by small seizures, and this remained after removing the percentage of variance explained by socio-economic factors and (particularly) education level. A moderate correlation was found between seizure-based predicted values of consumption prevalence and ESPAD values for the following year. CONCLUSIONS: Associating prevalence estimates in adolescents and cocaine seizure data at local level, after 'purifying' the data from trafficking- and wholesale-related large seizures, may represent a starting point for a geo-referenced, seizure-based analysis of initiation into cocaine consumption. This approach may support the collaboration between enforcement and health systems, helping to establish empirical regularities to be translated into useful information for local planners of drug prevention policies in areas at greater risk of increasing incidence.
4. Molinari E, Pagnini F, Castelnuovo G, Lozza E, Bosio CA. A new approach for psychological consultation: the psychologist at the chemist's. BMC Public Health. 2012 Jul 3;12:501.
Department of Psychology, Catholic University of Milan, Milan, Italy.

BACKGROUND: The prevalence of mental illness and psychological suffering is greater than the availability of primary care services in Europe and, in particular, in Italy. The main barriers that hinder the access to these services are economic, the lack of proximity of services and some prejudices that may promote stigma and shame.A new mental health service, named "Psychologist in the Neighbourhood" was created to intercept unexpressed needs for psychological assistance. The service allows everyone to ask for free psychological consultation, consisting of no more than four meetings with a psychologist, in certain chemists' shops around the city of Milan. This article aims to present the service specific features of this initiative and the results of a pilot study. METHODS: Information gathered on all users included socio-demographic data, the reasons why they approached this specific service, how they learnt about it, the main presented problem and, for a random sub-group, the level of psychological well-being (as measured by the PGWBI). Socio-demographic data were compared with previously collected information about general users of psychological services. The outcome of the intervention was assessed by the clinicians. RESULTS: During the two-year project a total of 1,775 people accessed the service. Compared to traditional users of psychological services, the participants in this service were characterized by a higher presence of females, unemployed and retired people. The main factors encouraging access were proximity and the fact that the service was free of charge. Many of the users were redirected to more specific services, while for about a third of the sample the consultation cycle was sufficient to resolve the presented problem. CONCLUSIONS: The interest and participation of the population was high and this initiative intercepted an unexpressed requirement for psychological support. Free access and home proximity, were the main reasons for accessing this specific service. Subjects were mostly re-directed to appropriate services, while about a third of the sample addressed and resolved their problem with the psychologist in the chemist's shop.These encouraging results suggest the benefits of bringing psychological consultations closer to citizens, particularly to those who cannot afford it, reducing socio-economic inequalities.

