Diseguaglianze
Ricerca bibliografica periodo 15 ottobre 2010 – 17 gennaio 2011
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1. La Torre G, Iarocci G, Cadeddu C, Boccia A. Influence of sociodemographic inequalities and chronic conditions on influenza vaccination coverage in Italy: results from a survey in the general population. Public Health. 2010 Dec;124(12):690-7. Epub 2010 Oct 30.
Clinical Medicine and Public Health Unit, Sapienza University of Rome, Rome,Italy. giuseppe.latorre@uniroma1.it
Abstract
OBJECTIVE: To assess inequalities in vaccination against seasonal influenza determined by sociodemographic and health-related factors.
STUDY DESIGN: A cross-sectional study was conducted using data from 128,040 subjects aged 1-89 years who participated the national survey 'Health Conditions and Health Care Services Use', conducted by the Italian National Centre of Statistics in 2005.
METHODS: This analysis included people aged ≥65 years, and individuals of any age with chronic medical conditions. The outcome variable was vaccination or non-vaccination against influenza in the last 12 months, and the explanatory variables were gender, age, smoking habit, educational level, macro-region of residence, chronic medical conditions, occupational status, marital status, self-assessed health status and self-assessed household income. Univariate and multivariate analyses were conducted using Chi-squared test and multiple logistic regression models. For the latter analysis, results are presented as odds ratios (OR) and 95% confidence intervals (CI) of being vaccination against influenza in the last 12 months.
RESULTS: Approximately 20% of subjects had been vaccinated against influenza in the previous 12 months. Older age (≥65 years), current smoker, poor health status, poor self-assessed household income and the presence of at least one chronic condition were positively associated with influenza vaccination (P < 0.05). The lowest ORs for influenza vaccination were found in current smokers (adjusted OR vs non-smokers 0.699, 95% CI 0.697-0.701), young adults (adjusted OR 15-24 years vs ≥65 years 0.073, 95% CI 0.072-0.073; adjusted OR 25-34 years vs ≥65 years 0.097, 95% CI 0.096-0.097), subjects with a lower secondary education or professional school (adjusted OR vs primary education 0.910, 95% CI 0.908-0.913), subjects living in the Islands (adjusted OR vs North-eastern Italy 0.760, 95% CI 0.757-0.763), and unemployed subjects (adjusted OR vs employed 0.867; 95% CI 0.859-0.875). The ORs for vaccination were lower for some chronic conditions (e.g. allergies, cirrhosis) than others (e.g. cancer, stroke, bronchitis). Younger age groups, including children aged 0-14 years, had lower ORs for vaccination.
CONCLUSIONS: Socio-economic factors, such as gender, age, educational level, occupational status and macro-region of residence, affect influenza vaccination coverage rates in the Italian general population. In addition, some chronic medical conditions are an obstacle for vaccination.
Abstract
OBJECTIVE: To assess inequalities in vaccination against seasonal influenza determined by sociodemographic and health-related factors.
STUDY DESIGN: A cross-sectional study was conducted using data from 128,040 subjects aged 1-89 years who participated the national survey 'Health Conditions and Health Care Services Use', conducted by the Italian National Centre of Statistics in 2005.
METHODS: This analysis included people aged ≥65 years, and individuals of any age with chronic medical conditions. The outcome variable was vaccination or non-vaccination against influenza in the last 12 months, and the explanatory variables were gender, age, smoking habit, educational level, macro-region of residence, chronic medical conditions, occupational status, marital status, self-assessed health status and self-assessed household income. Univariate and multivariate analyses were conducted using Chi-squared test and multiple logistic regression models. For the latter analysis, results are presented as odds ratios (OR) and 95% confidence intervals (CI) of being vaccination against influenza in the last 12 months.
RESULTS: Approximately 20% of subjects had been vaccinated against influenza in the previous 12 months. Older age (≥65 years), current smoker, poor health status, poor self-assessed household income and the presence of at least one chronic condition were positively associated with influenza vaccination (P < 0.05). The lowest ORs for influenza vaccination were found in current smokers (adjusted OR vs non-smokers 0.699, 95% CI 0.697-0.701), young adults (adjusted OR 15-24 years vs ≥65 years 0.073, 95% CI 0.072-0.073; adjusted OR 25-34 years vs ≥65 years 0.097, 95% CI 0.096-0.097), subjects with a lower secondary education or professional school (adjusted OR vs primary education 0.910, 95% CI 0.908-0.913), subjects living in the Islands (adjusted OR vs North-eastern Italy 0.760, 95% CI 0.757-0.763), and unemployed subjects (adjusted OR vs employed 0.867; 95% CI 0.859-0.875). The ORs for vaccination were lower for some chronic conditions (e.g. allergies, cirrhosis) than others (e.g. cancer, stroke, bronchitis). Younger age groups, including children aged 0-14 years, had lower ORs for vaccination.
CONCLUSIONS: Socio-economic factors, such as gender, age, educational level, occupational status and macro-region of residence, affect influenza vaccination coverage rates in the Italian general population. In addition, some chronic medical conditions are an obstacle for vaccination.
Breve commento a cura di Chiara Marinacci
Studio condotto con i dati dell’Indagine Istat sulle Condizioni di Salute ed il Ricorso ai Servizi Sanitari del 2005; a parità di morbosità cronica ed età , chi non risiede nel nord-est, oppure è disoccupato o non laureato ha minore probabilità di essersi vaccinato contro l’influenza nell’anno precedente. Questi dati evidenziano una eterogeneità geografica e sociale nell’impatto dei programmi di promozione della vaccinazione antinfluenzale, che sembrerebbe a maggior beneficio dei gruppi più avvantaggiati.
2. Banin P, Rimondi F, De Togni A, Cantoni S, Chiari G, Iughetti L, Salardi S, Zucchini S, Marsciani A, Suprani T, Tarchini L, Tozzola A, Xella R, Marsella M, De Sanctis V. Type 1 diabetes (T1DM) in children and adolescents of immigrated families in Emilia-Romagna (Italy). Acta Biomed. 2010 Dec;81(1):35-9.
Paediatric and Adolescent Unit, Department of Growth and Reproduction, Sant'Anna Hospital of Ferrara, Ferrara, Italy. p.banin@ospfe.it
Abstract
BACKGROUND AND AIM OF THE WORK: The etiology and natural history of T1DM are still unknown but certainly both genetics and environmental factors contribute to the development of the disease. Migration studies are an important tool to better understand the role of the environment. The aim of this study was to investigate some variables in diabetic children of immigrant families living in Emilia-Romagna compared with Italian diabetic children living in the same region.
METHODS: We recruited 73 diabetic children from immigrant families and 707 Italian diabetic children. All children were cared by Pediatric Diabetes Units of Emilia-Romagna (10 centers). The investigated variables were: gender, current age, place of birth, parents' country of origin, age at diagnosis, HbA1c and insulin regimen.
RESULTS: No significant difference with reference to gender neither among the two ethnic groups, nor in the current mean age was observed. Mean age at diagnosis in the Italian children was lower than in immigrant patients born outside Italy--group A- (7.4 vs. 9.6, p < 0.000) and higher compared to those born in Italy--group B- (7.4 vs. 5.7 p < 0.003; A vs. B p < 0.000). The immigrant patients showed higher mean HbA1c than Italian patients (8.8 vs. 8.2, p < 0.009).
CONCLUSIONS: A younger age at diagnosis of T1DM in immigrant children, born in Italy compared with those born in the country of origin, and with Italian patients, suggests the existence of some environmental determinants acquired with a more westernised lifestyle. Immigrant children have significantly poorer metabolic control compared with western patients. (www.actabiomedica.it)
Abstract
BACKGROUND AND AIM OF THE WORK: The etiology and natural history of T1DM are still unknown but certainly both genetics and environmental factors contribute to the development of the disease. Migration studies are an important tool to better understand the role of the environment. The aim of this study was to investigate some variables in diabetic children of immigrant families living in Emilia-Romagna compared with Italian diabetic children living in the same region.
METHODS: We recruited 73 diabetic children from immigrant families and 707 Italian diabetic children. All children were cared by Pediatric Diabetes Units of Emilia-Romagna (10 centers). The investigated variables were: gender, current age, place of birth, parents' country of origin, age at diagnosis, HbA1c and insulin regimen.
RESULTS: No significant difference with reference to gender neither among the two ethnic groups, nor in the current mean age was observed. Mean age at diagnosis in the Italian children was lower than in immigrant patients born outside Italy--group A- (7.4 vs. 9.6, p < 0.000) and higher compared to those born in Italy--group B- (7.4 vs. 5.7 p < 0.003; A vs. B p < 0.000). The immigrant patients showed higher mean HbA1c than Italian patients (8.8 vs. 8.2, p < 0.009).
CONCLUSIONS: A younger age at diagnosis of T1DM in immigrant children, born in Italy compared with those born in the country of origin, and with Italian patients, suggests the existence of some environmental determinants acquired with a more westernised lifestyle. Immigrant children have significantly poorer metabolic control compared with western patients. (www.actabiomedica.it)
Breve commento a cura di Chiara Marinacci
L’indagine condotta su ragazzi seguiti da servizi emiliani di diabetologia pediatrica evidenzia, oltre alle differenze nell’età media alla diagnosi di diabete di tipo1, un peggiore controllo metabolico tra i pazienti con famiglie immigrate. Lo studio suggerisce, dunque, la necessità di una maggiore attenzione dei servizi e degli operatori al superamento di barriere linguistiche e culturali che limitano il trasferimento delle informazioni sulla patologia, sul corretto stile di vita e sulla terapia.