5. Sacerdote C, Ricceri F, Rolandsson O, Baldi I, Chirlaque MD, Feskens E, Bendinelli B, Ardanaz E, Arriola L, Balkau B, Bergmann M, Beulens JW, Boeing H, Clavel-Chapelon F, Crowe F, de Lauzon-Guillain B, Forouhi N, Franks PW, Gallo V, Gonzalez C, Halkjær J, Illner AK, Kaaks R, Key T, Khaw KT, Navarro C, Nilsson PM, Dal Ton SO, Overvad K, Pala V, Palli D, Panico S, Polidoro S, Quirós JR, Romieu I, Sánchez MJ, Slimani N, Sluijs I, Spijkerman A, Teucher B, Tjønneland A, Tumino R, van der A D, Vergnaud AC, Wennberg P, Sharp S, Langenberg C, Riboli E, Vineis P, Wareham N. Lower educational level is a predictor of incident type 2 diabetes in European countries: The EPIC-InterAct study. Int J Epidemiol. 2012 Aug;41(4):1162-1173. Epub 2012 Jun 25.
Center for Cancer Prevention (CPO-Piemonte), Torino, Italy, Human Genetics Foundation (HuGeF), Torino, Italy, Department of Public Health and Clinical Medicine, Umea University, Sweden, Department of Environmental Medicine and Public Health, University of Padova, Italy, Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Spain, Murcia Regional Health Authority, Murcia, Spain, Division of Human Nutrition, Section of Nutrition and Epidemiology, University of Wageningen, The Netherlands, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy, Navarre Public Health Institute, Pamplona, Spain, Public Health Department of Gipuzkoa, Basque Government, San Sebastián, Spain, Inserm (Institut National de la Santé et de la Recherche Médicale), Centre for Research in Epidemiology and Population Health (CESP), France, Paris-South University, Villejuif Cedex, France, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands, Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, UK, MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK, Lund University Diabetes Center, Malmö, Sweden, Department of Public Health and Clinical Medicine, Umea University, Sweden, Harvard School of Public Health, Boston, MA, USA, School of Public Health, Imperial College London, London, UK, Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, UK, Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Barcelona, Spain, Danish Cancer Society Research Center, Copenhagen, Denmark, Department of Epidemiology, German Institute of Human Nutrition, Bergholz-Rehbrücke, Germany, Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany, Department of Clinical Gerontology, Addenbrooke's Hospital, Cambridge, UK, Unit of Preventive Medicine and Public Health School of Medicine, Murcia, Spain, Department of Psychosocial Cancer Research, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark, Department of Epidemiology, School of Public Health, Aarhus University, Aaarhus, Denmark, Nutritional Epidemiology Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy, Asturias Health & Health Care Council, Oviedo, Spain, Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France, Andalusian School of Public Health, Granada, Spain, National Institute for Public Health and the Environment, Centre for Prevention and Health Services Research, Bilthoven, The Netherlands, Cancer Registry and Histopathology Unit, Civile M.P. Arezzo Hospital, Ragusa, Italy, MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK and MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases worldwide. In high-income countries, low socioeconomic status seems to be related to a high incidence of T2DM, but very little is known about the intermediate factors of this relationship. Method We performed a case-cohort study in eight Western European countries nested in the EPIC study (n = 340 234, 3.99 million person-years of follow-up). A random sub-cohort of 16 835 individuals and a total of 12 403 incident cases of T2DM were identified. Crude and multivariate-adjusted hazard ratios (HR) were estimated for each country and pooled across countries using meta-analytical methods. Age-, gender- and country-specific relative indices of inequality (RII) were used as the measure of educational level and RII tertiles were analysed. RESULTS: Compared with participants with a high educational level (RII tertile 1), participants with a low educational level (RII tertile 3) had a higher risk of T2DM [HR: 1.77, 95% confidence interval (CI): 1.69-1.85; P-trend < 0.01]. The HRs adjusted for physical activity, smoking status and propensity score according to macronutrient intake were very similar to the crude HR (adjusted HR: 1.67, 95% CI: 1.52-1.83 in men; HR: 1.88, 95% CI: 1.73-2.05 in women). The HRs were attenuated only when they were further adjusted for BMI (BMI-adjusted HR: 1.36, 95% CI: 1.23-1.51 in men; HR: 1.32, 95% CI: 1.20-1.45 in women). CONCLUSION: This study demonstrates the inequalities in the risk of T2DM in Western European countries, with an inverse relationship between educational level and risk of T2DM that is only partially explained by variations in BMI.

6. Camilloni L, Farchi S, Chini F, Giorgi Rossi P, Borgia P, Guasticchi G. How socioeconomic status influences road traffic injuries and home injuries in Rome Int J Inj Contr Saf Promot. 2012 Jun 11.
Public Health Agency of Lazio Region, Via di Santa Costanza, Rome, 53 00198, Italy

Road traffic injuries (RTI) and home injuries (HI) are a relevant public health problem, especially among people living in deprived areas. The objective of this study was to explore the relationship between morbidity, hospitalisation, mortality from RTI and HI, and socioeconomic status (SES) of the area of residence. RTI and HI surveillance based on the Emergency Information System, the Hospital Information System and the Mortality Registry of Lazio region are the three sources of this study to create a unique surveillance system. For each subject, the SES index (5 levels) of its census tract of residence was obtained. The study population included emergency department admissions (year 2005) of residents in Rome, Italy. Incidence Rate Ratios (IRRs) have been estimated using Poisson Regression. The rates of RTI and HI emergency department visits were higher among the most deprived level of SES (IRR = 1.27, 95% CI: 1.24-1.30; IRR = 1.33, 95% CI: 1.29-1.37, respectively) compared to the most privileged ones; a similar result was found for hospitalisation (IRR = 1.19, 95% CI: 1.08-1.32; IRR = 1.11, 95% CI: 1.01-1.22). A strong relation was found between RTI mortality rates and poor level of SES. The study concluded that RTI and HI incidence were associated to sociodemographic factors

Commento a cura di C. Marinacci:
un altro esempio del valore d’uso della georeferenziazione di eventi sanitari, per attribuirvi un indice di condizione socioeconomica dell’area (sezione censuaria) di residenza del paziente, come proxy della sua posizione sociale. I risultati mostrano una maggior frequenza di accessi in Pronto Soccorso (PS), ricoveri e decessi per incidenti stradali, a carico della popolazione romana con peggiori condizioni socioeconomiche, forse spiegabile con una distribuzione sociale nei comportamenti scorretti alla guida o nell’uso di mezzi di protezione. Anche gli accessi in PS e i ricoveri per incidenti domestici presentano la stessa distribuzione; i rischi connessi a cattiva qualità delle abitazioni, concentrati nelle aree socioeconomicamente più svantaggiate, potrebbero esserne una causa. Maschi e bambini presentano un gradiente sociale più pronunciato nei ricoveri e negli accessi in PS, per entrambe le cause d’infortunio.

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